Modular Training Programme for a Fellowship in Robotic Assisted Laparoscopic Prostatectomy

1. No. 086 Modular Training Programme for a Fellowship in Robotic Assisted Laparoscopic Prostatectomy Dr Handoo Rhee, Urology Registrar, Greenslopes Private Hospital, Brisbane, QLD Dr Jason Paterdis, Urology Fellow, Greenslopes Private Hospital, Brisbane, QLD Dr Peter Heathcote, Consultant Urologist, Greenslopes Private Hospital, Brisbane, QLD Results Introduction Robotic assisted laparoscopic surgery (RALS) is fast becoming the face of minimally invasive surgery in all fields of surgery. Despite the popularity amongst clinicians and patients, the most appropriate and efficacious training programme in the field is yet to be decided. • In total, 128 patients were analysed • The patients were similar in age, body mass index, prostate size and final staging between the two groups. • The outcomes analysed include the mean console time, total operation time, mean blood loss, and margin positivity. There was no statistical difference between the two groups. (Table 1) • Graph 1 demonstrates the gradual increase in the proportion of operation performed by the trainee. Within 4 months, the fellow was able to complete the operation alone without significant console time delay or increased morbidity. • No statistical difference in post operative complications was observed. Aim To establish and demonstrate safe and efficacious modular training programme in robotic assisted laparoscopic prostatectomy (RALP) in a single private institute. • Methods • Between May 2011 and February 2012, 64 patients underwent RALP by 1 fellow and the mentor using the modular training programme. • 64 consecutive patients were operated on together by the fellow and the surgeon. The patients were compared with 64 consecutive patients operated on by the mentor alone, immediately prior to the implementation of the study • The modular training programme was adopted from Stolzenburg’s article which was designed for teaching laparoscopic radical prostatectomy Table 1. The comparison of outcomes between the mentor and the fellow Graph 1. This is a linear representation of the proportion of operation performed by the trainee Conclusions This study demonstrates that a comprehensive modular training programme in complicated robotic procedures could be implemented without significantly compromising patient safety. This maybe an appropriate model for RALS training in both public and private hospitals in Australia. • References • Stolzenburg J et al. Modular training for residents with no prior experience with open pelvic surgery in endoscopic extraperitoneal radical prostatectomy. Euro Urol, 2006; 49: 491-500. • Gray K, Heathcote P, Nicol D. Does teaching affect outcome with major open surgery. ANZ J Surg. 2008; 78: 646-647. Acknowledgements We would like to thank the practice nurse Lynne Morris for assisting us with gathering the information. Poster presentation sponsor