Alexander Beulens

267 Identifying surgical factors predicting postoperative potency in robot-assisted radical prostatectomy in the development of the objective assessment of surgical skills and eventually the development of postoperative prediction of the functional outcomes of patients. The difference in the ability of the surgeons to predict potency could also be explained by the fact that Expert 1 was the surgeon who performed the surgery and Expert 2 was an independent surgeon. It could be that Expert 1 is more familiar with his own techniques and outcomes and could therefore assess the patient’s postoperative status more accurately. This is in contrast to the findings of Stern et al. who performed a study asking the surgeon at the end of the RARP to predict long-term postoperative continence in the patients.25 The results showed the surgeon was unable to predict postoperative continence. Further studies should be performed with multiple experts assessing surgical videos of multiple surgeons to identify if the difference between the experts found in this study is the result of the difference in interpretation of the factors of the surgery assessed by the experts or a result of Expert 1 being the surgeon who performed the surgeries. Surgical video assessment templates Although the GEARS, PACE, and PROTEST assessment methods can be used to assess surgical skills, results showed no significant difference between the impotent and potent patients. This could be because the surgeon’s skill did not differ between the surgeries and thus no difference should be found between the potent and impotent patients. This is in contrast to the findings of Goldenberg et al. who performed a retrospective one-to-one matched case-control study with a single surgeon and reported the mean overall GEARS scores as an independent predictor of early postoperative continence (3 months after surgery) in 47 patients (24 incontinent vs. 23 continent) operated on by the same surgeon.19 These results showed that there is a difference in surgical skills in the same surgeon, which could influence postoperative continence results. Limitations TThis study is a retrospective study in which patients of a single surgeon were analysed. The sample size was based on the difference between novice and expert surgeon, since (in this study) the comparison was made with one expert surgeon the sample size might be too small. We tried to reduce the influence of preoperative factors which in the literature have been shown to influence the chances of the patient’s postoperative potency26–28 by matching the patient subgroups. Since no perfect matches existed, the best alternatives were sought. Patients who had a non-nervesparing procedure on either side were excluded from selection, since it is known that this has major effects on postoperative potency.41 Although we did not expect any se-

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