255 Identifying surgical factors predicting postoperative potency in robot-assisted radical prostatectomy Introduction Healthcare is constantly moving towards improvement in the quality of care and safety for patients. Increasing attention is being paid to the relocation of complex treatments to high-volume centres, as it is expected to improve the quality of care and increase patient safety due to the increased exposure of surgeons and staff.1–3 In the Netherlands, a move to high-volume centres has been seen in some specialties, including Urology.4 The Dutch Society of Urology (NVU) has, in a bid to improve functional results and reduce complications, decided to increase the minimal number of robot-assisted radical prostatectomy (RARP) surgeries per hospital from 50 surgeries a year to 100 surgeries a year. The question remains whether the higher number of surgeries per hospital or the quality of the surgeon influences outcome, since there are large variations in postoperative complication rates amongst surgeons with similar surgical volumes per centre5 or even in the same centre.6 The RARP is a complex but highly standardized procedure performed to cure localized prostate cancer. In the Netherlands, about 2500 men every year undergo surgical removal of the prostate to prevent progression of the disease. More than 90% of the prostatectomies in the Netherlands are performed with the surgical robot, and worldwide, the prostatectomy is the most performed procedure with the surgical robot. However, RARP is hampered by serious side-effects7–9 that have a large influence on the quality of life of those affected, such as urinary incontinence, which is present in 26% of the patients10 and erectile dysfunction in 14–90% of the patients.11,12 During RARP, as in all endoscopic procedures, the intracorporal surgical video can be recorded.13,14 These surgical videos can be analysed in order to gain insight into past performance and review previous procedures with adverse postoperative outcomes to learn for the future.15–18 Systematic evaluation of skills through the analysis of recorded surgical videos is believed to give more insight into the surgeons skills than a quota alone.15,16,18 Research has shown these results can be related to postoperative outcomes.15,18,19 The assessment of videos recorded during RARP might help in evaluating the surgical steps that are potentially linked to aspects of postoperative outcomes, such as surgical complications or functional outcomes (urinary incontinence and erectile dysfunction). In order to standardize surgical skills assessment using video analysis, multiple templates have been developed by different research groups.20–23 The correlation between these different video assessment methods and postoperative outcomes has been sparsely investigated. In a recent study, Goldenberg et al. found a correlation between the results of the Global Evaluative Assessment of Robotic Skills (GEARS)
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