When Should Operastions Requiring Suturing Be Performed in Laparoscopic Urologic Surgery?

Objective: We aimed to retrospectively compare the first four years outcome of a novice laparoscopic surgeon in suture-requiring laparoscopic procedures annual section. Methods: Between 2008-2012, a total of 160 laparoscopic suture-requiring procedures were retrospectively evaluated with conversions, operative times and hospital stay, and optimum time-interval to reach surgical competency. Results: All 12 ureterolithotomies were completed laparoscopically, 3 transperitoneal and 9 retroperitoneal approaches, witha mean operative time of 145.4±42.4 mins. and mean 2.4±0.7 days of hospital stay. Optimum experience was accomplished within 2nd years. All laparoscopic pyeloplasties were successfully completed with a mean operative time of 226.6±63.8 mins and mean 6.2±2.5 days of hospital stay. Optimum experience was accomplished within 4th years. All 6 partial nephrectomies were completed laparoscopically with a mean operative time of 195±31.4 mins, with 6.3±3.6 days hospital stay and without blood transfusion. The optimum experience was accomplished within 4th years in laparoscopic partial nephrectomy. Among 32 radical prostatectomies, 25 were completed with laparoscopy and 7 with open conversion. The mean operative time was 300±103.9 mins and hospital stay of 8.1±5.7 days. The optimum experience was gained at the 4th year in laparoscopic prostatectomy. Conclusion: A novice surgeon can gain laparoscopic competency within 1 year for ureterolithotomy, within 2 years in pyeloplasty, and within 3 years in partial nephrectomy and radical prostatectomy. (JAREM 2013; 3: 8-13)