Surgeon Performance Predicts Early Continence After Robot-Assisted Radical Prostatectomy

This study explores the relationship between surgeon technical performance and patient outcomes, specifically focusing on early return to continence after robot-assisted radical prostatectomy (RARP). Through a matched case-control analysis of unedited surgical videos, a blinded observer assessed critical procedural steps using the Global Evaluative Assessment of Robotic Skill (GEARS) and the Generic Error Rating Tool (GERT). The primary outcome measured was continence status at three months post-surgery. While no significant differences in errors were observed between groups, multivariate analysis revealed that higher overall GEARS scores, as well as specific scores related to urethrovesical anastomosis and bladder neck, were independently predictive of improved continence outcomes.

The findings suggest a potential link between the technical skills of surgeons and functional recovery in RARP patients. This highlights the importance of evaluating surgical performance in the context of training and accreditation for urologists, indicating a need for further research to confirm these relationships and their implications for surgical education.