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Learning Curve of Laparoscopic Radical Prostatectomy in a University Teaching Hospital: Experience after the First 600 Cases  Luis Martínez-Piñeiro, Felipe.

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Presentation on theme: "Learning Curve of Laparoscopic Radical Prostatectomy in a University Teaching Hospital: Experience after the First 600 Cases  Luis Martínez-Piñeiro, Felipe."— Presentation transcript:

1 Learning Curve of Laparoscopic Radical Prostatectomy in a University Teaching Hospital: Experience after the First 600 Cases  Luis Martínez-Piñeiro, Felipe Cáceres, Carlos Sánchez, Angel Tabernero, José R. Cansino, Sergio Alonso, Jesús Cisneros, Jesús J. de la Peña  European Urology Supplements  Volume 5, Issue 19, Pages (November 2006) DOI: /j.eursup Copyright © 2006 European Association of Urology Terms and Conditions

2 Fig. 1 Operating time of the whole series. Arrows point out when the different surgeons did their first case. Surgeon 6 comprises a group of four different surgeons performing laparoscopic radical prostatectomies only occasionally. European Urology Supplements 2006 5, DOI: ( /j.eursup ) Copyright © 2006 European Association of Urology Terms and Conditions

3 Fig. 2 Operating time of the different surgeons (interpolation line).
European Urology Supplements 2006 5, DOI: ( /j.eursup ) Copyright © 2006 European Association of Urology Terms and Conditions

4 Fig. 3 Percentage of patients who needed intraoperative or postoperative blood transfusion among the series. Interpolation line shows tendency. European Urology Supplements 2006 5, DOI: ( /j.eursup ) Copyright © 2006 European Association of Urology Terms and Conditions

5 Fig. 4 Percentage of minor (Intra.Minor) and major intraoperative complications (Intra.Major) related to surgeon. Only surgeons 1 and 2 (S1, S2), who had the first learning curve, had major complications. The group of surgeons number 6, with limited laparoscopic experience, had significantly more minor complications. European Urology Supplements 2006 5, DOI: ( /j.eursup ) Copyright © 2006 European Association of Urology Terms and Conditions

6 Fig. 5 Percentage of positive surgical margins according to pT category and number of cases. Coloured numbers in the graph represent the percentage of cases with unilateral or bilateral preservation of neurovascular bundles for each group of patients. European Urology Supplements 2006 5, DOI: ( /j.eursup ) Copyright © 2006 European Association of Urology Terms and Conditions

7 Fig. 6 Percentage of positive surgical margins in pT2 cases according to each surgeon and the number of cases operated consecutively by each of them. European Urology Supplements 2006 5, DOI: ( /j.eursup ) Copyright © 2006 European Association of Urology Terms and Conditions

8 Fig. 7 Percentage of positive surgical margins in pT3–4 cases according to each surgeon and the number of cases operated consecutively by each of them. European Urology Supplements 2006 5, DOI: ( /j.eursup ) Copyright © 2006 European Association of Urology Terms and Conditions

9 Fig. 8 Location of single and combined positive surgical margins. Relative percentage among patients with positive margins. Posterolat.=posterolateral; bladd.=bladder. European Urology Supplements 2006 5, DOI: ( /j.eursup ) Copyright © 2006 European Association of Urology Terms and Conditions

10 Fig. 9 Location of single and combined positive surgical margins of surgeon 1. Relative percentage among patients with positive margins. Patients 1–122 were operated with the combined retrograde-descending technique and patients 123–168 with the descending technique. The technique of apical dissection was modified after patient 88. Posterolat.=posterolateral. European Urology Supplements 2006 5, DOI: ( /j.eursup ) Copyright © 2006 European Association of Urology Terms and Conditions


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