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Safety of Live Robotic Surgery: Results from a Single Institution
Live surgery events (LSEs) have become one of the most attended activities at surgical meetings and provide a unique opportunity for the audience to observe the decision-making process used by skilled and experienced surgeons in real time. However, there is an ongoing discussion on whether patients...
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| Published in: | European urology focus 2019-07, Vol.5 (4), p.693-697 |
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| creator | Ogaya-Pinies, Gabriel Abdul-Muhsin, Haidar Palayapalayam-Ganapathi, Hariharan Bonet, Xavier Rogers, Travis Rocco, Bernardo Coelho, Rafael Hernandez-Cardona, Eduardo Jenson, Cathy Patel, Vipul |
| description | Live surgery events (LSEs) have become one of the most attended activities at surgical meetings and provide a unique opportunity for the audience to observe the decision-making process used by skilled and experienced surgeons in real time. However, there is an ongoing discussion on whether patients treated during LSE are at higher risk of complications.
To examine LSE outcomes for robot-assisted radical prostatectomy (RARP) and establish patient safety and efficacy.
From January 2008 to April 2016, >9000 patients underwent RARP at our institution, performed by a single surgeon. From this group, 36 patients underwent live RARP surgery (LS group) transmitted via video link from our institution to an external congress. A control group was obtained from our database to compare outcomes between the LS group and patients undergoing RARP under regular circumstances. The data were prospectively collected in a customized database and retrospectively analyzed.
All patients underwent RARP performed by a single surgeon at our institution.
Postoperative outcomes were compared between the LS (n=36) and the control (n=108) groups using Student’s t test and analysis of variance for continuous variables, and a two-tailed Fisher’s exact test for categorical variables. Statistical significance was set at p |
| doi_str_mv | 10.1016/j.euf.2017.08.004 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1935402422</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2405456917301967</els_id><sourcerecordid>1935402422</sourcerecordid><originalsourceid>FETCH-LOGICAL-c353t-b4e2d6be39a0021ccc5142397a8580eccdc951c1a8fbe47f8205057d76167b273</originalsourceid><addsrcrecordid>eNp9kE1LxDAURYMoKjo_wI1k6ab1JU3aVFcifsGAMKPr0KavQ4a20SQV5t_bYUZx5erdxbkX3iHkgkHKgOXX6xTHNuXAihRUCiAOyCkXIBMh8_LwTz4hsxDWAMCkKDKVHZMTrlRechCn5G5ZtRg31LV0br-QLlztojV0OfoV-s0NXWAYuxho611PK7q0w6pD-jKEaOMYrRvOyVFbdQFn-3tG3h8f3u6fk_nr08v93TwxmcxiUgvkTV5jVlYAnBljJBM8K4tKSQVoTGNKyQyrVFujKFrFQYIsmiJneVHzIjsjV7vdD-8-RwxR9zYY7LpqQDcGzcpMCuCC8wllO9R4F4LHVn9421d-oxnorTy91pM8vZWnQelJ3tS53M-PdY_Nb-NH1QTc7gCcnvyy6HUwFgeDjfVoom6c_Wf-GzZLfdk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1935402422</pqid></control><display><type>article</type><title>Safety of Live Robotic Surgery: Results from a Single Institution</title><source>ScienceDirect Journals</source><creator>Ogaya-Pinies, Gabriel ; Abdul-Muhsin, Haidar ; Palayapalayam-Ganapathi, Hariharan ; Bonet, Xavier ; Rogers, Travis ; Rocco, Bernardo ; Coelho, Rafael ; Hernandez-Cardona, Eduardo ; Jenson, Cathy ; Patel, Vipul</creator><creatorcontrib>Ogaya-Pinies, Gabriel ; Abdul-Muhsin, Haidar ; Palayapalayam-Ganapathi, Hariharan ; Bonet, Xavier ; Rogers, Travis ; Rocco, Bernardo ; Coelho, Rafael ; Hernandez-Cardona, Eduardo ; Jenson, Cathy ; Patel, Vipul</creatorcontrib><description>Live surgery events (LSEs) have become one of the most attended activities at surgical meetings and provide a unique opportunity for the audience to observe the decision-making process used by skilled and experienced surgeons in real time. However, there is an ongoing discussion on whether patients treated during LSE are at higher risk of complications.
