Effect of learning curve on the perioperative course of robotic-assisted laparoscopic donor nephrectomy compared with laparoscopic donor nephrectomy


DUMLU E. G. , Kilinç I., PARLAK Ö. , ÖZSOY M. , Demirci B., Karakan S., ...More

Revista da Associacao Medica Brasileira, vol.67, no.7, pp.1033-1037, 2021 (Journal Indexed in SCI Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 67 Issue: 7
  • Publication Date: 2021
  • Doi Number: 10.1590/1806-9282.20210526
  • Title of Journal : Revista da Associacao Medica Brasileira
  • Page Numbers: pp.1033-1037
  • Keywords: Donor, Laparoscopy, Nephrectomy, Renal transplantation, Robotics

Abstract

© 2021 Associacao Medica Brasileira. All rights reserved.OBJECTIVE: This study was designed to compare the standard and robotic-assisted laparoscopic donor nephrectomy in terms of perioperative course, short-term postoperative outcome, and to evaluate the effect of surgeon's learning curve on these parameters. METHODS: This was a prospective randomized study including 60 patients (mean age, 47 years; age, 21-72 years; 26 males, 34 females) who had been planned laparoscopic donor nephrectomies in our clinic. For comparison of standard and robot-assisted techniques and to evaluate the impact of learning curve, patients were randomized into three groups by a computer, each group containing 20 patients. Group 1: Standard laparoscopic donor nephrectomies; Group 2: The first 20 patients who underwent robot-assisted laparoscopic donor nephrectomy; and Group 3: The next 20 patients who underwent robot-assisted laparoscopic donor nephrectomy. RESULTS: Operative time was significantly higher in Group 2 (221.0±45.1 min) than both Group 1 (183.5±16.9 min, p=0.001) and Group 3 (186.5±20.6 min, p=0.002). Similarly, time for laparoscopic system setup was significantly higher in Group 2 (39.5±8.6 min), which contained the first cases of robot-assisted laparoscopic donor nephrectomy where surgeon had least experience than Group 1 (19.3±3.7 min, p<0.001) and Group 3 (24.0±9.4 min, p<0.001). On the other hand, duration of operation and time for laparoscopic system setup was similar between Groups 1 and 3. CONCLUSIONS: Learning curve extends the operative time and laparoscopic system setup time in robotic-assisted laparoscopic donor nephrectomy, however, after the learning process was completed, these parameters were similar between robotic-assisted and standard laparoscopic nephrectomy.