@article{Klein_Marquette_Capon_Alezra_Blanc_Estrade_Bernhard_Bladou_Robert_2023, title={Implementing HoLEP in an Academic Department With Multiple Surgeons in Training: Mentoring Is the Key for Success}, volume={4}, url={https://siuj.org/index.php/siuj/article/view/232}, DOI={10.48083/10.48083/UJCR1584}, abstractNote={<p>Objective Holmium laser enucleation of the prostate (HoLEP) has been recommended for the surgical management<br>of benign prostatic hyperplasia (BPH) in most of the international guidelines, regardless of prostatic volume. The<br>main advantages reported by randomized clinical studies are reduced perioperative bleeding, catheterization time,<br>and length of hospital stay, but this technique is also described as difficult to master with a steep learning curve.<br>The objective of this study was to describe the clinical outcomes of HoLEP in the real-life setting of an academic<br>department with multiple operators with no previous experience.<br>Methods A retrospective observational study was conducted including all consecutive cases performed in our<br>department from April 2012 to October 2020. Over the study period, 31 different operators were involved. In April<br>2012, 2 surgeons were trained by an experienced urologist. The 29 others learned the technique progressively with the<br>help of the first 2 surgeons (surgical mentoring).<br>Results A total of 1259 patients were included. Preoperatively, the mean prostate volume and Qmax were 82.3 g<br>and 9.4 mL/s, respectively. The mean operative time was 79.7 min. The intraoperative complication rate was 5.6%<br>(n = 71), with the need for conversion being 0.6%. Postoperatively, the complication rate was 18.6% (n = 234). Surgeon’s<br>experience reduced the perioperative complication rates (P = 0.01), operative time (P &lt; 0.001), and length of hospital<br>stay (P &lt; 0.001), but the difference in blood transfusion rate was statistically non-significant (P = 0.3).<br>Conclusions Most of the 31 urologists in training were able to master HoLEP progressively, with good functional<br>outcomes and acceptable complication rates. Supervision by trained urologists was critical for the safe dissemination<br>of the technique in our department.</p&gt;}, number={1}, journal={Société Internationale d’Urologie Journal}, author={Klein, Clément and Marquette, Thibault and Capon, Grégoire and Alezra, Eric and Blanc, Peggy and Estrade, Vincent and Bernhard, Jean-Christophe and Bladou, Franck and Robert, Grégoire}, year={2023}, month={Jan.}, pages={11-18} }