ArticleJournal of robotic surgery2025
Does experience translate? A multicenter evaluation of the learning curve in single-port robotic prostatectomy based on prior multiport proficiency.
Article in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
10 authors.
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Abstract
Single-port robot-assisted radical prostatectomy (SP-RARP) offers potential benefits over multiport RARP (MP-RARP), including fewer incisions and reduced postoperative pain. However, the influence of prior MP-RARP experience on early SP-RARP learning curves remains unclear. We retrospectively analyzed 622 consecutive SP-RARP cases performed by four surgeons with differing MP-RARP caseloads (> 1,000, > 400, > 200, and > 100) across multiple centers. The primary endpoint of this study was the difference between the trends of four operators with different levels of MP-RARP experience in (1) operative time, (2) console time, (3) 90-day complications, (4) 1-pad continence duration, and (5) positive surgical margins in organ-confirmed disease. Operative time and console time were inversely correlated with previous MP-RARP volume, with statistically significant reductions observed in surgeons with higher prior experience, except for Surgeon A, who exhibited increasing trends (general linear model p < 0.001 for operative time and p = 0.005 for console time). The 90-day complication rate decreased proportionally with increasing MP-RARP experience (log-rank p < 0.001), with significant inter-surgeon variability, excluding Surgeon A (p = 0.011). While the average time to achieve 1-pad continence varied among surgeons, no statistically significant trend was identified (log-rank p = 0.127). Positive surgical margin rates differed significantly in patients with pT2 or lower stage (log-rank p < 0.001), although inter-surgeon differences excluding Surgeon A were not significant (log-rank p = 0.810). Extensive MP-RARP experience facilitated procedural efficiency and reduced complications during the SP-RARP learning curve without significantly affecting early functional recovery or oncologic control. Future prospective studies should focus on standardized SP training programs and long-term functional and oncologic outcomes to optimize patient benefits.
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