ArticleWorld journal of urology2025
Evaluating the learning curve for single-port radical prostatectomy: a multi-institutional cohort analysis.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Development and validation of objective performance metrics for robot-assisted basic surgical skills in a simulated anastomosis task using a single-port robotic system.Journal of robotic surgery · 2026Article
- Da Vinci Single-Port Robotic Surgery in Europe: Where Do We Stand? A Systematic Review.Journal of clinical medicine · 2025Review
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesSingle-port robot-assisted radical prostatectomy (SP-RARP) represents an evolution in minimally invasive surgery but introduces unique technical challenges. Existing evidence on SP-RARP learning curves is limited to single-center or single-surgeon experiences. This multicenter study aimed to define proficiency milestones for SP-RARP across multiple surgeons using robust statistical methods. MATERIALS AND
methodsWe retrospectively analyzed data from 327 patients who underwent SP-RARP performed by eight experienced multiport surgeons transitioning to the single-port platform across three U.S. centers (2019-2024). Learning curves for operative time (OT) and estimated blood loss (EBL) were evaluated using cumulative sum (CUSUM) analysis and piecewise linear regression. Piecewise multivariable logistic regression was used to adjust for confounders.
resultsOf the 327 cases, 111 were transperitoneal (TP) and 216 extraperitoneal (EP). No clear proficiency plateau was observed for the TP approach, with persistent variability in OT and EBL. In contrast, EP cases demonstrated breakpoints at 55 cases for OT (95% CI: 53.8-55.6; R² = 0.91) and 97 cases for EBL (95% CI: 92.3-101.1; R² = 0.97). Multivariable analysis confirmed a significant association between case volume and OT (p = 0.048), but not for EBL (p = 0.12).
conclusionThis is the first multicenter study to evaluate SP-RARP learning curves using CUSUM and piecewise regression. Clear proficiency thresholds were identified for the EP approach (OT at 55, EBL at 97 cases), though only OT was confirmed after adjustment. No definitive plateau was reached for the TP approach, suggesting different learning dynamics.
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