Evidence map›Paper›PMID 31444604›Full record

ArticleWorld journal of urology2020

Using video review to understand the technical variation of robot-assisted radical prostatectomy in a statewide surgical collaborative.

Richard C Wu, Zachary J Prebay, Parin Patel, Tae Kim, Ji Qi, Jaya Telang, Susan Linsell, Eduardo Kleer, David C Miller, James O Peabody and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in World journal of urology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 2 countries.

Richard C WuDepartment of Urology, University of Michigan, North Campus Research Complex Building 16, 114W, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
Zachary J PrebaySchool of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Parin PatelDepartment of Urology, Detroit Medical Center, Detroit, MI, USA.
Tae KimDepartment of Urology, University of Michigan, North Campus Research Complex Building 16, 114W, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
Ji QiDepartment of Urology, University of Michigan, North Campus Research Complex Building 16, 114W, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
Jaya TelangDepartment of Urology, University of Michigan, North Campus Research Complex Building 16, 114W, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
Susan LinsellDepartment of Urology, University of Michigan, North Campus Research Complex Building 16, 114W, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
Eduardo KleerIHA-Urology, St. Joseph Healthcare, Ypsilanti, MI, USA.
David C MillerDepartment of Urology, University of Michigan, North Campus Research Complex Building 16, 114W, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA.
James O PeabodyVattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA.
Khurshid R GhaniDepartment of Urology, University of Michigan, North Campus Research Complex Building 16, 114W, 2800 Plymouth Road, Ann Arbor, MI, 48109, USA. kghani@med.umich.edu.
William K JohnstonOakland University/Beaumont School of Medicine, Auburn Hills, MI, USA.
Michigan Urological Surgery Improvement Collaborative
University of Michigan · USHenry Ford Health System · USMedical College of Wisconsin · USOakland University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeVideo assessment is an emerging tool for understanding surgical technique. Patient outcomes after robot-assisted radical prostatectomy (RARP) may be linked to technical aspects of the procedure. In an effort to refine surgical approaches and improve outcomes, we sought to understand technical variation for the key steps of RARP in a surgical collaborative.

methodsThe Michigan Urological Surgery Improvement Collaborative (MUSIC) is a statewide quality improvement collaborative with the aim of improving prostate cancer care. MUSIC surgeons were invited to submit representative complete videos of nerve-sparing RARP for blinded analysis. We also analyzed peri-operative outcomes from these surgeons in the registry.

resultsSurgical video data from 20 unique surgeons identified many variations in technique and time to complete different steps. Common to all surgeons was a transperitoneal approach and a running urethrovesical anastomosis. Prior to anastomosis, 25% surgeons undertook a posterior reconstruction and 30% employed urethral suspension. 65% surgeons approached the seminal vesicle anteriorly. For control of the dorsal vein complex, suture ligation was used in 60%, and vascular stapler was 15%. The majority (80%) of surgeons employed clips for managing pedicles. In examining patient outcomes for surgeons, peri-operative outcomes were not correlated with surgeon's operative time; however, surgeons with an EBL > 400 ml had significant difference among the five different techniques employed.

conclusionsDespite the worldwide popularity of RARP, the operation is still far from standardized. Correlating variation in technique with clinical outcomes may help provide objective data to support best practices with the goal to improve patient outcomes.

Indexed as

Quality ImprovementRobotic Surgical ProceduresVideo RecordingHumansMaleMichiganProstatectomyProstatic NeoplasmsTreatment OutcomeProstate cancerRadical prostatectomyRobotic surgeryTechniqueVideo assessment

Identifiers

PMID31444604
OpenAlexW2969467079

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.