Live surgery: highly educational or harmful?
Purpose Live surgery (LS) is considered a useful teaching opportunity. The benefits must be balanced with patient safety concerns. To evaluate the rate of complications of a series of urologic LS performed by experts during the Congress Challenge in Laparoscopy and Robotics (CILR). Methods We presen...
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| Veröffentlicht in: | World journal of urology 2018-02, Vol.36 (2), p.171-175 |
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| creator | Rocco, B. Grasso, A. A. C. De Lorenzis, E. Davis, J. W. Abbou, C. Breda, A. Erdogru, T. Gaston, R. Gill, I. S. Liatsikos, E. Oktay, B. Palou, J. Piéchaud, T. Stolzenburg, J. U. Sun, Y. Albo, G. Villavicencio, H. Zhang, X. Disanto, V. Emiliozzi, P. Pansadoro, V. |
| description | Purpose
Live surgery (LS) is considered a useful teaching opportunity. The benefits must be balanced with patient safety concerns. To evaluate the rate of complications of a series of urologic LS performed by experts during the Congress Challenge in Laparoscopy and Robotics (CILR).
Methods
We present a large, multi-institution, multi-surgeon database that derives from 12 CILR events, from 2004 to 2015 with a total of 224 cases. Radical prostatectomy (RP) was the most common procedure and a selection of complex cases was noted. The primary measure was postoperative complications and use of a Postoperative Morbidity Index (PMI) to allow quantitative weighing of postoperative complications.
Results
From 12 events, the number of cases increased from 11 in 2004 to 27 in 2015 and a total of 27 surgeons. Of 224 cases (164 laparoscopic and 60 robotic), there were 26 (11.6%) complications: 5 grade I, 5 grade II, 3 grade IIIa, 12 grade IIIb and 1 grade V, the latter from laparoscopic cystectomy. Analysis of PMI was 23 times higher from cystectomy compared to RP.
Conclusions
In the setting of live surgery, the overall rate of complications is low considering the complexity of surgeries. The PMI is not higher in more complex procedures, whereas RP seems very safe. |
| doi_str_mv | 10.1007/s00345-017-2118-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1963278142</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1963278142</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-c8d7944d36c33d5576b24bb15bd900f955533fc5e3adce2505e1fddf781bc6ca3</originalsourceid><addsrcrecordid>eNp1kE1LAzEQhoMotlZ_gBdZ8OLBaCYfm10vIsUvKHjRc8gm2XbLbleTRui_N2WriOBpDvO87wwPQqdAroAQeR0IYVxgAhJTgALDHhoDZwwXkub7aEwk5ZiXBRuhoxCWJIE5EYdoREugnPF8jC5nzafLQvRz5zc32aKZL9pN5mw0et30K91mvc8W2nd1bG-P0UGt2-BOdnOC3h7uX6dPePby-Dy9m2HDJF1jU1hZcm5ZbhizQsi8oryqQFS2JKQuhRCM1UY4pq1xVBDhoLa2lgVUJjeaTdDF0Pvu-4_owlp1TTCubfXK9TEoKHNGE81pQs__oMs--vT3lio5LQRNxyYIBsr4PgTvavXum077jQKitirVoFIlQ2qrUkHKnO2aY9U5-5P4dpcAOgAhrVbJ36_T_7Z-AbbjfIU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1994285253</pqid></control><display><type>article</type><title>Live surgery: highly educational or harmful?</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Rocco, B. ; Grasso, A. A. C. ; De Lorenzis, E. ; Davis, J. W. ; Abbou, C. ; Breda, A. ; Erdogru, T. ; Gaston, R. ; Gill, I. S. ; Liatsikos, E. ; Oktay, B. ; Palou, J. ; Piéchaud, T. ; Stolzenburg, J. U. ; Sun, Y. ; Albo, G. ; Villavicencio, H. ; Zhang, X. ; Disanto, V. ; Emiliozzi, P. ; Pansadoro, V.</creator><creatorcontrib>Rocco, B. ; Grasso, A. A. C. ; De Lorenzis, E. ; Davis, J. W. ; Abbou, C. ; Breda, A. ; Erdogru, T. ; Gaston, R. ; Gill, I. S. ; Liatsikos, E. ; Oktay, B. ; Palou, J. ; Piéchaud, T. ; Stolzenburg, J. U. ; Sun, Y. ; Albo, G. ; Villavicencio, H. ; Zhang, X. ; Disanto, V. ; Emiliozzi, P. ; Pansadoro, V.</creatorcontrib><description>Purpose
Live surgery (LS) is considered a useful teaching opportunity. The benefits must be balanced with patient safety concerns. To evaluate the rate of complications of a series of urologic LS performed by experts during the Congress Challenge in Laparoscopy and Robotics (CILR).
