To examine the association between the quality of neurovascular bundle dissection and urinary continence recovery after robotic-assisted radical prostatectomy.
Patients who underwent RARPs from 2016 to 2018 in two institutions with ≥1-year postoperative follow-up were included. The primary outcomes were time to urinary continence recovery. Surgical videos were independently assessed by 3 blinded raters using the validated Dissection Assessment for Robotic Technique (DART) tool after standardized training. Cox regression was used to test the association between DART scores and urinary continence recovery while adjusting for relevant patient features.
121 RARP performed by 23 surgeons with various experience levels were included. The median follow-up was 24 months (95% CI 20 - 28 months). The median time to continence recovery was 7.3 months (95% CI 4.7 - 9.8 months). After adjusting for patient age, higher scores of certain DART domains, specifically tissue retraction and efficiency, were significantly associated with increased odds of continence recovery (p<0.05).
Technical skill scores of neurovascular bundle dissection vary among surgeons and correlate with urinary continence recovery. Unveiling the specific robotic dissection skillsets which impact patient outcomes has the potential to focus surgical training.
JU open plus. 2023 Aug 02 [Epub]
Runzhuo Ma, Steven Cen, Edward Forsyth, Patrick Probst, Aeen Asghar, William Townsend, Alvin Hui, Aditya Desai, Michael Tzeng, Emily Cheng, Ashwin Ramaswamy, Christian Wagner, Jim C Hu, Andrew J Hung
Center for Robotic Simulation & Education, Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, California., Department of Radiology, University of Southern California, Los Angeles, California., Department of Urology, Weill Cornell Medicine, New York, New York., Department of Urology and Urologic Oncology, St. Antonius-Hospital, Gronau, Germany.