title: Impact of Robotic Fellowship Experience on Perioperative Outcomes of Robotic-Assisted Laparoscopic Partial Nephrectomy.
abstract: BACKGROUND
  We analyzed differences in patient selection and perioperative outcomes between robotic-fellowship trained and non-fellowship trained surgeons in their initial experience with robotic-assisted laparoscopic partial nephrectomy.
  
  
  METHODS
  Data through surgeon case 10 was analyzed. Forty patients were identified from two fellowship trained surgeons (n = 20) and two non-fellowship trained surgeons (n = 20).
  
  
  RESULTS
  Fellowship trained surgeons performed surgery on masses of higher nephrometry score (8.0 vs. 6.0, p = 0.007) and more posterior location (60 vs. 25%, p = 0.03). Retroperitoneal approach was more common (50 vs. 0%, p = 0.0003). Fellowship trained surgeons trended toward shorter warm ischemia time (25.5 vs. 31.0 min, p = 0.08). There was no significant difference in perioperative complications (35 vs. 35%, p = 0.45) or final positive margin rates (0 vs. 15%, p = 0.23).
  
  
  CONCLUSIONS
  Fellowship experience may allow for treating more challenging and posterior tumors in initial practice and significantly more comfort performing retroperitoneal robotic-assisted laparoscopic partial nephrectomy.
authors.affiliation: Department of Urology, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Moriarty
authors.affiliation: Department of Urology, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Kenneth G
authors.initials: KG
authors.lastname: Nepple
authors.affiliation: Department of Urology, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Chad R
authors.initials: CR
authors.lastname: Tracy
authors.affiliation: Department of Urology, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Strigenz
authors.affiliation: Department of Urology, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Lee
authors.affiliation: Department of Urology, University of Iowa, Iowa City, Iowa, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Brown
keywords: Fellowship training; Laparoscopic surgeries; Partial nephrectomy; Perioperative period; Robotics