Presented by: Jennifer L Nguyen BS
Department of Urology, Hackensack University Medical Center

Introduction

To evaluate the learning curve of single port robotic-assisted partial nephrectomy (PN) between two experienced robotic surgeons at a single institution.

Materials

We utilized a single center, prospective database, and selected patients who underwent single port partial nephrectomy between May 2017 and October 2022 by two experienced surgeons. Demographics and clinical characteristics were analyzed for those with complete data. Outcomes between surgeons were compared with Wilcoxon rank sum test for continuous variables or Fisher’s exact test for categorical variables. Operating times were used as a surrogate endpoint for learning curve and were plotted against case numbers separately for each surgeon and fitted with LOESS curves.

Results

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There were 93 patients in this study, with 21 (22.6%) for surgeon 1 and 72 (77.4%) for surgeon 2. There was no significant difference in age, sex, BMI, or smoking status between the two surgeons. In regards to perioperative outcomes, there was no difference in EBL or intraoperative and major postoperative complications. In terms of learning curve, it suggests a decrease in OR time between cases 5 and 15 for surgeon 1, followed by a rebound in operative time in cases 15-22. For surgeon 2, there is a decrease in OR time at case 35.

Conclusion

We did note a decrease in operative time in both surgeons within the first 5-35  cases and a rebound toward their most recent experience. This rebound may reflect the surgeons tackling more complex cases. Further analysis of this and other factors is needed to delineate proficiency in single-port robotic PN.

Funding

No funding was received for this article.

Co-Authors

Teona Iarajuli, MD
Hackensack Meridian School of Medicine

Angelo Cadiente,
Hackensack Meridian School of Medicine

Katherine Kim,
Hackensack Meridian School of Medicine

Allison Brown,
Hackensack Meridian School of Medicine

Ruchir Chaturvedi,
Hackensack Meridian School of Medicine

Meghana Singh,
Hackensack Meridian School of Medicine

Ali Mahkdoom,
Hackensack Meridian School of Medicine

Simon Gelman,
Hackensack Meridian School of Medicine

Fahad Sheckley,
Department of Urology, Hackensack University Medical Center

Mutahar Ahmed, MD
Department of Urology, Hackensack University Medical Center

Michael Stifelman, MD
Department of Urology, Hackensack University Medical Center