The Learning Curves for Laser Application in Urology Procedures: Review of the Literature Learning Curves for Urological Lasers
Journal of Lasers in Medical Sciences,
Vol. 11 No. Supplement (2020),
30 December 2020
,
Page S8-S15
Abstract
Introduction: Currently, a laser is a popular technology in urological surgeries. The important laser-related issue is the time when a surgeon reaches an acceptable level of safety and efficacy using laser technology.
Methods: In this review, we aimed to assess the learning curves of three types of surgeries in urology, including photoselective vaporization of the prostate (PVP), holmium laser enucleation of the prostate (HoLEP), and retrograde intra-renal surgeries (RIRSs). Here, we searched Medline, Web of Science, Google Scholar, EMBASE, and Scopus for such keywords as Urology, laser, laser vaporization, prostate, nephrolithiasis, benign prostatic hyperplasia (BPH), and learning curve.
Results: We evaluated 14 studies about PVP, 17 about RIRS, and 29 studies about HoLEP. Also, we separately discussed the learning curves of these three kinds of surgeries in detail.
Conclusion: All the urologists, even expert surgeons, should attend a formal training course and have a skilled tutor present in their first cases.
- HoLEP, Laser, Learning curve, PVP, Surgery, Urology
How to Cite
References
Abedi A, Razzaghi MR, Rahavian A, Hazrati E, Aliakbari F, Vahedisoraki V, et al. Is Holmium laser enucleation of the prostate a good surgical alternative in benign prostatic hyperplasia management? A review article. J Lasers Med Sci. 2020;11(2):197-203. doi: 10.34172/jlms.2020.33.
Allameh F, Basiri A, Razzaghi M, Abedi AR, Fallah-Karkan M, Ghiasy S, et al. Clinical efficacy of transurethral resection of the prostate combined with oral anticholinergics or botulinum toxin - A injection to treat benign prostatic hyperplasia with overactive bladder: A case-control study. Clin Pharmacol. 2020;12:75-81. doi: 10.2147/CPAA.S256051.
Saredi G, Pirola GM, Pacchetti A, Lovisolo JA, Borroni G, Sembenini F, et al. Evaluation of the learning curve for thulium laser enucleation of the prostate with the aid of a simulator tool but without tutoring: comparison of two surgeons with different levels of endoscopic experience. BMC Urol. 2015;15:49. doi: 10.1186/s12894-015-0045-2.
Enikeev D, Glybochko P, Rapoport L, Gahan J, Gazimiev M, Spivak L, et al. A randomized trial comparing the learning curve of 3 endoscopic enucleation techniques (HoLEP, ThuFLEP, and MEP) for BPH using mentoring approach-initial results. Urology. 2018;121:51-7. doi: 10.1016/j.urology.2018.06.045.
Simforoosh N, Dadpour M, Mousapour P, Honarkar Ramezani M. Improving early urinary continence recovery after radical prostatectomy by applying a sutureless technique for maximal preservation of the intrapelvic urethra: A 17-year single-surgeon experience. Urologia. 2020;87(4):178-84. doi: 10.1177/0391560320925570.
Malek RS. Photoselective KTP laser vaporization of obstructive BPH (PVP). In: Baba S, Ono Y, editors. Interventional management of urological diseases. Recent advances in endourology; vol. 8. Tokyo: Springer Japan; 2006.
Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications of transurethral resection of the prostate (TURP)--incidence, management, and prevention. Eur Urol. 2006;50(5):969-80. doi: 10.1016/j.eururo.2005.12.042.
Seki N, Nomura H, Yamaguchi A, Naito S. Evaluation of the learning curve for photoselective vaporization of the prostate over the course of 74 cases. J Endourol. 2008;22(8):1731-5. doi: 10.1089/end.2007.0368.
Zang Y, Shan Y, Xue B, Yang D, Sun C, Gao J. UP-3.082: The learning curve of 120-W photoselective vaporization of the prostate for benign prostatic hyperplasia. Urology. 2009;74(4):S319-S20. doi: 10.1016/j.urology.2009.07.086.
Misrai V, Faron M, Guillotreau J, Bruguiere E, Bordier B, Shariat SF, et al. Assessment of the learning curves for photoselective vaporization of the prostate using GreenLight™ 180-Watt-XPS laser therapy: defining the intra-operative parameters within a prospective cohort. World J Urol. 2014;32(2):539-44. doi: 10.1007/s00345-013-1163-7.