Methods
We present a large, multi-institution, multi-surgeon database that derives from 12 CILR events, from 2004 to 2015 with a total of 224 cases. Radical prostatectomy (RP) was the most common procedure and a selection of complex cases was noted. The primary measure was postoperative complications and use of a Postoperative Morbidity Index (PMI) to allow quantitative weighing of postoperative complications.
Results
From 12 events, the number of cases increased from 11 in 2004 to 27 in 2015 and a total of 27 surgeons. Of 224 cases (164 laparoscopic and 60 robotic), there were 26 (11.6%) complications: 5 grade I, 5 grade II, 3 grade IIIa, 12 grade IIIb and 1 grade V, the latter from laparoscopic cystectomy. Analysis of PMI was 23 times higher from cystectomy compared to RP.
Conclusions
In the setting of live surgery, the overall rate of complications is low considering the complexity of surgeries. The PMI is not higher in more complex procedures, whereas RP seems very safe.</description><identifier>ISSN: 0724-4983</identifier><identifier>EISSN: 1433-8726</identifier><identifier>DOI: 10.1007/s00345-017-2118-1</identifier><identifier>PMID: 29124346</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cohort Studies ; Cystectomy - education ; Female ; Humans ; Laparoscopy ; Laparoscopy - education ; Lymph Node Excision - education ; Male ; Medicine ; Medicine & Public Health ; Morbidity ; Nephrectomy - education ; Nephrology ; Oncology ; Original Article ; Postoperative Complications - epidemiology ; Prostate cancer ; Prostatectomy ; Prostatectomy - education ; Retrospective Studies ; Robotic surgery ; Robotic Surgical Procedures - education ; Severity of Illness Index ; Surgery ; Urologic Surgical Procedures - education ; Urology</subject><ispartof>World journal of urology, 2018-02, Vol.36 (2), p.171-175</ispartof><rights>Springer-Verlag GmbH Germany 2017</rights><rights>World Journal of Urology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-c8d7944d36c33d5576b24bb15bd900f955533fc5e3adce2505e1fddf781bc6ca3</citedby><cites>FETCH-LOGICAL-c372t-c8d7944d36c33d5576b24bb15bd900f955533fc5e3adce2505e1fddf781bc6ca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00345-017-2118-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00345-017-2118-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29124346$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rocco, B.</creatorcontrib><creatorcontrib>Grasso, A. A. C.</creatorcontrib><creatorcontrib>De Lorenzis, E.</creatorcontrib><creatorcontrib>Davis, J. W.</creatorcontrib><creatorcontrib>Abbou, C.</creatorcontrib><creatorcontrib>Breda, A.</creatorcontrib><creatorcontrib>Erdogru, T.</creatorcontrib><creatorcontrib>Gaston, R.</creatorcontrib><creatorcontrib>Gill, I. S.</creatorcontrib><creatorcontrib>Liatsikos, E.</creatorcontrib><creatorcontrib>Oktay, B.</creatorcontrib><creatorcontrib>Palou, J.</creatorcontrib><creatorcontrib>Piéchaud, T.</creatorcontrib><creatorcontrib>Stolzenburg, J. U.</creatorcontrib><creatorcontrib>Sun, Y.</creatorcontrib><creatorcontrib>Albo, G.</creatorcontrib><creatorcontrib>Villavicencio, H.</creatorcontrib><creatorcontrib>Zhang, X.</creatorcontrib><creatorcontrib>Disanto, V.</creatorcontrib><creatorcontrib>Emiliozzi, P.</creatorcontrib><creatorcontrib>Pansadoro, V.</creatorcontrib><title>Live surgery: highly educational or harmful?</title><title>World journal of urology</title><addtitle>World J Urol</addtitle><addtitle>World J Urol</addtitle><description>Purpose
Live surgery (LS) is considered a useful teaching opportunity. The benefits must be balanced with patient safety concerns. To evaluate the rate of complications of a series of urologic LS performed by experts during the Congress Challenge in Laparoscopy and Robotics (CILR).
