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Linking surgical skills to postoperative outcomes: a Delphi study on the robot-assisted radical prostatectomy

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Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

Objective

To develop an assessment instrument for the evaluation of surgical videos to elucidate the association between surgical skills and postoperative outcomes after a robot-assisted radical prostatectomy (RARP).

Design

A Delphi study consisting of two consecutive online surveys and a consensus group meeting.

Setting

Urology departments of general, teaching and university hospitals in the Netherlands.

Participants

All Dutch urologists with a specialization in RARP.

Results

Of 18 invited experts, 12 (67%) participated in the first online survey. In the second round, 9 of the 18 invited experts participated (50%). The Delphi meeting was attended by 5 of the 18 (27%) invited experts. The panel identified seven surgical steps with a possible association to postoperative outcomes. The experts also expected an association between adverse postoperative outcomes and the frequency of camera removals, the number of stitches placed, the amount of bleeding, and the extent of coagulation. These factors were incorporated into an assessment instrument.

Conclusions

Experts in the field of RARP achieved consensus on 7 surgical steps and 4 aspects of the RARP procedure that may be related to adverse postoperative outcomes. The resulting assessment instrument will be tested in future research to determine its validity.

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Acknowledgements

The authors thank H.P. Beerlage, A.E. Boeken Kruger, J.B.W. Rietbergen, J.P.M. Sedelaar, P.C. Weijerman, M.B. Busstra, O.S. Klaver, and B.C. Knipscheer for their participation during the Delphi process.

Author information

Authors and Affiliations

  1. Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands

    A. J. W. Beulens & C. Wagner

  2. Department of Urology, Catharina Hospital, Eindhoven, The Netherlands

    A. J. W. Beulens

  3. Department of Urology, Erasmus Medical Centre, Rotterdam, The Netherlands

    W. M. Brinkman

  4. Department of Urology, Dutch Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

    H. G. Van der Poel

  5. Department of Urology, VU Medical Centre, Amsterdam, The Netherlands

    A. N. Vis

  6. Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands

    J. P. van Basten

  7. Department of Oncological Urology, University Medical Centre Utrecht, Utrecht, The Netherlands

    R. P. Meijer

  8. Department of Urology, Rijnstate Hospital, Arnhem, The Netherlands

    C. J. Wijburg

  9. Department of Urology, Urologist NP, Catharina Hospital, Eindhoven, The Netherlands

    A. J. M. Hendrikx

  10. School of Health Professions Education, Maastricht University, Maastricht, The Netherlands

    J. J. G. van Merriënboer

  11. VU Medical Centre, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands

    C. Wagner

  12. Catharina Hospital Eindhoven, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands

    A. J. W. Beulens

Authors
  1. A. J. W. Beulens
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  2. W. M. Brinkman
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  3. H. G. Van der Poel
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  4. A. N. Vis
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  5. J. P. van Basten
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  6. R. P. Meijer
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  7. C. J. Wijburg
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  8. A. J. M. Hendrikx
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  9. J. J. G. van Merriënboer
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Corresponding author

Correspondence to A. J. W. Beulens.

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Conflict of interest

Drs. Beulens, Dr. Brinkman, Dr. van der Poel, Dr. Vis, Dr. van Basten, Dr. Meijer, Dr. Wijburg, Dr. Hendrikx, Prof. van Merrienboer,, and Prof. Wagner have no conflicts of interest or financial ties to disclose.

Appendix

Appendix

See Table 5 and Fig. 1.

Table 5 PROTEST assessment instrument
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Fig. 1
figure 1

Visual representation of the Delphi Survey

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Beulens, A.J.W., Brinkman, W.M., Van der Poel, H.G. et al. Linking surgical skills to postoperative outcomes: a Delphi study on the robot-assisted radical prostatectomy. J Robotic Surg 13, 675–687 (2019). https://doi.org/10.1007/s11701-018-00916-9

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  • DOI: https://doi.org/10.1007/s11701-018-00916-9

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