1213 THE EVALUATION OF THE LEARNING CURVE ASSOCIATED WITH ROBOTIC RADICAL CYSTECTOMY: INITIAL 100 CASES

mains one of the most effective treatment for patients with localized, invasive bladder cancer. However, little study has been undertaken to evaluate less-invasive surgical approaches to this disease. Utilizing our mature experience with robotic-assisted laparoscopic radical cystectomy (RRC), we analyzed the changes in peri-operative outcomes that may reflect progress along the learning curve. METHODS: 100 patients underwent radical cystectomy and urinary diversion at our institution from 1-06‐8/08 for clinically-localized bladder cancer. Operative outcomes, pathological results, and complications were stratified by quintiles with 20 cases in each group. Multiple paired regression models were also constructed t evaluate co-variates predictive of changes or breakpoints in the learning curve. Statistical analysis was performed using SAS version 9.2 (Cary, NC). RESULTS: Table shows the mean outcomes based on time during the experience. Statistical cutpoint for OR time occurred at case 20. On multivariate analysis, statistical cutpoint for EBL was noted at the 20th case, with no significant changes thereafter. With regard to OR time, a statistical cutpoint was noted at the 40th case. No significant changes were noted for LN count, complication rates, bowel function, or length of stay. CONCLUSIONS: Our evolving experience with robotic radical cystectomy appears to be favorable with reduction in blood loss and operative times with increasing experience. These results come in the face of applying this technique to older patients with increased comorbidities.