Bastard C, Misrai V, Roupret M, Zorn K, Hueber PA, Peyronnet B. MP13-09 assessment of the learning curves for prostate photoselective vaporization using GreenLightTM 180-Watt-XPS laser therapy: A multicentric study. J Urol. 2017;197(4S):e156-e157. doi: 10.1016/j.juro.2017.02.452.
Castellan P, Marchioni M, Rizzoli A, Di Nicola M, Porfilio I, Ghahhari J, et al. The surgical experience influences the safety and efficacy of photovaporization of prostate with 180-W XPS GreenLight laser: Comparison between novices vs expert surgeons learning curves. J Endourol. 2018;32(11):1071-7. doi: 10.1089/end.2018.0437.
Angulo JC, Arance I, Garcia-Tello A, Las Heras MM, Andres G, Gimbernat H, et al. Virtual reality simulator for training on photoselective vaporization of the prostate with 980 nm diode laser and learning curve of the technique. Actas Urol Esp. 2014;38(7):451-8. doi: 10.1016/j.acuroe.2014.06.003.
Gomez Sancha F, Bachmann A, Choi BB, Tabatabaei S, Muir GH. Photoselective vaporization of the prostate (GreenLight PV): lessons learnt after 3500 procedures. Prostate Cancer Prostatic Dis. 2007;10(4):316-22. doi: 10.1038/sj.pcan.4500989.
Subramonian K, Muir G. The 'learning curve' in surgery: what is it, how do we measure it and can we influence it? BJU Int. 2004;93(9):1173-4. doi: 10.1111/j.1464-410X.2004.04891.x.
Robert G, Cornu JN, Fourmarier M, Saussine C, Descazeaud A, Azzouzi AR, et al. Multicentre prospective evaluation of the learning curve of holmium laser enucleation of the prostate (HoLEP). BJU Int. 2016;117(3):495-9. doi: 10.1111/bju.13124.
Haraguchi T, Takenaka A, Yamazaki T, Nakano Y, Miyake H, Tanaka K, et al. The relationship between the reproducibility of holmium laser enucleation of the prostate and prostate size over the learning curve. Prostate Cancer Prostatic Dis. 2009;12(3):281-4. doi: 10.1038/pcan.2009.16.
Shah HN, Mahajan AP, Sodha HS, Hegde S, Mohile PD, Bansal MB. Prospective evaluation of the learning curve for holmium laser enucleation of the prostate. J Urol. 2007;177(4):1468-74. doi: 10.1016/j.juro.2006.11.091.
Kampantais S, Dimopoulos P, Tasleem A, Acher P, Gordon K, Young A. Assessing the learning curve of Holmium laser enucleation of prostate (HoLEP). A systematic review. Urology. 2018;120:9-22. doi: 10.1016/j.urology.2018.06.012.
Kim M, Lee HE, Oh SJ. Technical aspects of holmium laser enucleation of the prostate for benign prostatic hyperplasia. Korean J Urol. 2013;54(9):570-9. doi: 10.4111/kju.2013.54.9.570.
Elzayat EA, Khalaf I, Elgallad M, Hosny H, Elhilali M. Holmium laser enucleation of prostate in patients with prostate size ≤60 cm3. Urology. 2009;73(1):95-9. doi: 10.1016/j.urology.2008.06.049.
Elshal AM, Nabeeh H, Eldemerdash Y, Mekkawy R, Laymon M, El-Assmy A, et al. Prospective assessment of learning curve of Holmium Laser enucleation of the prostate for treatment of benign prostatic hyperplasia using a multidimensional approach. J Urol. 2017;197(4):1099-107. doi: 10.1016/j.juro.2016.11.001.
Jeong CW, Oh JK, Cho MC, Bae JB, Oh SJ. Enucleation ratio efficacy might be a better predictor to assess learning curve of holmium laser enucleation of the prostate. Int Braz J Urol. 2012;38(3):362-72. doi: 10.1590/s1677-55382012000300009.
Seki N, Mochida O, Kinukawa N, Sagiyama K, Naito S. Holmium laser enucleation for prostatic adenoma: analysis of learning curve over the course of 70 consecutive cases. J Urol. 2003;170(5):1847-50. doi: 10.1097/01.ju.0000092035.16351.9d.
