INDIVIDUAL LEARNING CURVE FOR RADICAL ROBOT- ASSISTED PROSTATECTOMY BASED ON THE EXAMPLE OF THREE PROFESSIONALS WORKING IN ONE CLINIC

P.I. Rasner, D.Yu. Pushkar, K.B. Kolontarev, D.V. Kotenko

MSMSU n.a. A.I. Evdokimov, Moscow

The appearance of new surgical technique always requires evaluation of its effectiveness  and ease of acquisition. A comparative study of the results of the first three  series of successive robot-assisted radical prostatectomy (R ARP)  performed on at time by three surgeons, was conducted. The series consisted of 40 procedures, and were divided into 4 groups of 10 operations   for the analysis. When comparing data,  statistically significant improvement of intra- and postoperative performance in each series was revealed, with increase in the number  of operations performed, and in  each subsequent series compared with the preceding one. We recommend to perform the planned conversion at the first operation. In our study, previous laparoscopic experience did not provide any significant advantages in the acquisition  of robot- assisted technology. To characterize  the individual learning curve, we recommend the use of the number of operations that  the surgeon looked in the life-surgery regimen and/or in which he participated as an assistant before his own surgical activity, as well as the  indicator «technical defect». In addition to the term «individual learning curve», we propose to introduce the terms «surgeon’s individual training phase» and «clinic’s learning curve».

Key words: da Vinci robotic system, robot-assisted prostatectomy, perioperative complications, individual learning curvе