JOURNAL OF CLINICAL SURGERY ›› 2023, Vol. 31 ›› Issue (10): 969-973.doi: 10.3969/j.issn.1005-6483.2023.10.019

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Venous anatomy based standard operating procedure to improve the learning curve of robotic-assisted laparoscopic partial nephrectomy

  

  1. Department of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China
  • Received:2022-11-08 Accepted:2022-11-08 Online:2023-10-20 Published:2023-10-20

Abstract: Objective   To evaluate the value of establishing a standard operating procedure(SOP) based on the venous anatomy system to improve the learning curve of robotic-assisted laparoscopic partial nephrectomy(VAB-RAPN).  Methods   The clinicopathological data of 40 consecutive patients who underwent RAPN were collected.Patients were divided into Group A,B,C,and D,with 10 cases in each group.All procedures were completed by a single surgeon.Our procedure is to perform the operation by identifying the landmark of the gonadal vein,inferior vena cava,renal vein,and lumbar vein.The differences in operation time(OT),renal warm ischemia time(WIT),estimated blood loss(EBL),time of drainage removed,positive surgical margins(PSM) and operative complications were compared.And the significance of the groups was statistically analyzed.  Results   All the patients successfully underwent the operation.The average OT of the 40 patients was 114.25 ± 30.65 min.The average renal WIT was 22.5 ± 7.42 min.And the average EBL was 290 ± 314.44 ml.With the accumulation of surgical cases,the OT of groups A,B,C,and D gradually shortened,which were 142 min,122 min,107 min,and 87 min.The WIT gradually shortened,which were 30 min,23 min,22 min,and 18 min.The time of drainage removed was 5.9 d,6.1 d,5.6 d,and 5.1 d.The EBLs in group D were 335 ml,330 ml,335 ml,and 160 ml.No significant difference had been found in drainage removal and post-operative complications.  Conclusion   By conducting the standard operating procedures,the junior surgeon can manipulate the RAPN in 10 cases.After 20 cases,the surgeon has mastered the core skills of RAPN.After 30 cases,the surgeon can manage the procedure skillfully.The learning curve shows a significant decline after 30 cases.And it can help to save the OT and WIT,and reduce intraoperative EBL.The VAB-RAPN standard procedure in our center is worth being recommended.

Key words: venous anatomy, standard operating procedure, robotic-assisted laparoscopic surgery, partial nephrectomy, learning curve

[1] WANG Zuheng, LIU Zhe, HUANG Jie, et al. Application of one needle continuous suture with barbed thread in nephron sparing nephrectomy [J]. JOURNAL OF CLINICAL SURGERY, 2023, 31(6): 587-591.
[2] LIU Haijin, HUANG Haijin, YU Keyang, et al. Single-center experience of robotic-assisted laparoscopic pediatric hiatal hernia surgery [J]. JOURNAL OF CLINICAL SURGERY, 2023, 31(5): 415-418.
[3] LU Guoliang, SUN Ting, HUANG Jiezhou, et al. Learning curve assessment for Percutaneous trans-jugular vein closure of Atrial septal defect with curve-controllable sheath catheter:A single center experience [J]. JOURNAL OF CLINICAL SURGERY, 2022, 30(5): 441-443.
[4] CHEN Jiacai, ZENG Binghua, LI Jinyu, et al. Efficacy of laparoscopic partial nephrectomy in the treatment of cT1 stage renal cell carcinoma and its effect on renal function [J]. JOURNAL OF CLINICAL SURGERY, 2022, 30(2): 121-124.
[5] . Difficulty and technique improvement of laparoscopic surgery for renal sinus tumor [J]. JOURNAL OF CLINICAL SURGERY, 2021, 29(2): 195-198.
[6] ZHANG Yunlong, YU Weimin, CHENG Fan, et al.. Clinical analysis of laparoscopic partial nephrectomy in the treatment of superior calyx neck atresia [J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(8): 781-783.
[7] SONG Dianbin, ZHANG Jingjing, MA Guang, et al.. Effect of preoperative MSCTA and intraoperative ultrasound on postoperative laparoscopic occlusion of renal segmental arterial partial nephrectomy  [J]. JOURNAL OF CLINICAL SURGERY, 2019, 27(1): 82-84.
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