Hwang JC, Park SM, Lee JB. Holmium laser enucleation of the prostate for benign prostatic hyperplasia: effectiveness, safety, and overcoming of the learning curve. Korean J Urol. 2010;51(9):619-24. doi: 10.4111/kju.2010.51.9.619.
Brunckhorst O, Ahmed K, Nehikhare O, Marra G, Challacombe B, Popert R. Evaluation of the learning curve for Holmium laser enucleation of the prostate using multiple outcome measures. Urology. 2015;86(4):824-9. doi: 10.1016/j.urology.2015.07.021.
Kim KH, Kim KT, Oh JK, Chung KJ, Yoon SJ, Jung H, et al. Enucleated weight/enucleation Time, Is it appropriate for estimating enucleation skills for Holmium laser enucleation of the prostate? A consideration of energy consumption. World J Mens Health. 2018;36(1):79-86. doi: 10.5534/wjmh.17039.
Shigemura K, Yamamichi F, Kitagawa K, Yamashita M, Oka Y, Tanaka H, et al. Does surgeon experience affect operative time, adverse events and continence outcomes in Holmium laser enucleation of the prostate? A review of more than 1,000 cases. J Urol. 2017;198(3):663-70. doi: 10.1016/j.juro.2017.04.087.
Placer J, Gelabert-Mas A, Vallmanya F, Manresa JM, Menendez V, Cortadellas R, et al. Holmium laser enucleation of prostate: outcome and complications of self-taught learning curve. Urology. 2009;73(5):1042-8. doi: 10.1016/j.urology.2008.12.052.
El-Hakim A, Elhilali MM. Holmium laser enucleation of the prostate can be taught: the first learning experience. BJU Int. 2002;90(9):863-9. doi: 10.1046/j.1464-410x.2002.03071.x.
Kobayashi S, Yano M, Nakayama T, Kitahara S. Predictive risk factors of postoperative urinary incontinence following holmium laser enucleation of the prostate during the initial learning period. Int Braz J Urol. 2016;42(4):740-6. doi: 10.1590/S1677-5538.IBJU.2015.0477.
Bae J, Oh SJ, Paick JS. The learning curve for holmium laser enucleation of the prostate: a single-center experience. Korean J Urol. 2010;51(10):688-93. doi: 10.4111/kju.2010.51.10.688.
Jeon BJ, Chung H, Bae JH, Jung H, Lee JG, Choi H. Analysis of present status for surgery of benign prostatic hyperplasia in Korea using nationwide healthcare system data. Int Neurourol J. 2019;23(1):22-9. doi: 10.5213/inj.1836198.099.
Soto-Mesa D, Amorin-Diaz M, Perez-Arviza L, Fernandez-Pello Montes S, Martin-Huescar A. Holmium laser enucleation of the prostate and retropubic prostatic adenomectomy: morbidity analysis and anesthesia considerations. Actas Urol Esp. 2015;39(9):535-45. doi: 10.1016/j.acuroe.2015.09.007.
Lerner LB, Tyson MD, Mendoza PJ. Stress incontinence during the learning curve of holmium laser enucleation of the prostate. J Endourol. 2010;24(10):1655-8. doi: 10.1089/end.2010.0021.
Kim SH, Yoo C, Choo M, Paick JS, Oh SJ. Factors affecting de novo urinary retention after Holmium laser enucleation of the prostate. PloS One. 2014;9(1):e84938. doi: 10.1371/journal.pone.0084938.
Peyronnet B, Robert G, Comat V, Roupret M, Gomez-Sancha F, Cornu JN, et al. Learning curves and perioperative outcomes after endoscopic enucleation of the prostate: a comparison between GreenLight 532-nm and holmium lasers. World J Urol. 2017;35:973-83. doi: 10.1007/s00345-016-1957-5.
Tan SS, Sarker SK. Simulation in surgery: a review. Scott Med J. 2011;56(2):104-9. doi: 10.1258/smj.2011.011098.
Abedi AR, Razzaghi MR, Allameh F, Aliakbari F, FallahKarkan M, Ranjbar A. Pneumatic lithotripsy versus laser lithotripsy for ureteral Stones. J Lasers Med Sci. 2018;9(4):233-6. doi: 10.15171/jlms.2018.42.
Allameh F, Razzaghi M, Fallah-Karkan M, Hosseini B, Tayyebi Azar A, Ranjbar A, et al. Comparison of stone retrieval basket, stone cone and Holmium laser: Which one is better in retropulsion and stone-free status for patients with upper ureteral calculi? J Lasers Med Sci. 2019;10(3):179-84. doi: 10.15171/jlms.2019.28.
