The following is a summary of “Prospective learning curve analysis of en bloc resection of bladder tumor using an ex vivo porcine model,” published in the February 2024 issue of Surgery by Yao et al.
This prospective study investigates the learning curve associated with en bloc resection of bladder tumors (ERBT) in an ex vivo porcine model. Eight endoscopists with varying experience levels were tasked with performing 30 ERBT procedures, each on artificial lesions within a porcine bladder model. Endoscopists were categorized into junior (less than 100 transurethral resection of bladder tumor (TURBT) procedures) and senior (at least 100 TURBT procedures) groups. Procedure metrics were recorded, including time, perforation, en bloc resection success, and detrusor muscle (DM) preservation. Cumulative sum (CUSUM) analysis identified inflection points in the learning curves.
Results showed successful resection of 240 artificial lesions. The inflection point was observed at the 16th procedure for junior endoscopists and the 13th procedure for senior endoscopists. In both groups, significant improvements were noted in procedure time, perforation rates, piecemeal resection, and DM preservation in the consolidation phase compared to the initial phase. Furthermore, procedure times were consistently lower for senior endoscopists across both phases. These findings suggest a marked enhancement in ERBT performance following the learning curve inflection point in the ex vivo model. The researchers recommend a minimum of 16 ERBT procedures for urologists with less than 100 TURBT experiences and 13 procedures for those with at least 100 TURBT experiences before advancing to live animal training or supervised clinical practice.
Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-024-02355-w