To examine LSE outcomes for robot-assisted radical prostatectomy (RARP) and establish patient safety and efficacy.
From January 2008 to April 2016, >9000 patients underwent RARP at our institution, performed by a single surgeon. From this group, 36 patients underwent live RARP surgery (LS group) transmitted via video link from our institution to an external congress. A control group was obtained from our database to compare outcomes between the LS group and patients undergoing RARP under regular circumstances. The data were prospectively collected in a customized database and retrospectively analyzed.
All patients underwent RARP performed by a single surgeon at our institution.
Postoperative outcomes were compared between the LS (n=36) and the control (n=108) groups using Student’s t test and analysis of variance for continuous variables, and a two-tailed Fisher’s exact test for categorical variables. Statistical significance was set at p<0.05.
There were no significant differences in baseline characteristics (age, body mass index, comorbidities, preoperative Gleason score, Sexual Health Inventory for Men score and American Urological Association symptom score) between the groups. The median console time was shorter for the LS group (73min, interquartile range [IQR] 70–79) than for the control group (78min, IQR 75–87; p=0.0371). No major complications were reported in either group, and only four minor complications were observed in the control group (p=0.2415). After median follow-up of 31 mo (IQR 18–50), only one patient (2.77%) in the LS group experienced biochemical recurrence, compared to four (3.71%) in the control group (p=0.7927). There was no significant difference in continence rates between the LS and control groups (97.22% vs 93.52%; p=0.7768). No differences in potency rate were evident by the end of the follow-up period (LS 69.44%, control group 70.37%; p=0.8432). The retrospective nature, the lack of randomization, and the single-institution experience are limitations of the study.
In this series of live transmitted RARPs, perioperative results (oncological and functional outcomes and complications) were similar to those found in daily practice. After careful patient selection, LSEs are safe with minimal patient morbidity in the hands of an experienced surgeon working with a familiar surgical team. Further evaluation of the results from other surgeons at other centers is necessary.
We investigated the safety of surgeries broadcast live from our institution. We found that outcomes were similar to those for patients undergoing surgery under regular circumstances in terms of the rate of complications and oncological and functional outcomes. We conclude that live transmitted surgery is safe in well-selected patients in the hands of an experienced surgeon.
We evaluated the safety of live robot-assisted radical prostatectomy by analyzing live transmitted surgeries performed in our institution. The perioperative results (oncological and functional outcomes and complications) were similar to those found in daily practice.</description><identifier>ISSN: 2405-4569</identifier><identifier>EISSN: 2405-4569</identifier><identifier>DOI: 10.1016/j.euf.2017.08.004</identifier><identifier>PMID: 28869204</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Aged ; Humans ; Live surgery ; Live surgical event ; Male ; Middle Aged ; Prostatectomy - methods ; Prostatic Neoplasms - surgery ; Retrospective Studies ; Robotic prostatectomy ; Robotic Surgical Procedures - adverse effects ; Robotic Surgical Procedures - methods ; Safety ; Treatment Outcome ; Urology ; Webcasts as Topic</subject><ispartof>European urology focus, 2019-07, Vol.5 (4), p.693-697</ispartof><rights>2017 European Association of Urology</rights><rights>Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-b4e2d6be39a0021ccc5142397a8580eccdc951c1a8fbe47f8205057d76167b273</citedby><cites>FETCH-LOGICAL-c353t-b4e2d6be39a0021ccc5142397a8580eccdc951c1a8fbe47f8205057d76167b273</cites><orcidid>0000-0002-6620-3287 ; 0000-0002-9135-0035</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28869204$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ogaya-Pinies, Gabriel</creatorcontrib><creatorcontrib>Abdul-Muhsin, Haidar</creatorcontrib><creatorcontrib>Palayapalayam-Ganapathi, Hariharan</creatorcontrib><creatorcontrib>Bonet, Xavier</creatorcontrib><creatorcontrib>Rogers, Travis</creatorcontrib><creatorcontrib>Rocco, Bernardo</creatorcontrib><creatorcontrib>Coelho, Rafael</creatorcontrib><creatorcontrib>Hernandez-Cardona, Eduardo</creatorcontrib><creatorcontrib>Jenson, Cathy</creatorcontrib><creatorcontrib>Patel, Vipul</creatorcontrib><title>Safety of Live Robotic Surgery: Results from a Single Institution</title><title>European urology focus</title><addtitle>Eur Urol Focus</addtitle><description>Live surgery events (LSEs) have become one of the most attended activities at surgical meetings and provide a unique opportunity for the audience to observe the decision-making process used by skilled and experienced surgeons in real time. However, there is an ongoing discussion on whether patients treated during LSE are at higher risk of complications.
