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Proceedings Paper

Is the learning curve endless? One surgeon's experience with robotic prostatectomy
Author(s): Vipul Patel; Rahul Thaly; Ketul Shah
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Paper Abstract

Introduction: After performing 1,000 robotic prostatectomies we reflected back on our experience to determine what defined the learning curve and the essential elements that were the keys to surmounting it. Method: We retrospectively assessed our experience to attempt to define the learning curve(s), key elements of the procedure, technical refinements and changes in technology that facilitated our progress. Result: The initial learning curve to achieve basic competence and the ability to smoothly perform the procedure in less than 4 hours with acceptable outcomes was approximately 25 cases. A second learning curve was present between 75-100 cases as we approached more complicated patients. At 200 cases we were comfortably able to complete the procedure routinely in less than 2.5 hours with no specific step of the procedure hindering our progression. At 500 cases we had the introduction of new instrumentation (4th arm, biopolar Maryland, monopolar scissors) that changed our approach to the bladder neck and neurovascular bundle dissection. The most challenging part of the procedure was the bladder neck dissection. Conclusion: There is no single parameter that can be used to assess or define the learning curve. We used a combination of factors to make our subjective definition this included: operative time, smoothness of technical progression during the case along with clinical outcomes. The further our case experience progressed the more we expected of our outcomes, thus we continually modified our technique and hence embarked upon yet a new learning curve.

Paper Details

Date Published: 23 March 2007
PDF: 3 pages
Proc. SPIE 6424, Photonic Therapeutics and Diagnostics III, 642413 (23 March 2007); doi: 10.1117/12.701298
Show Author Affiliations
Vipul Patel, The Ohio State Univ. (United States)
Rahul Thaly, The Ohio State Univ. (United States)
Ketul Shah, The Ohio State Univ. (United States)

Published in SPIE Proceedings Vol. 6424:
Photonic Therapeutics and Diagnostics III
Henry Hirschberg M.D.; Brian Jet-Fei Wong M.D.; Reza S. Malek M.D.; Kenton W. Gregory M.D.; Nikiforos Kollias M.D.; Bernard Choi; Steen J. Madsen; Guillermo J. Tearney M.D.; Justus F. R. Ilgner M.D.; Haishan Zeng, Editor(s)

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