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Background <p>We developed a structured robot-assisted training curriculum for urology residents with limited prior experience in open and laparoscopic surgeries. We evaluated the curriculum by comparing outcomes of resident-performed robot-assisted radical prostatectomy with those of experienced, proctor-certified surgeons.</p> Methods <p>From 53 resident-performed and 175 non-resident-performed robot-assisted radical prostatectomy cases, propensity score matching (up to 1:2 ratio) yielded 46 resident-performed and 83 non-resident-performed cases. We compared operative and console times, estimated blood loss, perioperative complications, positive surgical margins, and immediate urinary continence after catheter removal. Our training program included video lectures and dry-laboratory training using procedure-specific models (three-dimensional pelvic model and vesicourethral anastomosis models) and optional low-cost tasks.</p> Results <p>Operative time (median [IQR]) was longer in resident-performed cases (249 [227–284] vs 208 [182–237] min; <i>p</i> &lt; 0.001), as was total console time (213 [188–244] vs 166 [144–192] min; <i>p</i> &lt; 0.001) and console time excluding pelvic lymph node dissection (200 [186–222] vs 158 [137–180] min; <i>p</i> &lt; 0.001). When the procedure was subdivided into five phases, from bladder takedown to vesicourethral anastomosis, residents required longer times for all phases (all <i>p</i> ≤ 0.002). There were no significant differences between the two groups in estimated blood loss, positive surgical margin rates, immediate urinary continence, or perioperative complications.</p> Conclusions <p>In this study, residents trained under the curriculum performed surgery safely with acceptable surgical outcomes, despite longer operative times. These findings indicate that a structured training curriculum mitigates potential risks associated with resident participation in robotic surgery. Further refinement of standardized training models is necessary to enhance operative efficiency.</p>

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Comparison of surgical outcomes of robot-assisted radical prostatectomy between residents under our training curriculum and experienced surgeons: a propensity score-matched analysis

  • 期刊论文

  • 发表日期：

    2026年4月11日

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  • Sunao Nohara,
  • Yu Ozawa,
  • Keisuke Aoki,
  • Shin Koike,
  • Kei Ushijima,
  • Toshiaki Kayaba,
  • Masumi Yamada,
  • Yu Odagaki,
  • Hideo Sakamoto,
  • Choichiro Ozu,
  • Kunihiko Yoshioka

摘要

Background

We developed a structured robot-assisted training curriculum for urology residents with limited prior experience in open and laparoscopic surgeries. We evaluated the curriculum by comparing outcomes of resident-performed robot-assisted radical prostatectomy with those of experienced, proctor-certified surgeons.

Methods

From 53 resident-performed and 175 non-resident-performed robot-assisted radical prostatectomy cases, propensity score matching (up to 1:2 ratio) yielded 46 resident-performed and 83 non-resident-performed cases. We compared operative and console times, estimated blood loss, perioperative complications, positive surgical margins, and immediate urinary continence after catheter removal. Our training program included video lectures and dry-laboratory training using procedure-specific models (three-dimensional pelvic model and vesicourethral anastomosis models) and optional low-cost tasks.

Results

Operative time (median [IQR]) was longer in resident-performed cases (249 [227–284] vs 208 [182–237] min; p < 0.001), as was total console time (213 [188–244] vs 166 [144–192] min; p < 0.001) and console time excluding pelvic lymph node dissection (200 [186–222] vs 158 [137–180] min; p < 0.001). When the procedure was subdivided into five phases, from bladder takedown to vesicourethral anastomosis, residents required longer times for all phases (all p ≤ 0.002). There were no significant differences between the two groups in estimated blood loss, positive surgical margin rates, immediate urinary continence, or perioperative complications.

Conclusions

In this study, residents trained under the curriculum performed surgery safely with acceptable surgical outcomes, despite longer operative times. These findings indicate that a structured training curriculum mitigates potential risks associated with resident participation in robotic surgery. Further refinement of standardized training models is necessary to enhance operative efficiency.