To examine LSE outcomes for robot-assisted radical prostatectomy (RARP) and establish patient safety and efficacy.
From January 2008 to April 2016, >9000 patients underwent RARP at our institution, performed by a single surgeon. From this group, 36 patients underwent live RARP surgery (LS group) transmitted via video link from our institution to an external congress. A control group was obtained from our database to compare outcomes between the LS group and patients undergoing RARP under regular circumstances. The data were prospectively collected in a customized database and retrospectively analyzed.
All patients underwent RARP performed by a single surgeon at our institution.
Postoperative outcomes were compared between the LS (n=36) and the control (n=108) groups using Student’s t test and analysis of variance for continuous variables, and a two-tailed Fisher’s exact test for categorical variables. Statistical significance was set at p<0.05.
There were no significant differences in baseline characteristics (age, body mass index, comorbidities, preoperative Gleason score, Sexual Health Inventory for Men score and American Urological Association symptom score) between the groups. The median console time was shorter for the LS group (73min, interquartile range [IQR] 70–79) than for the control group (78min, IQR 75–87; p=0.0371). No major complications were reported in either group, and only four minor complications were observed in the control group (p=0.2415). After median follow-up of 31 mo (IQR 18–50), only one patient (2.77%) in the LS group experienced biochemical recurrence, compared to four (3.71%) in the control group (p=0.7927). There was no significant difference in continence rates between the LS and control groups (97.22% vs 93.52%; p=0.7768). No differences in potency rate were evident by the end of the follow-up period (LS 69.44%, control group 70.37%; p=0.8432). The retrospective nature, the lack of randomization, and the single-institution experience are limitations of the study.
In this series of live transmitted RARPs, perioperative results (oncological and functional outcomes and complications) were similar to those found in daily practice. After careful patient selection, LSEs are safe with minimal patient morbidity in the hands of an experienced surgeon working with a familiar surgical team. Further evaluation of the results from other surgeons at other centers is necessary.
We investigated the safety of surgeries broadcast live from our institution. We found that outcomes were similar to those for patients undergoing surgery under regular circumstances in terms of the rate of complications and oncological and functional outcomes. We conclude that live transmitted surgery is safe in well-selected patients in the hands of an experienced surgeon.
We evaluated the safety of live robot-assisted radical prostatectomy by analyzing live transmitted surgeries performed in our institution. The perioperative results (oncological and functional outcomes and complications) were similar to those found in daily practice.</description><subject>Aged</subject><subject>Humans</subject><subject>Live surgery</subject><subject>Live surgical event</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prostatectomy - methods</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Retrospective Studies</subject><subject>Robotic prostatectomy</subject><subject>Robotic Surgical Procedures - adverse effects</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Safety</subject><subject>Treatment Outcome</subject><subject>Urology</subject><subject>Webcasts as Topic</subject><issn>2405-4569</issn><issn>2405-4569</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LxDAURYMoKjo_wI1k6ab1JU3aVFcifsGAMKPr0KavQ4a20SQV5t_bYUZx5erdxbkX3iHkgkHKgOXX6xTHNuXAihRUCiAOyCkXIBMh8_LwTz4hsxDWAMCkKDKVHZMTrlRechCn5G5ZtRg31LV0br-QLlztojV0OfoV-s0NXWAYuxho611PK7q0w6pD-jKEaOMYrRvOyVFbdQFn-3tG3h8f3u6fk_nr08v93TwxmcxiUgvkTV5jVlYAnBljJBM8K4tKSQVoTGNKyQyrVFujKFrFQYIsmiJneVHzIjsjV7vdD-8-RwxR9zYY7LpqQDcGzcpMCuCC8wllO9R4F4LHVn9421d-oxnorTy91pM8vZWnQelJ3tS53M-PdY_Nb-NH1QTc7gCcnvyy6HUwFgeDjfVoom6c_Wf-GzZLfdk</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Ogaya-Pinies, Gabriel</creator><creator>Abdul-Muhsin, Haidar</creator><creator>Palayapalayam-Ganapathi, Hariharan</creator><creator>Bonet, Xavier</creator><creator>Rogers, Travis</creator><creator>Rocco, Bernardo</creator><creator>Coelho, Rafael</creator><creator>Hernandez-Cardona, Eduardo</creator><creator>Jenson, Cathy</creator><creator>Patel, Vipul</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6620-3287</orcidid><orcidid>https://orcid.org/0000-0002-9135-0035</orcidid></search><sort><creationdate>201907</creationdate><title>Safety of Live Robotic Surgery: Results from a Single Institution</title><author>Ogaya-Pinies, Gabriel ; 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However, there is an ongoing discussion on whether patients treated during LSE are at higher risk of complications.
