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What is it about?
The European Association of Urology Robotic Urology Section (ERUS) proposed a structured curriculum for training novice surgeons in robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC). The curriculum was tested in a prospective trial involving one trainee and 21 patients. Results showed that the procedure can be taught safely and efficiently using a proficiency-based training method. The peri- and postoperative outcomes after the procedure performed by the trainee were similar to those recorded after the mentor. However, operating time was significantly longer in the trainee group. The trainee was able to obtain results similar to those of the mentor after 20 cases. The study confirms that proficiency-based modular training is effective in teaching iRARC and that the ERUS curriculum assists novice surgeons during the learning curve for iRARC.
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Why is it important?
This research is important because it provides the first clinical validation of the European Association of Urology Robotic Urology Section (ERUS) curriculum for training in robot-assisted radical cystectomy with intracorporeal urinary diversion (iRARC). The study demonstrates that the procedure can be taught safely and efficiently when implementing a structured proficiency-based training method. The findings of this study are crucial in the implementation of structured training programs and confirm that the era of 'see one, do one, teach one' is over. The ERUS has set standards for robot-assisted prostatectomy and robot-assisted partial nephrectomy modular training, which have proven to be effective, and this study shows that the proposed iRARC surgical curriculum is also effective. Key Takeaways: 1. The ERUS curriculum assists novice surgeons during the learning curve for iRARC and should be encouraged in order to guarantee optimal outcomes during the learning phase of this procedure. 2. The peri- and postoperative outcomes after (t)iRARC were similar to those recorded after (m)iRARC, confirming the safety of the ERUS curriculum. 3. The trainee was able to obtain results similar to those of the mentor after 20 cases, demonstrating that proficiency-based modular training is effective in teaching iRARC. 4. Operating time was significantly longer in the (t)iRARC group, but the complication rate was similar between the two groups, confirming the effectiveness of the ERUS curriculum. 5. A novel training possibility for the four steps of iRARC requiring bilateral dissection is proposed, which saves operating time and allows the trainee to attempt multiple steps during one procedure, accelerating the learning process.
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This page is a summary of: Teaching robotic cystectomy: prospective pilot clinical validation of the ERUS training curriculum, BJU International, March 2023, Wiley,
DOI: 10.1111/bju.15993.
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