332 Chapter 13 Non-Technical Skills. A survey among robot surgeons shows while surgical video assessment was traditionally only used in research, it is now accepted as a method of quality assurance and self-reflection in daily practice. Most surgeons use postoperative patient outcome analysis to learn from their past performances. They use edited surgical videos during team meetings in order to gain insight into the specific facets (e.g., surgical steps) of RARP in relation to postoperative complications and functional outcomes (i.e., urinary continence and erectile function). What is the relation between a surgeon’s performance and a patient’s postoperative outcomes? Although surgical video assessment is increasing in popularity, most methods used are still time consuming, subjective and cumbersome. The search for more objective and quicker assessment methods such as automated analysis of the movements of surgical instruments has been difficult. Multiple templated assessment methods (GEARS, PACE, and PROTEST) have been designed, although these assessments are still subjective, they do help the assessor as a guide for surgical skills assessment. In this thesis we investigated the usefulness of standardised templated assessment methods (the PROTEST, PACE14 and GEARS12 assessment methods) for the prediction of postoperative outcomes. None of the factors in these standardised templated assessment methods could be used to predict the urinary continence or potency status of the patients. In contrast to a study by group of Stern et.al.22, the results do show expert surgeons are able to predict the postoperative continence or potency status of their patients. The results of both studies show expert focus on the quality of the neurovascular bundles in case of potency, and the length of the urethral stump after resection in case of urinary continence in order to predict postoperative outcome. Further research was performed to objectively assess the influence of the urethral stump length on postoperative continence. The residual urethra stump has effects on urinary continence after a RARP. These findings show the residual urethra stump was significantly longer in the continent group compared to the incontinent group (10,50 vs 12,94 mm, p= 0.018). Although this relation was proven in previous studies using MRI images23,24 and pathology results25, we demonstrated that it is possible to measure the residual urethra stump during surgery. If the technique can be adapted for use during surgery instead of in pre-recorded surgical video’s, it will be possible to measure the urethral length during surgery in order to adapt surgical techniques to spare as much urethral length as possible. Further research into the objective assessment of surgical skills was done by investi-
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