Dong Gil Shin1,2, Hyeon Woo Kim1, Sung Woo Park1, Chang Soo Park3, Seong Choi4, Tae Hee Oh5, Dong Hwan Lee6, Chang Yell Lee7, Jung Man Kim8, Jeong Zoo Lee1. 1. Department of Urology, Pusan National University School of Medicine, Busan, South Korea. 2. Medical Research Institute, Pusan National University Hospital, Busan, South Korea. 3. Yopyeonhan Urologic Clinic, Busan, South Korea. 4. Department of Urology, Kosin University College of Medicine, Busan, South Korea. 5. Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea. 6. Department of Urology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea. 7. Department of Urology, BHS Han-seo Hospital, Busan, South Korea. 8. Department of Urology, Busan St. Mary's Medical Center, Busan, South Korea.
Abstract
OBJECTIVES: To introduce a new surgical mentorship, the "hand-grab navigated technique," to shorten the learning curve for Holmium laser enucleation of the prostate. METHODS: Patients with benign prostatic hyperplasia were managed at six institutions with Holmium laser enucleation of the prostate. An analysis was done in the 200 of these patients (the set of first 20 patients treated with Holmium laser enucleation of the prostate by 10 surgeons) who were sorted into two groups depending on the surgeon's instructional group. Surgeons in group I learned Holmium laser enucleation of the prostate by self-study by using videos and written information, whereas those in group II were instructed by "the hand-grab navigated technique" along with the self-study. To evaluate the efficiency of hand-grab navigated technique, enucleation and morcellation efficiencies between the two groups were compared. RESULTS: The mean prostate volume was 49.5 ± 23.8 and 51.1 ± 25.2 g in group I and II, respectively, showing no significant difference. The enucleation efficiency was significantly greater (P = 0.01) in group II (0.35 ± 0.20 g/min) than in group I (0.21 ± 0.12 g/min). Morcellation efficiency was also significantly greater (P = 0.03) in group II (3.08 ± 3.27 g/min) than in group I (2.43 ± 2.68 g/min). CONCLUSION: The learning curve for Holmium laser enucleation of the prostate can be shortened with the "hand-grab navigated technique" when combined with the self-study.
OBJECTIVES: To introduce a new surgical mentorship, the "hand-grab navigated technique," to shorten the learning curve for Holmium laser enucleation of the prostate. METHODS:Patients with benign prostatic hyperplasia were managed at six institutions with Holmium laser enucleation of the prostate. An analysis was done in the 200 of these patients (the set of first 20 patients treated with Holmium laser enucleation of the prostate by 10 surgeons) who were sorted into two groups depending on the surgeon's instructional group. Surgeons in group I learned Holmium laser enucleation of the prostate by self-study by using videos and written information, whereas those in group II were instructed by "the hand-grab navigated technique" along with the self-study. To evaluate the efficiency of hand-grab navigated technique, enucleation and morcellation efficiencies between the two groups were compared. RESULTS: The mean prostate volume was 49.5 ± 23.8 and 51.1 ± 25.2 g in group I and II, respectively, showing no significant difference. The enucleation efficiency was significantly greater (P = 0.01) in group II (0.35 ± 0.20 g/min) than in group I (0.21 ± 0.12 g/min). Morcellation efficiency was also significantly greater (P = 0.03) in group II (3.08 ± 3.27 g/min) than in group I (2.43 ± 2.68 g/min). CONCLUSION: The learning curve for Holmium laser enucleation of the prostate can be shortened with the "hand-grab navigated technique" when combined with the self-study.