Complications of robotic-assisted laparoscopic radical prostatectomy: Experience Sharing from 2000 cases involving a single surgeon

Purpose: Sharing experiences of complications with robotic-assisted laparoscopic radical prostatectomy (RALP) in 2000 patients treated by a single surgeon. Materials and Methods: We retrospectively reviewed 2,000 prostate cancer patients who underwent RALP (Group I, cases 1-1,000; Group II, cases 1001-2000) from December 2005 to September 2020 to compare the complications of the first 1000 patients with those of the latter 1000. All procedures were performed by the same experienced surgeon. Perioperative surgical complications were classified using the Clavien-Dindo classification. Complications were classified as minor (Clavien-Dindo Grades I-II) and major (Clavien-Dindo Grades III-IV), respectively. There was no Grade V complication. Results: Seventy-two cases developed complications in Group I: 26 with Clavien-Dindo Grade I, 29 with Grade II, 12 with Grade III, and 4 with Grade IV. The cases that developed complications in Group II, however, were lower at 48 cases: 15 with Clavien-Dindo Grade I, 17 with Grade II, 15 with Grade III, and 1 with Grade IV. Cases with minor Clavien-Dindo Grade (I-II) complications decreased significantly from Group I to Group II, at 55-32 patients (P = 0.0416). The transfusion rate was 1.1% in Group I, which was significantly higher than that in Group II at 0.1% (P = 0.0151). Conclusion: The assessment of the two groups indicated that the surgeon's learning curve for RALP improved with significantly fewer minor Clavien-Dindo Grade (I-II) group complications after 1000 surgeries.