259 Identifying surgical factors predicting postoperative potency in robot-assisted radical prostatectomy was based on a publication by Volpe et al.29 In this study, both experts and fellows were observed during a RARP using the GEARS score in order to determine their ability to perform a RARP. The results showed a significant higher score for the experts compared to the fellows. These results show it is possible to detect a difference in sample means of 2.65 on the total GEARS score (range 6–30). For this study, we assume the GEARS scores in the incontinent patients are similar to that of a fellow, and the GEARS scores in the continent patients are similar to that of an expert. Based on a power calculation using 0.05 as alpha, a power of 0.80, and an effect size of 2.65, a sample size of 6 patients per subgroup would be sufficient for the main objective of this study. Prediction of continence by the surgeon who performed the surgery and the independent expert surgeon The surgical videos were evaluated by two expert surgeons (the surgeon who performed the surgery (HvdP, self-assessment, hereafter called Expert 1) and an independent expert in RARP (JPvB, expert assessment, hereafter called Expert 2). The experts were asked to base their predictions on the prostate apical dissection phase, vesicourethral anastomosis phase, and NVB dissection of the RARP procedure. The entirety of the surgical videos were provided to the experts. The experts were blinded to the postoperative status of patients. The experts were asked to predict the likely postoperative outcome of the patient in absolute terms of potency/impotency or undetermined. The experts were asked to describe the factors on which they based their predictions during analysis of the surgical video. After prediction, the results of the experts were compared with the postoperative status of the patients. The video assessment templates used for Surgical skills analysis. Surgical videos were analysed by a single rater (AB) with training in surgical video analysis and expertise of the surgical procedure. This rater performed the surgical video analysis using GEARS, PACE and PROTEST methods. Since we did not expect any sequence effects due to the differences in focus in the assessment methods, no counterbalancing or randomization of assessment methods was performed. The rater was blinded to the postoperative status of the patients. The surgical video analysis was performed by watching the video and completing the different templated assessment methods. The surgical videos were watched a total of three times, since only one templated assessment method was assessed each time the video was watched. The assessment methods used during this study are described below: (i) The GEARS.21 The focus of the GEARS method lies in general robot surgical principals (i.e., depth perception, bimanual dexterity, efficiency, force sensitivity,
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