To examine LSE outcomes for robot-assisted radical prostatectomy (RARP) and establish patient safety and efficacy.
From January 2008 to April 2016, >9000 patients underwent RARP at our institution, performed by a single surgeon. From this group, 36 patients underwent live RARP surgery (LS group) transmitted via video link from our institution to an external congress. A control group was obtained from our database to compare outcomes between the LS group and patients undergoing RARP under regular circumstances. The data were prospectively collected in a customized database and retrospectively analyzed.
All patients underwent RARP performed by a single surgeon at our institution.
Postoperative outcomes were compared between the LS (n=36) and the control (n=108) groups using Student’s t test and analysis of variance for continuous variables, and a two-tailed Fisher’s exact test for categorical variables. Statistical significance was set at p<0.05.
There were no significant differences in baseline characteristics (age, body mass index, comorbidities, preoperative Gleason score, Sexual Health Inventory for Men score and American Urological Association symptom score) between the groups. The median console time was shorter for the LS group (73min, interquartile range [IQR] 70–79) than for the control group (78min, IQR 75–87; p=0.0371). No major complications were reported in either group, and only four minor complications were observed in the control group (p=0.2415). After median follow-up of 31 mo (IQR 18–50), only one patient (2.77%) in the LS group experienced biochemical recurrence, compared to four (3.71%) in the control group (p=0.7927). There was no significant difference in continence rates between the LS and control groups (97.22% vs 93.52%; p=0.7768). No differences in potency rate were evident by the end of the follow-up period (LS 69.44%, control group 70.37%; p=0.8432). The retrospective nature, the lack of randomization, and the single-institution experience are limitations of the study.
In this series of live transmitted RARPs, perioperative results (oncological and functional outcomes and complications) were similar to those found in daily practice. After careful patient selection, LSEs are safe with minimal patient morbidity in the hands of an experienced surgeon working with a familiar surgical team. Further evaluation of the results from other surgeons at other centers is necessary.
We investigated the safety of surgeries broadcast live from our institution. We found that outcomes were similar to those for patients undergoing surgery under regular circumstances in terms of the rate of complications and oncological and functional outcomes. We conclude that live transmitted surgery is safe in well-selected patients in the hands of an experienced surgeon.
We evaluated the safety of live robot-assisted radical prostatectomy by analyzing live transmitted surgeries performed in our institution. The perioperative results (oncological and functional outcomes and complications) were similar to those found in daily practice.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>28869204</pmid><doi>10.1016/j.euf.2017.08.004</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-6620-3287</orcidid><orcidid>https://orcid.org/0000-0002-9135-0035</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | European urology focus, 2019-07, Vol.5 (4), p.693-697 |
| issn | 2405-4569 2405-4569 |
| language | eng |
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| source | ScienceDirect Journals |
| subjects | Aged Humans Live surgery Live surgical event Male Middle Aged Prostatectomy - methods Prostatic Neoplasms - surgery Retrospective Studies Robotic prostatectomy Robotic Surgical Procedures - adverse effects Robotic Surgical Procedures - methods Safety Treatment Outcome Urology Webcasts as Topic |
| title | Safety of Live Robotic Surgery: Results from a Single Institution |
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