MILAN, ITALY (Press Release) - March 16, 2013 - There are many and vast complexities associated with defining procedural competences for urological procedures, with the majority of learning curve trials focusing on the latest surgical techniques, according to a study conducted by a joint group of UK, US and Belgian researches. The findings suggest that there is a clear lack of data pertaining to basic urological procedures.
The results of the study will be presented at the 28th Annual EAU Congress in Milan, which is taking place on 15-19 March 2013. The objective of this investigation was to determine the number of cases a urological surgeon must complete to achieve proficiency for different urological procedures.
The authors systematically searched the MEDLINE®, EMBASETM and PsycINFO® databases until December 2011 and reviewed the name of the procedure, statistical analysis, number of participants, procedure setting, level of participants, outcomes and learning curves. Forty-nine studies defined the learning curve (LC) for different urological procedures. The LC for open radical prostatectomy ranged from 250 – 1 000 cases and laparoscopic radical prostatectomy from 200-750 cases. The LC for robot assisted laparoscopic prostatectomy has been reported to be 40 procedures as a minimum number.
Irrespective of prior laparoscopic experience, there is a significant reduction in operative time (p 0.008), blood loss (p 0.008) and complication rates (p=0.042) after 100 RALP’s. Robot assisted radical cystectomy has a documented LC of 16-30 cases, depending on which outcome variable is being measured. Converting from laparoscopic to robot assisted partial nephrectomy would require a LC of 5–25 cases. The authors emphasised that the available literature can act as a guide for the learning curve of trainee urologists and although the learning curve may vary amongst individual surgeons, a consensus should exist for minimal number of cases to achieve proficiency.
About the European Association of Urology
The EAU represents the leading authority within Europe on urological practice, research and education. Over 16,000 medical professionals have joined its ranks and help to create forward-looking solutions for continuous improvement, professional growth and knowledge sharing. The EAU delivers training, stimulates research and broadcasts information. The EAU’s scientific publications encourage discussion and its expert recommendations guide urologists in their every-day practice.
H. Abboudi, et al., “Learning curves for urological procedures - a systematic review,” Abstract Nr: 14; 28th Annual EAU Congress, 15 to 19 March 2013; Milan, Italy.
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