title: Resident involvement and experience do not affect perioperative complications following robotic prostatectomy.
abstract: OBJECTIVE
  Most urologic training programs use robotic prostatectomy (RP) as an introduction to teach residents appropriate robotic technique. However, concerns may exist regarding differences in RP outcomes with resident involvement. Our objective was therefore to evaluate whether resident involvement affects complications, operative time, or length of stay (LOS) following RP.
  
  
  METHODS
  Using the National Surgical Quality Improvement Program database (2005-2011), we identified patients who underwent RP, stratified them by resident presence or absence during surgery, and compared hospital LOS, operative time, and postoperative complications using bivariable and multivariable analyses. A secondary analysis comparing outcomes of interest across postgraduate year (PGY) levels was also performed.
  
  
  RESULTS
  A total of 5,087 patients who underwent RPs were identified, in which residents participated in 56%, during the study period. After controlling for potential confounders, resident present and absent groups were similar in 30-day mortality (0.0 vs. 0.2%, p = 0.08), serious morbidity (1.8 vs. 2.1%, p = 0.33), and overall morbidity (5.1 vs. 5.4%, p = 0.70). While resident involvement did not affect LOS, operative time was longer when residents were present (median 208 vs. 183 min, p < 0.001). Similar findings were noted when assessing individual PGY levels.
  
  
  CONCLUSIONS
  Regardless of PGY level, resident involvement in RPs appears safe and does not appear to affect postoperative complications or LOS. While resident involvement in RPs does result in longer operative times, this is necessary for the learning process.
authors.affiliation: University of North Carolina School of Medicine, Chapel Hill, NC, USA.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: McMillan
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Viera
authors.forename: Jonathan
authors.initials: J
authors.lastname: Matthews
authors.forename: Mathew C
authors.initials: MC
authors.lastname: Raynor
authors.forename: Michael E
authors.initials: ME
authors.lastname: Woods
authors.forename: Raj S
authors.initials: RS
authors.lastname: Pruthi
authors.forename: Eric M
authors.initials: EM
authors.lastname: Wallen
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Nielsen
authors.forename: Angela B
authors.initials: AB
authors.lastname: Smith
mesh_terms: D000368:Aged; D002983:Clinical Competence; D016208:Databases, Factual; D006801:Humans; D007396:Internship and Residency; D007431:Intraoperative Complications / Q000453:epidemiology*; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D011468:Prostatectomy / Q000193:education* / Q000379:methods / Q000706:statistics & numerical data; D011471:Prostatic Neoplasms / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000193:education* / Q000379:methods / Q000706:statistics & numerical data; D014572:Urology / Q000193:education