Simforoosh N, Radfar MH, Valipour R, Dadpour M, Kashi AH. Laparoscopic Pyelolithotomy for the Management of Large Renal Stones with Intrarenal Pelvis Anatomy. Urol J [Internet]. 2020Apr.13 [cited 2020Dec.9];16(7). Available from: https://journals.sbmu.ac.ir/urolj/index.php/uj/article/view/5576
Radfar MH, Dadpour M, Simforoosh N, Basiri A, Nouralizadeh A, Shakiba B, et al. Laparoscopic pyelolithotomy in patients with previous ipsilateral renal stone surgery. Urologia. 2019:391560319890993. doi: 10.1177/0391560319890993.
Akman T, Binbay M, Ugurlu M, Kaba M, Akcay M, Yazici O, et al. Outcomes of retrograde intrarenal surgery compared with percutaneous nephrolithotomy in elderly patients with moderate-size kidney stones: a matched-pair analysis. J Endourol. 2012;26(6):625-9. doi: 10.1089/end.2011.0526.
Skolarikos A, Gravas S, Laguna MP, Traxer O, Preminger GM, de la Rosette J. Training in ureteroscopy: a critical appraisal of the literature. BJU Int. 2011;108(6):798-805. doi: 10.1111/j.1464-410X.2011.10337.x.
Weinberg JJ, Ansong K, Smith AD. Complications of ureteroscopy in relation to experience: report of survey and author experience. J Urol. 1987;137(3):384-5. doi: 10.1016/s0022-5347(17)44040-7.
Razzaghi MR, Fallah Karkan M, Ghiasy S, Javanmard B. Laser application in iran urology: A narrative review. J Lasers Med Sci. 2018;9(1):1-6. doi: 10.15171/jlms.2018.01.
Berardinelli F, Cindolo L, De Francesco P, Proietti S, Hennessey D, Dalpiaz O, et al. The surgical experience influences the safety of retrograde intrarenal surgery for kidney stones: a propensity score analysis. Urolithiasis. 2017;45(4):387-92. doi: 10.1007/s00240-016-0919-0.
da Cruz JA, Thiago C, de Queiros Barros U, de la Roca RL , Lima JP, Di Migueli R. MP33-17 the learning curve for retrograde intra-renal surgery (RIRS): How many cases are necessary? J Urol. 2016;195(4S):e443. doi: 10.1016/j.juro.2016.02.1374.
Cho SY, Choo MS, Jung JH, Jeong CW, Oh S, Lee SB, et al. Cumulative sum analysis for experiences of a single-session retrograde intrarenal stone surgery and analysis of predictors for stone-free status. PloS One. 2014;9(1):e84878. doi: 10.1371/journal.pone.0084878.
Brooke Johnson D, Pearle MS. Complications of ureteroscopy. Urol Clin North Am. 2004;31(1):157-71. doi: 10.1016/S0094-0143(03)00089-2.
Komori M, Izaki H, Daizumoto K, Tsuda M, Kusuhara Y, Mori H, et al. Complications of flexible ureteroscopic treatment for renal and ureteral calculi during the learning curve. Urol Int. 2015;95(1):26-32. doi: 10.1159/000368617.
Clayton DB, Pope JC. The increasing pediatric stone disease problem. Ther Adv Urol. 2011;3(1):3-12. doi: 10.1177/1756287211400491.
Suliman A, Burki T, Garriboli M, Glass J, Taghizadeh A. Flexible ureterorenoscopy to treat upper urinary tract stones in children. Urolithiasis. 2020;48(1):57-61. doi: 10.1007/s00240-018-1083-5.
Bas O, Dede O, Aydogmus Y, Utangac M, Yikilmaz TN, Damar E, et al. Comparison of retrograde intrarenal surgery and micro-percutaneous nephrolithotomy in moderately sized pediatric kidney stones. J Endourol. 2016;30(7):765-70. doi: 10.1089/end.2016.0043.
Sforza S, Tuccio A, Grosso AA, Crisci A, Cini C, Masieri L. Could surgical experience of adult endourologist overcome the learning curve of retrograde intrarenal surgery in children? Urolithiasis. 2020;48(5):459-64. doi: 10.1007/s00240-019-01161-x.
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