Live surgery: Safety study after 17 editions of retroperitoneoscopic surgery

Abstract

Introduction: Live surgery has become an excellent tool for medical training. Despite this, there is controversy about the safety of the patients involved.

Objective: To analyze the results of live surgeries performed in 17 consecutive retroperitoneoscopy courses organized in our center. Procedures performed were partial nephrectomy (PN), radical nephrectomy (RN) and nephroureterectomy (NU).

Material and methods: Review from January 2010 to October 2017 of all live surgeries carried out by an expert surgical team in the retroperitoneoscopy courses, compared with a control group of surgeries performed in standard conditions. A matching (1:1 for each RN and 1:2 for each PN and NU) according to age, body mass index and comorbidities was performed.

Results: Twenty-one live surgeries were analyzed (eight PN, seven RN and six NU) with a global median follow-up of 38 months. No significant differences were observed between both groups in terms of perioperative variables (operative time, operative bleeding and intraoperative complications) or of postoperative complications and length of hospital stay. Likewise, there were no differences between recurrence rates (PN: 0% vs. 6.3%, p = 0.47, NU: 33.3% vs. 66.7%, p = 0.180, RN: 0% vs. 28.6%, p = 0,127).

Conclusions: Live surgery in the hands of expert surgeons in a suitable environment and with well-selected patients does not increase the risk of complications and allows maintaining the same oncological outcomes.

Keywords: Cirugía en directo; Complicaciones; Complications; Live surgery; Nefrectomía; Nephrectomy; Retroperitoneoscopia; Retroperitoneoscopy; Safety; Seguridad.