Methods
We present a large, multi-institution, multi-surgeon database that derives from 12 CILR events, from 2004 to 2015 with a total of 224 cases. Radical prostatectomy (RP) was the most common procedure and a selection of complex cases was noted. The primary measure was postoperative complications and use of a Postoperative Morbidity Index (PMI) to allow quantitative weighing of postoperative complications.
Results
From 12 events, the number of cases increased from 11 in 2004 to 27 in 2015 and a total of 27 surgeons. Of 224 cases (164 laparoscopic and 60 robotic), there were 26 (11.6%) complications: 5 grade I, 5 grade II, 3 grade IIIa, 12 grade IIIb and 1 grade V, the latter from laparoscopic cystectomy. Analysis of PMI was 23 times higher from cystectomy compared to RP.
Conclusions
In the setting of live surgery, the overall rate of complications is low considering the complexity of surgeries. The PMI is not higher in more complex procedures, whereas RP seems very safe.</description><subject>Cohort Studies</subject><subject>Cystectomy - education</subject><subject>Female</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - education</subject><subject>Lymph Node Excision - education</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Nephrectomy - education</subject><subject>Nephrology</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prostate cancer</subject><subject>Prostatectomy</subject><subject>Prostatectomy - education</subject><subject>Retrospective Studies</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - education</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Urologic Surgical Procedures - education</subject><subject>Urology</subject><issn>0724-4983</issn><issn>1433-8726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kE1LAzEQhoMotlZ_gBdZ8OLBaCYfm10vIsUvKHjRc8gm2XbLbleTRui_N2WriOBpDvO87wwPQqdAroAQeR0IYVxgAhJTgALDHhoDZwwXkub7aEwk5ZiXBRuhoxCWJIE5EYdoREugnPF8jC5nzafLQvRz5zc32aKZL9pN5mw0et30K91mvc8W2nd1bG-P0UGt2-BOdnOC3h7uX6dPePby-Dy9m2HDJF1jU1hZcm5ZbhizQsi8oryqQFS2JKQuhRCM1UY4pq1xVBDhoLa2lgVUJjeaTdDF0Pvu-4_owlp1TTCubfXK9TEoKHNGE81pQs__oMs--vT3lio5LQRNxyYIBsr4PgTvavXum077jQKitirVoFIlQ2qrUkHKnO2aY9U5-5P4dpcAOgAhrVbJ36_T_7Z-AbbjfIU</recordid><startdate>20180201</startdate><enddate>20180201</enddate><creator>Rocco, B.</creator><creator>Grasso, A. A. C.</creator><creator>De Lorenzis, E.</creator><creator>Davis, J. W.</creator><creator>Abbou, C.</creator><creator>Breda, A.</creator><creator>Erdogru, T.</creator><creator>Gaston, R.</creator><creator>Gill, I. S.</creator><creator>Liatsikos, E.</creator><creator>Oktay, B.</creator><creator>Palou, J.</creator><creator>Piéchaud, T.</creator><creator>Stolzenburg, J. U.</creator><creator>Sun, Y.</creator><creator>Albo, G.</creator><creator>Villavicencio, H.</creator><creator>Zhang, X.</creator><creator>Disanto, V.</creator><creator>Emiliozzi, P.</creator><creator>Pansadoro, V.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature 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>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20180201</creationdate><title>Live surgery: highly educational or harmful?</title><author>Rocco, B. ; Grasso, A. A. C. ; De Lorenzis, E. ; Davis, J. W. ; Abbou, C. ; Breda, A. ; Erdogru, T. ; Gaston, R. ; Gill, I. S. ; Liatsikos, E. ; Oktay, B. ; Palou, J. ; Piéchaud, T. ; Stolzenburg, J. 