Learning robotic pyeloplasty without simulators: an assessment of the learning curve in the early robotic era

OBJECTIVE: To analyze our experience and learning curve for robotic pyeloplasty during this robotic procedure. METHODS: Ninety-nine patients underwent 100 consecutive procedures. Cases were divided into 4 groups of 25 consecutive procedures to analyze the learning curve. RESULTS: The median anastomo...

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Detalhes bibliográficos
Autores: Chammas Jr, Mario F., Mitre, Anuar I., Arap, Marco A., Hubert, Nicholas, Hubert, Jacques
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:Brasil
Recursos:Universidade de São Paulo (USP)
Repositorio:Clinics
Idioma:inglés
OAI Identifier:oai:revistas.usp.br:article/159499
Acesso em linha:https://www.revistas.usp.br/clinics/article/view/159499
Access Level:acceso abierto
Palavra-chave:Robotic-Assisted
Laparoscopy
Ureteropelvic Junction Obstruction
Education
Learning Curve
Descrição
Resumo:OBJECTIVE: To analyze our experience and learning curve for robotic pyeloplasty during this robotic procedure. METHODS: Ninety-nine patients underwent 100 consecutive procedures. Cases were divided into 4 groups of 25 consecutive procedures to analyze the learning curve. RESULTS: The median anastomosis times were 50.0, 36.8, 34.2 and 29.0 minutes (p=0.137) in the sequential groups, respectively. The median operative times were 144.6, 119.2, 114.5 and 94.6 minutes, with a significant difference between groups 1 and 2 (p=0.015), 1 and 3 (p=0.002), 1 and 4 (po0.001) and 2 and 4 (p=0.022). The mean hospital stay was 7.08, 4.76, 4.88 and 4.20 days, with a difference between groups 1 and 2 (po0.001), 1 and 3 (po0.001) and 1 and 4 (po0.001). Clinical and radiological improvements were observed in 98.9% of patients. One patient presented with recurrent obstruction. CONCLUSIONS: Our results demonstrate a high success rate with low complication rates. A significant decrease in hospital stay and surgical time was evident after 25 cases.