Operative, oncologic and functional reflections of surgical training and post-training practice in laparoscopic radical prostatectomy

Objective: In this study, the outcomes of the first and the last 50 laparoscopic radical prostatectomy (LRP) cases that took part in the learning curve of a surgeon in our clinic who transferred the post-training technique were evaluated. Materials and methods: Between November 2004 and June 2008, 172 LRP cases performed by an advanced laparoscopy trained surgeon were evaluated. Demographic, clinical, operative and pathological data of the patients were investigated. Results: Of the first 50 cases, 90% were performed transperitoneally and 94% of the last 50 cases were performed extraperitoneally. When we compared the first and the last 50 cases, the operation time, vesicourethral anastomosis, hospitalization and catheterization times, and the amount of bleeding were lesser in the latter. However, pathological stage, positive surgical margins, continence ratios in the early postoperative period (first 6 months) were similar. Only one of the first 50 and none of the last 50 cases had a major complication requiring secondary surgery. Conclusion: Our data showed that practical and long time training (9 months) was important in the transfer of LRP technique. Besides the significant improvement on operative data, owing to the mentioned training program, there were no results reflecting an improvement on oncologic and functional data compared to the beginning of the application.