Difficulties in Robotic Radical Prostatectomy

Abstract

The task of learning robotic-assisted laparoscopic prostatectomy (RALP) can be quite challenging for both novice and experienced open or laparoscopic surgeons alike. Therefore, prior to the first procedure, adequate training and planning is required as the entire surgical team prepares for the upcoming challenge. The learning curve to achieve basic competency has been estimated to be between 20 and 25 cases.^{1, 2} However, during the initial stage of the learning curve, the surgeon should screen potential operative candidates cautiously to minimize the technical challenges of the procedure by selecting “ideal candidates” so that the surgical team can ease into the experience. As the experience of the surgeon and robotic team develops, one can begin to entertain the idea of tackling more challenging clinical scenarios, as studies have shown that difficult cases were attempted after performing a median of 50 procedures.³