ORLANDO, FL (UroToday) - Canadian investigators created a teaching and mentoring method called "block" surgery to simplify and improve time efficiency and safety while maintaining acceptable oncological and functional outcomes during the learning curve of a laparoscopic radical prostatectomy (LRP).

The LRP was broken down into 10 key "blocks" assigned different levels of difficulty. Practicing urologists were recruited from multiple centers. They compared the clinical outcomes when trainees did less than 50% of the case (group I), more than 50% of the case (group II), 100% of the case (group III) and when the mentor did the case alone (group IV).

They compared operative demographic data, peri-operative data, and post-operative oncological and functional data. Erectile incontinence data were captured using the IIEF and UCLA Prostate Cancer Index (UCLA PCI). Prior to the study, all those being mentored had at least 100 laparoscopic cases completed. A total of 8 urologists were mentored from 4 academic and 2 private centers. A total of 303 cases were completed (Grp I-34 cases, Grp II-27 cases, Grp III-55 cases, Grp IV-187 cases). There were no significant demographic differences between the 4 groups including the median blood loss, mean morphine use post-operatively, length of stay, conversion rate, complications, stage, positive margins and PSA level after 6 months. A difference was noted in the mean operative time (I-215, II-235, III-210, IV-178 minutes, p