Mp73-19 Multi-Institutional Learning Curve Analysis of Three Single-Port Robotic Radical Prostatectomy Approaches From the Sparc

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment (MP73)1 May 2024MP73-19 MULTI-INSTITUTIONAL LEARNING CURVE ANALYSIS OF THREE SINGLE-PORT ROBOTIC RADICAL PROSTATECTOMY APPROACHES FROM THE SPARC Roxana Ramos, Nicolas Soputro, Marcio C. Moschovas, Ethan Ferguson, Adriana M. Pedraza, Michael Raver, Jaya S. Chavali, Ruben S. Calvo, Carter Mikesell, Celeste Manfredi, Elizabeth Snajdar, Yuzhi Wang, Kennedy Okhawere, Mustafa Almajedi, Adam Lorentz, Ketan K. Badani, Craig Rogers, Ryan Nelson, Michael Stifelman, Jean Joseph, Riccardo Autorino, Jeffrey Nix, Bertram Yuh, Simone Crivellaro, Moses Kim, Mutahar Ahmed, Vipul Patel, and Jihad Kaouk Roxana RamosRoxana Ramos , Nicolas SoputroNicolas Soputro , Marcio C. MoschovasMarcio C. Moschovas , Ethan FergusonEthan Ferguson , Adriana M. PedrazaAdriana M. Pedraza , Michael RaverMichael Raver , Jaya S. ChavaliJaya S. Chavali , Ruben S. CalvoRuben S. Calvo , Carter MikesellCarter Mikesell , Celeste ManfrediCeleste Manfredi , Elizabeth SnajdarElizabeth Snajdar , Yuzhi WangYuzhi Wang , Kennedy OkhawereKennedy Okhawere , Mustafa AlmajediMustafa Almajedi , Adam LorentzAdam Lorentz , Ketan K. BadaniKetan K. Badani , Craig RogersCraig Rogers , Ryan NelsonRyan Nelson , Michael StifelmanMichael Stifelman , Jean JosephJean Joseph , Riccardo AutorinoRiccardo Autorino , Jeffrey NixJeffrey Nix , Bertram YuhBertram Yuh , Simone CrivellaroSimone Crivellaro , Moses KimMoses Kim , Mutahar AhmedMutahar Ahmed , Vipul PatelVipul Patel , and Jihad KaoukJihad Kaouk View All Author Informationhttps://doi.org/10.1097/01.JU.0001009564.26544.1c.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Since the clearance of the da Vinci SP platform for single-port (SP) robot-assisted radical prostatectomy (RARP) in 2018, multiple robotic surgeons have adopted various approaches for this procedure, including transperitoneal (TP), extraperitoneal (EP), and transvesical (TV). One argument against the adoption of SP RARP is the hypothesized steep learning curve (LC). Our aim is to present data from the Single-Port Advanced Research Consortium (SPARC) regarding the LC for SP TP, EP, and TV RARP. METHODS: Retrospective analysis of all consecutive SP RARP cases performed in 13 centers from November 2020 to October 2023. Cases were categorized according to approach (TP, EP, or TV) and further divided into two groups: the first 25% and the last 25% performed by each surgeon. We only considered surgeons with a minimum experience of 10 cases per approach. We compared groups for each approach using non-parametric methods to assess changes in patient selection and perioperative outcomes. RESULTS: A total of 14 experienced robotic surgeons performed 548 TP, 952 EP, and 250 TV SP RARP cases. Two surgeons exclusively performed the TP approach. Four surgeons initiated their LC with TP and transitioned to EP at a median point of 25 cases. One surgeon exclusively conducted TV cases. The remaining surgeons performed a combination of the three approaches since their adoption of SP RARP.When comparing the first 25% to the last 25%, larger prostates are operated on in TP and TV approaches with significantly less blood loss. Operative time was shorter with more experience in EP and TV approaches. There are two factors to which we attribute the increase in positive margins rate in the TV approach, (1) selection of patients with more aggressive disease and (2) increase in nerve-sparing performance. There was no difference in intraoperative complications rate. The length of stay and postoperative complications rate significantly decreased for the latest EP cases. CONCLUSIONS: In our experience with 1750 SP RARP cases during a three-year timeframe, we found that the LC varies among different approaches, with improvements in surgical efficiency observed for the EP and TV techniques. Intraoperative complication rates were very low regardless of the approach and stage of LC. These findings provide valuable insights into the adoption of SP RARP. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1190 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Roxana Ramos More articles by this author Nicolas Soputro More articles by this author Marcio C. Moschovas More articles by this author Ethan Ferguson More articles by this author Adriana M. Pedraza More articles by this author Michael Raver More articles by this author Jaya S. Chavali More articles by this author Ruben S. Calvo More articles by this author Carter Mikesell More articles by this author Celeste Manfredi More articles by this author Elizabeth Snajdar More articles by this author Yuzhi Wang More articles by this author Kennedy Okhawere More articles by this author Mustafa Almajedi More articles by this author Adam Lorentz More articles by this author Ketan K. Badani More articles by this author Craig Rogers More articles by this author Ryan Nelson More articles by this author Michael Stifelman More articles by this author Jean Joseph More articles by this author Riccardo Autorino More articles by this author Jeffrey Nix More articles by this author Bertram Yuh More articles by this author Simone Crivellaro More articles by this author Moses Kim More articles by this author Mutahar Ahmed More articles by this author Vipul Patel More articles by this author Jihad Kaouk More articles by this author Expand All Advertisement PDF downloadLoading ...