B Rocco1, A A C Grasso2, E De Lorenzis2, J W Davis3, C Abbou4, A Breda5, T Erdogru6, R Gaston7, I S Gill8, E Liatsikos9, B Oktay10, J Palou5, T Piéchaud7, J U Stolzenburg11, Y Sun12, G Albo2, H Villavicencio5, X Zhang13, V Disanto14, P Emiliozzi14, V Pansadoro14. 1. Department of Urology, Nuovo Ospedale Civile Sant' Agostino Estense (N.O.C.S.A.E.) di Baggiovara, University of Modena and Reggio Emilia, Modena, Italy. bernardo.rocco@gmail.com. 2. Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. 3. Department of Urology, Anderson Cancer Center, University of Texas, Houston, TX, USA. 4. Department of Urology, Henri Mondor Hospital, Créteil, France. 5. Urology Department, Fundacio Puigvert, Cartagena, Barcelona, Spain. 6. Departments of Urology and Minimally Invasive and Robotic Surgery, Memorial Atasehir Hospital, Istanbul, Turkey. 7. Department of Urology, Clinique Saint Augustin, Bordeaux, France. 8. Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California Institute of Urology, Los Angeles, CA, USA. 9. Department of Urology, University of Patras, Patras, Greece. 10. Medical Faculty, Department of Urology, Uludag University, Gorukle, Bursa, Turkey. 11. Department of Urology, University of Leipzig, Leipzig, Germany. 12. Department of Urology, Changhai Hospital, Second Military University, Shanghai, China. 13. Department of Urology, Chinese PLA General Hospital, Medical School of Chinese PLA, Beijing, People's Republic of China. 14. Department of Urology, Pansadoro Foundation, Rome, Italy.
Abstract
PURPOSE: Live surgery (LS) is considered a useful teaching opportunity. The benefits must be balanced with patient safety concerns. To evaluate the rate of complications of a series of urologic LS performed by experts during the Congress Challenge in Laparoscopy and Robotics (CILR). METHODS: We present a large, multi-institution, multi-surgeon database that derives from 12 CILR events, from 2004 to 2015 with a total of 224 cases. Radical prostatectomy (RP) was the most common procedure and a selection of complex cases was noted. The primary measure was postoperative complications and use of a Postoperative Morbidity Index (PMI) to allow quantitative weighing of postoperative complications. RESULTS: From 12 events, the number of cases increased from 11 in 2004 to 27 in 2015 and a total of 27 surgeons. Of 224 cases (164 laparoscopic and 60 robotic), there were 26 (11.6%) complications: 5 grade I, 5 grade II, 3 grade IIIa, 12 grade IIIb and 1 grade V, the latter from laparoscopic cystectomy. Analysis of PMI was 23 times higher from cystectomy compared to RP. CONCLUSIONS: In the setting of live surgery, the overall rate of complications is low considering the complexity of surgeries. The PMI is not higher in more complex procedures, whereas RP seems very safe.
PURPOSE: Live surgery (LS) is considered a useful teaching opportunity. The benefits must be balanced with patient safety concerns. To evaluate the rate of complications of a series of urologic LS performed by experts during the Congress Challenge in Laparoscopy and Robotics (CILR). METHODS: We present a large, multi-institution, multi-surgeon database that derives from 12 CILR events, from 2004 to 2015 with a total of 224 cases. Radical prostatectomy (RP) was the most common procedure and a selection of complex cases was noted. The primary measure was postoperative complications and use of a Postoperative Morbidity Index (PMI) to allow quantitative weighing of postoperative complications. RESULTS: From 12 events, the number of cases increased from 11 in 2004 to 27 in 2015 and a total of 27 surgeons. Of 224 cases (164 laparoscopic and 60 robotic), there were 26 (11.6%) complications: 5 grade I, 5 grade II, 3 grade IIIa, 12 grade IIIb and 1 grade V, the latter from laparoscopic cystectomy. Analysis of PMI was 23 times higher from cystectomy compared to RP. CONCLUSIONS: In the setting of live surgery, the overall rate of complications is low considering the complexity of surgeries. The PMI is not higher in more complex procedures, whereas RP seems very safe.
Entities:
Keywords:
Live case demonstration; Live-surgery broadcast; Mentoring; Surgical complications; Surgical education; Training
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