Abstract
Background: It is important for urologists to be aware of the number of cases they need to perform of a particular technique before they are deemed fully competent. Therefore the aim of this study was to conduct a systematic review to determine the number of cases a urologist must complete to master the learning curve across all procedures studied.
Methods: The MEDLINE, EMBASE and PsycINFO databases were systematically searched until January 2012. References from retrieved articles were reviewed to broaden the search. The procedure name, statistical analysis, number of participants, procedure setting, level of participants and outcomes were reviewed.
Results: Eighty-one studies investigating the learning curves from a variety of urological procedures encompassing both upper and lower urinary tract operations were identified. The majority of papers (21) looked at the learning curves for robot-assisted laparoscopic prostatectomy, with results ranging from 60 to 330 cases. Variables used to determine the learning curves often included oncological measures, complication rates, blood loss, operative time and functional outcomes. Nineteen papers looked at various procedures within renal surgery such as single site and robot-assisted (5-25 cases) partial nephrectomy; laparoscopic, single site and robot-assisted radical nephrectomy; laparoscopic (30 cases), single site (30 cases) and robot-assisted pyeloplasty (15-20); and cryoablation. Ten papers investigated techniques for the management of benign prostatic disease such as transurethral resection of prostate (TURP), Holep and photoselective vaporization. The remaining procedures studied included laparoscopic prostatectomy (250-700 cases), radical retropubic prostatectomy (29 cases), perineal prostatectomy, urethrovesical anastamosis, transrectal ultrasound biopsy, artificial sphincter surgery, transvaginal (15 cases) and transobturator tape (undetermined), laparoscopuc sacropexy, robotic sacrocolpopexy, percutaneous nephrolithotomy (45-105 cases), ureteroscopy (undetermined), robotic cystectomy (30 cases), transvesicoscopic ureteral re-implantation (26 cases), sutureless circumcision, laparoscopic single site, adrenelectomy and sentinel node biopsy for penile oncology cases (undetermined).
Methods: The MEDLINE, EMBASE and PsycINFO databases were systematically searched until January 2012. References from retrieved articles were reviewed to broaden the search. The procedure name, statistical analysis, number of participants, procedure setting, level of participants and outcomes were reviewed.
Results: Eighty-one studies investigating the learning curves from a variety of urological procedures encompassing both upper and lower urinary tract operations were identified. The majority of papers (21) looked at the learning curves for robot-assisted laparoscopic prostatectomy, with results ranging from 60 to 330 cases. Variables used to determine the learning curves often included oncological measures, complication rates, blood loss, operative time and functional outcomes. Nineteen papers looked at various procedures within renal surgery such as single site and robot-assisted (5-25 cases) partial nephrectomy; laparoscopic, single site and robot-assisted radical nephrectomy; laparoscopic (30 cases), single site (30 cases) and robot-assisted pyeloplasty (15-20); and cryoablation. Ten papers investigated techniques for the management of benign prostatic disease such as transurethral resection of prostate (TURP), Holep and photoselective vaporization. The remaining procedures studied included laparoscopic prostatectomy (250-700 cases), radical retropubic prostatectomy (29 cases), perineal prostatectomy, urethrovesical anastamosis, transrectal ultrasound biopsy, artificial sphincter surgery, transvaginal (15 cases) and transobturator tape (undetermined), laparoscopuc sacropexy, robotic sacrocolpopexy, percutaneous nephrolithotomy (45-105 cases), ureteroscopy (undetermined), robotic cystectomy (30 cases), transvesicoscopic ureteral re-implantation (26 cases), sutureless circumcision, laparoscopic single site, adrenelectomy and sentinel node biopsy for penile oncology cases (undetermined).
Original language | English |
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Journal | Scottish Medical Journal |
Volume | 57 |
Issue number | 4 |
DOIs | |
Publication status | Published - Nov 2012 |