Comparison of open and robotic-assisted partial nephrectomy approaches using multicentric data (UroCCR-47 study).

We compared the outcomes of robotic-assisted partial nephrectomy (RPN) and open partial nephrectomy (OPN) using contemporary data to respond to unmet clinical needs. Data from patients included in the registry who underwent partial nephrectomy between January 01, 2014 and June 30, 2017 within 20 centres of the French Network for Research on Kidney Cancer UroCCR were collected (NCT03293563). Statistical methods included adjusted multivariable analyses. Rates of peri- and post-operative transfusion, and of surgical revision, were lower in the RPN (n = 1434) than the OPN (n = 571) group (2.9% vs. 6.0%, p = 0.0012; 3.8% vs. 11.5%, p < 0.0001; 2.4% vs. 6.7%, p < 0.0001, respectively). In multivariable analyses, RPN was independently associated with fewer early post-operative complications than OPN (overall: odds-ratio [95% confidence interval, CI] = 0.48 [0.35-0.66]; severe: 0.29 [0.16-0.54], p < 0.0001 for both) and shorter hospital stays (34% [30%; 37%], p < 0.0001). RPN was also a significantly associated with a decresedrisk of post-operative acute renal failure, and new-onset chronic kidney disease at 3 and 12 months post-surgery. There were no between-group differences in oncological outcomes. In comparison with OPN, RPN was associated with improved peri- and post-operative morbidity, better functional outcomes, and shorter hospital stays. Our results support the use of RPN, even for large and complex tumours.

[Complications in urological surgery: Monitoring and classification]. / Les complications en chirurgie urologique. Recueil et classification.

The objective of this article was to discuss the statistics of surgical complications in urology and the methods of collection and classification. In the absence of a comprehensive national registry of complications, we used statistics from insurance companies as indicators. They are limited by the exclusion of complications that did not result in a claim. Overall, urology is less exposed to claims than other surgical specialties. It comes far behind orthopedic surgery, gynecology-obstetrics and visceral surgery. The new techniques in urological surgery and in particular the rise of robotic surgery do not seem to have modified the number of claims handled by medical insurance companies. It is unfortunate that complications in urological surgery are not collected, reported, and discussed in order to develop prevention, treatment, and strategies for educational purposes. The lack of an established definition and classification of surgical complications, as well as methodological differences in the collection of related information, has hampered the evaluation of their public health and health economics impact. Awareness of this problem is growing among learned societies and practitioners. Complication reporting should be organized on a national basis and should respect the following points: - definition of the collection process according to a validated system. For urology, the Martin table revised by the EAU working group would be adapted; - classification of complications according to a validated system such as Clavien-Dindo or CCI.

[Complications of radical nephrectomy and partial nephrectomy: What are they? How can they be anticipated and managed?] / Les complications de la néphrectomie totale et de la néphrectomie partielle : quelles sont-elles, comment les prévenir et les prendre en charge ?

INTRODUCTION: Surgical techniques of radical and partial nephrectomy have changed over the last 20years. Indications for partial nephrectomy have widened and mini-invasive surgery (laparoscopy and robotic assistance) has become widely used. However, both still have a significant morbidity. The objective of this article is to review complications of renal surgery and their predictive factors and to offer algorithms of management. METHODS: Recent literature regarding complications of radical and partial nephrectomy was queried using Pubmed engine search. The most relevant articles were analyzed and served as a basis for this work. RESULTS: The literature on complications of radical and partial nephrectomy has a low level of evidence. There are only retrospective series. The most frequent complications of radical nephrectomy occur during surgery in 5-10% of the cases: wound of the pedicle or of an adjacent organ. The management can often be conservative. Laparoscopy has a similar morbidity compare to the open approach but has greatly increased postoperative outcomes and comfort. Partial nephrectomy has a 20% complication rate. Many factors have an impact on the risk of complications (tumor size, inflammation of perirenal fat, access, surgeon experience, centre volume, comorbidities and age of the patient) and must be taken into consideration before advising partial nephrectomy. The two most feared complications of partial nephrectomy are bleeding (per- or postoperative, 10% of the cases) and urinary fistula (<5% of the cases). Robotic assistance is associated with a lower morbidity in many publications. CONCLUSION: Complications after partial and radical nephrectomy are quite frequent but have decreased with the improvement of surgical techniques. French urologists should maintain their interest in novel technologies and simplification of perioperative pathway to further improve patients' outcomes.

[Complications in urological surgery. Prevention]. / Complications chirurgicales en urologie adulte. La prévention.

