2008 Annual Meeting Abstracts

---

Surgical Complications Following Robotic Prostatectomy: Lessons Learned During The Initial 500 Cases
Douglas E Sutherland, Compton J. Benjamin*, Song Hau Tran*, Jason D. Engel, Harold A. Frazier, II
George Washington University, Washington, DC

Introduction: We determined the incidence of surgical complications resulting from robotic prostatectomy (RAP) during the initiation phase of a new robotics program.
Methods: The first 500 patients undergoing RAP performed by two surgeons (HAF, JDE) without formal laparoscopic or robotic surgical training were reviewed for evidence of a complication during or after the surgery. The Clavien classification system, a standardized and validated scale for complication reporting, was applied to all complications. The complication rate was determined per 100 patients treated, and statistical significance was determined with the chi-square test.
Results: A total of 59 patients (11.9%) experienced a total of 82 complications. Fifty patients experienced a single complication and 9 patients experienced >2 complications. Two patients were converted to an open procedure. A total of 6 patients required a blood transfusion (1.2%). The average hospital stay was 1.3 days and 9.4% required either a return visit to the emergency department or readmission. Sixty five percent of complications were grade I or II, and 22% were grade III. Only 2 grade IV complications occurred, and there were no deaths. The complications rate decreased with experience (p= 0.048).
Conclusions: Complications following RAP are most commonly minor, requiring expectant or medical intervention only, even during the initiation of a RAP program. The complication rate improved throughout the study period, but stabilized significantly after 200 procedures in this cohort.

Complication rate with experience (per 100 patients treated).

Patients treated	Number of patients with a complication	p value
1-100	17
101-200	14
201-300	11
301-400	10
401-500	7	0.048

---