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U.</creatorcontrib><creatorcontrib>Sun, Y.</creatorcontrib><creatorcontrib>Albo, G.</creatorcontrib><creatorcontrib>Villavicencio, H.</creatorcontrib><creatorcontrib>Zhang, X.</creatorcontrib><creatorcontrib>Disanto, V.</creatorcontrib><creatorcontrib>Emiliozzi, P.</creatorcontrib><creatorcontrib>Pansadoro, V.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rocco, B.</au><au>Grasso, A. A. C.</au><au>De Lorenzis, E.</au><au>Davis, J. W.</au><au>Abbou, C.</au><au>Breda, A.</au><au>Erdogru, T.</au><au>Gaston, R.</au><au>Gill, I. S.</au><au>Liatsikos, E.</au><au>Oktay, B.</au><au>Palou, J.</au><au>Piéchaud, T.</au><au>Stolzenburg, J. U.</au><au>Sun, Y.</au><au>Albo, G.</au><au>Villavicencio, H.</au><au>Zhang, X.</au><au>Disanto, V.</au><au>Emiliozzi, P.</au><au>Pansadoro, V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Live surgery: highly educational or harmful?</atitle><jtitle>World journal of urology</jtitle><stitle>World J Urol</stitle><addtitle>World J Urol</addtitle><date>2018-02-01</date><risdate>2018</risdate><volume>36</volume><issue>2</issue><spage>171</spage><epage>175</epage><pages>171-175</pages><issn>0724-4983</issn><eissn>1433-8726</eissn><abstract>Purpose
Live surgery (LS) is considered a useful teaching opportunity. The benefits must be balanced with patient safety concerns. To evaluate the rate of complications of a series of urologic LS performed by experts during the Congress Challenge in Laparoscopy and Robotics (CILR).
Methods
We present a large, multi-institution, multi-surgeon database that derives from 12 CILR events, from 2004 to 2015 with a total of 224 cases. Radical prostatectomy (RP) was the most common procedure and a selection of complex cases was noted. The primary measure was postoperative complications and use of a Postoperative Morbidity Index (PMI) to allow quantitative weighing of postoperative complications.
Results
From 12 events, the number of cases increased from 11 in 2004 to 27 in 2015 and a total of 27 surgeons. Of 224 cases (164 laparoscopic and 60 robotic), there were 26 (11.6%) complications: 5 grade I, 5 grade II, 3 grade IIIa, 12 grade IIIb and 1 grade V, the latter from laparoscopic cystectomy. Analysis of PMI was 23 times higher from cystectomy compared to RP.
Conclusions
In the setting of live surgery, the overall rate of complications is low considering the complexity of surgeries. The PMI is not higher in more complex procedures, whereas RP seems very safe.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29124346</pmid><doi>10.1007/s00345-017-2118-1</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | World journal of urology, 2018-02, Vol.36 (2), p.171-175 |
| issn | 0724-4983 1433-8726 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Cohort Studies Cystectomy - education Female Humans Laparoscopy Laparoscopy - education Lymph Node Excision - education Male Medicine Medicine & Public Health Morbidity Nephrectomy - education Nephrology Oncology Original Article Postoperative Complications - epidemiology Prostate cancer Prostatectomy Prostatectomy - education Retrospective Studies Robotic surgery Robotic Surgical Procedures - education Severity of Illness Index Surgery Urologic Surgical Procedures - education Urology |
| title | Live surgery: highly educational or harmful? |
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