229 Identifying surgical factors predicting postoperative urinary continence in robot-assisted radical prostatectomy Abstract Background Surgical technique in robot assisted radical prostatectomy (RARP) may determine in a significant extent the postoperative recovery of urinary continence and erectile function. This raises the question whether an experienced urologist can predict these functional outcomes based on the observation of the used surgical technique by video analysis. Our research questions are: (1) Are expert surgeons able to predict postoperative urinary continence of RARP by performing surgical video analysis of the nerve sparing technique, apical dissection, and construction of the vesico-urethral anastomosis? (2) Can results of the templated assessment methods (GEARS, PACE and PROTEST) be related to postoperative urinary continence? Methods Two subgroups of patients were selected from an institutional database, the subgroups were matched based on their postoperative reported urinary continence levels (continency group; continency vs. incontinence). Surgical skills were measured by a single trained assessor using three different templated assessment methods; the global evaluative assessment of robotic skill (GEARS), the Prostatectomy Assessment and Competence Evaluation (PACE), and the PROTEST method. As a fourth assessment method the videos were analysed by two expert surgeons, and they were asked to predict postoperative continence levels in all surgeries. Results The different aspects of GEARS, PACE, and PROTEST methods showed no differences in the continency and potency groups. Expert 1 was able to correctly assess continence in 66.7% (8/12 patients) of the patients. Expert 2 was able to correctly assess continence in 33.3% (4/12 patients) of the patients. Conclusion Results of this study show the prediction of continence levels by expert surgeons gives insight into peri-operative factors which according to expert opinion influence postoperative urinary continence.
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