Resident Involvement in Urologic Robotic Surgery Public Deposited

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Last Modified
  • February 27, 2019
Creator
  • McMillan, Daniel
    • Affiliation: Gillings School of Global Public Health, Public Health Leadership Program
Abstract
  • Resident inexperience in the operating room has long been debated as a contributor to adverse patient outcomes. Since its introduction, robotic surgery has become an integral part of health care delivery, particularly for the surgical treatment of prostate cancer. The purpose of this paper is to examine the outcomes of resident involvement in urologic robotic procedures. The first section includes a systematic review of the available literature, evaluating the aforementioned topic and identifying potential gaps in this collection of studies. Examination of the four articles that met inclusion criteria demonstrated preliminarily encouraging results of the safety of resident involvement, as well as a need for studies with larger sample sizes and more generalizable results. The second section is original research reporting the results of patient outcomes with and without resident participation in robotic prostatectomies (RP), one of the most common urologic robotic surgeries. Using the National Surgical Quality Improvement Program database (2005 – 2011), 5,087 patients who underwent RP were identified to evaluate this relationship. After adjusting for potential confounders, resident involvement did not affect 30-day mortality, serious morbidity or overall morbidity. Resident involvement did, however, result in significantly longer operative times. Nevertheless, the results support that resident participation in RPs appears safe, regardless of postgraduate year level. To date, this study is unique among many of those assessed during the systematic review as it utilizes standardized data from over 200 participating medical centers and includes a significantly larger sample size than any other previously published study on this topic.
Date of publication
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Rights statement
  • In Copyright
Note
  • Paper type: Research or research design
  • Track: HC&P
Advisor
  • Viera, Anthony
Reviewer
  • Smith, Angela
Degree
  • Master of Public Health
Degree granting institution
  • University of North Carolina at Chapel Hill
Language
Deposit record
  • 564d1737-ca9b-4211-9c3e-c1926665c3df
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