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Rev Assoc Med Bras (1992) · Jul 2021
Randomized Controlled TrialEffect of learning curve on the perioperative course of robotic-assisted laparoscopic donor nephrectomy compared with laparoscopic donor nephrectomy.
- Ersin Gürkan Dumlu, İbrahim Kılınç, Ömer Parlak, Mustafa Özsoy, Bahar Demirci, Sebnem Karakan, and Mehmet Kilic.
- Yıldırım Beyazıt University, Faculty of Medicine, Department of General Surgery - Ankara, Turkey.
- Rev Assoc Med Bras (1992). 2021 Jul 1; 67 (7): 1033-1037.
ObjectiveThis 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.MethodsThis 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.ResultsOperative 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.ConclusionsLearning 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.
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