{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:11:14Z","timestamp":1790698274550,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,11,18]],"date-time":"2018-11-18T00:00:00Z","timestamp":1542499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate automated performance metrics (APMs) and clinical data of experts and super\u2010experts for four cardinal steps of robot\u2010assisted radical prostatectomy (RARP): bladder neck dissection; pedicle dissection; prostate apex dissection; and vesico\u2010urethral anastomosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods<\/jats:title>\n                    <jats:p>We captured APMs (motion tracking and system events data) and synchronized surgical video during RARP. APMs were compared between two experience levels: experts (100\u2013750 cases) and super\u2010experts (2100\u20133500 cases). Clinical outcomes (peri\u2010operative, oncological and functional) were then compared between the two groups. APMs and outcomes were analysed for 125 RARPs using multi\u2010level mixed\u2010effect modelling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For the four cardinal steps selected, super\u2010experts showed differences in select APMs compared with experts (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05). Despite similar PSA and Gleason scores, super\u2010experts outperformed experts clinically with regard to peri\u2010operative outcomes, with a greater lymph node yield of 22.6 vs 14.9 nodes, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.01), less blood loss (125 vs 130\u00a0mL, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.01), and fewer readmissions at 30\u00a0days (1% vs 13%, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.02). A similar but nonsignificant trend was seen for oncological and functional outcomes, with super\u2010experts having a lower rate of biochemical recurrence compared with experts (5% vs 15%, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.13) and a higher continence rate at 3\u00a0months (36% vs 18%, respectively;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.14).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found that experts and super\u2010experts differed significantly in select APMs for the four cardinal steps of RARP, indicating that surgeons do continue to improve in performance even after achieving expertise. We hope ultimately to identify associations between APMs and clinical outcomes to tailor interventions to surgeons and optimize patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.14599","type":"journal-article","created":{"date-parts":[[2018,10,25]],"date-time":"2018-10-25T06:37:53Z","timestamp":1540449473000},"page":"861-868","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["Experts vs super\u2010experts: differences in automated performance metrics and clinical outcomes for robot\u2010assisted radical prostatectomy"],"prefix":"10.1111","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7201-6736","authenticated-orcid":false,"given":"Andrew J.","family":"Hung","sequence":"first","affiliation":[{"name":"Center for Robotic Simulation and Education Catherine and Joseph Aresty Department of Urology USC Institute of Urology University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6119-4265","authenticated-orcid":false,"given":"Paul J.","family":"Oh","sequence":"additional","affiliation":[{"name":"Center for Robotic Simulation and Education Catherine and Joseph Aresty Department of Urology USC Institute of Urology University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6740-8401","authenticated-orcid":false,"given":"Jian","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Robotic Simulation and Education Catherine and Joseph Aresty Department of Urology USC Institute of Urology University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saum","family":"Ghodoussipour","sequence":"additional","affiliation":[{"name":"Center for Robotic Simulation and Education Catherine and Joseph Aresty Department of Urology USC Institute of Urology University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christianne","family":"Lane","sequence":"additional","affiliation":[{"name":"Southern California Clinical and Translational Science Institute Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Jarc","sequence":"additional","affiliation":[{"name":"Medical Research Intuitive Surgical, Inc. Norcross GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inderbir S.","family":"Gill","sequence":"additional","affiliation":[{"name":"Center for Robotic Simulation and Education Catherine and Joseph Aresty Department of Urology USC Institute of Urology University of Southern California Los Angeles CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21387"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ucl.2014.07.002"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra054785"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1300625"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2006.01.057"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.12315"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-006-0137-4"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1997.02502.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4070-8"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2016.11.100"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.10.048"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2014.09.017"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.07.081"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.11.028"},{"key":"e_1_2_7_16_1","unstructured":"Surgical I.Intuitive Surgical Inc. 2016 Annual Report 2016. 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