Mentoring Through HoLEPs Learning Curve
October 20, 2019 –
Like many surgeries, HoLEP has a learning curve, but it is by no means overly challenging and is certainly worth the effort to attain the procedure’s advantages. In our program, novice surgeons require just 20 to 25 supervised cases before they can perform HoLEP alone, compared to 50 cases indicated in literature.4-6
One reason for the training period is that several crucial steps in the operation can be new to the surgeon, depending on the prostate size and configuration.For example, as we safely enucleate the prostate, it can be challenging anatomically to get between the adenoma and capsule. We must work close to the sphincter while safely preserving it. Surgeons also learn to find and maintain the right cutting plane while being mindful of the capsule’s position.
Proper hands-on training shortens the learning curve for these HoLEP techniques.What’s more, surgeons perform very well during training. Research has shown that the outcomes of HoLEP during the learning curve are comparable to those of surgeons experienced in HoLEP.7
- El-Hakim A, Elhilali MM. Holmium laser enucleation of the prostate can be taught: the first learning experience. BJU Int. 2002 Dec;90(9):863-9.
- Shah HN, Mahajan AP, Sodha HS, et al. Prospective evaluation of the learning curve for holmium laser enucleation of the prostate. J Urol. 2007 Apr;177(4):1468-74.
- Seki N, Mochida O, Kinukawa N, Sagiyama K, Naito S. Holmium laser enucleation for prostatic adenoma: analysis of learning curve over the course of 70 consecutive cases. J Urol. 2003 Nov;170(5):1847-50.
- Large T, Krambeck AE. Evidence-based outcomes of holmium laser enucleation of the prostate. CurrOpin Urol. 2018 May;28(3):301-308.