The objective of this article was to summarize the means and tools of prevention and safety of care to reduce non-random surgical complications in urology, related to the care environment and the patient. The prevention of complications is an essential strategy to be applied in a standardized way in urological surgery, as in the world of aeronautics, from which we can draw valuable lessons. This prevention is multifactorial and concerns interventions, systems and human factors. The essential points listed below must be traceable: the quality of the assessment of the patient and his co-morbidities. This is a multidisciplinary task; the relevance of the surgical indication, which must take into account the state of the art at the time it is given; the expertise of the urologist and his continuing education; the relevance of the surgical indication, which must take into account the state of the art at the time it is given; the quality of the information provided to the patient and his family, and to the medical and paramedical team involved in the patient's care; the quality of the professional environment and equipment; compliance with recommended safety rules (e.g. checklist, identity check). All these points are not isolated but interdependent. They must be recorded in the patient's file, the quality and completeness of which is essential to the patient's follow-up, to the prevention and management of complications and to the understanding, if necessary, of the truth of the medical facts.

[Complications in urological surgery: Bladder surgery]. / Les complications chirurgicales en urologie adulte : chirurgie de la vessie.

CONTEXT-OBJECTIVE: The management of bladder tumors is based on two major interventions, the risks of complications of which can be significant. The objective of this work is to provide an update on the complications related to bladder surgery, to detail the preventive measures and management strategies in practice. METHODS: Bibliographic search using Medline bibliographic database (Pubmed) using the following keywords: transurethral resection of the bladder, cystectomy, neobladder, Bricker, complications, anastomotic strictures. RESULTS: Trans-urethral resection of the bladder (TURB) essentially exposes to the risk of hemorrhage (2 to 4%) and bladder perforation (1 to 3%). Total cystectomy is associated with significant morbidity and mortality, despite recent technical advances. The most frequent early complications are ileus (23 to 30%) and infectious complications (29 to 38%). Late complications included by functional complications (urinary and sexual), anastomotic strictures (7 to 12%), metabolic complications of continent derivation (25 to 46%) and stomial complications in case of non-continent derivation. The management of complications is well codified. It is however essential to anticipate and put in place preventive measures, especially for infectious and thromboembolic complications, including an exhaustive pre-operative assessment, prehabilitation of the patient and enhanced recovery after surgery. CONCLUSION: Preventing, analyzing and understanding complications in bladder surgery is essential to reduce mortality and morbidity.

[Complications in urological surgery: Prostate surgery]. / Les complications chirurgicales en urologie adulte : chirurgie de la prostate.

Prostate surgery mainly addresses the treatment of the two most common pathologies of the prostate: benign prostatic hypertrophy (BPH), symptomatic or complicated, and prostate cancer (PCa). The objective of this manuscript was to present after review of the literature the main intraoperative and postoperative surgical complications associated with radical prostatectomy and surgery of the BPH whatever the surgical approach. The incidence and type of these complications may vary depending on the patient's comorbidities and the type of surgery. Regarding radical prostatectomy, the main complications are hemorrhagic, digestive and urinary. During or after surgery of BPH, hemorrhagic and urinary complications dominate. The management of these complications relies on general principles based on a low level of evidence, but usually associate a structured diagnostic pathway and an appropriate treatment decision.

[Complications in endourology: Ureteroscopy and percutaneous nephrolithotomy]. / Complications en endo-urologie : urétéroscopie et néphrolithotomie percutanée.

If surgical treatment of urinary stones is indicated, the urologist has now different modalities depending on each situation. This includes extracorporeal lithotripsy, ureteroscopy (rigid and flexible), and percutaneous nephrolithotomy. Ureteroscopy is also performed for diagnostic purposes, and for the treatment of upper urinary tract tumors. Indications, as well as the steps of each of these techniques will not be discussed in this review. Only intra- and postoperative complications of ureteroscopy and percutaneous nephrolithotomy will be reviewed, including diagnostic, management, and preventive measures.

[Surgical complications in adult urology: Pelvic and perineal surgery]. / Les complications chirurgicales en urologie adulte : chirurgie du pelvis et du périnée.

Pelvic and perineal surgeries and in particular those for stress urinary incontinence and prolapse are functional surgeries, which require careful selection of patients and assessment of discomfort to expect satisfactory surgical results and reduce failure rates and of complications. Before offering pelvic and perineal surgery, the risk of potential complications should be carefully assessed and discussed with patients. Recent attention to the potential complications prosthetic mesh has raised awareness in the urological community to report complications. This chapter will focus on the complications of surgeries used for stress urinary incontinence (synthetic retropubic or transobturator suburethral slings, colposuspension, pubovaginal slings, artificial urinary sphincter, adjustable periurethral balloons and periurethral injections of bulking agents) and sacrocolpopexies. The epidemiology of complications, the minimum assessment to be carried out, treatment and prevention will be discussed.

[Surgical complications in adult urology: Surgery of the external genitalia]. / Les complications chirurgicales en urologie adulte : chirurgie des organes génitaux externes.

AIM: Define and present the complications of surgery of the external genitalia (EG), as well as their management. METHOD: Bibliographic search using the Medline (NLM Pubmed tool) and Embase bibliographic databases using the following keywords: scrotal surgery, orchidopexy, hydrocele, varicocele, testicular biopsy, vasectomy, cryptorchidism, orchiectomy, testicular implant, subcapsular orchiectomy, spermatic cord cyst, posthectomy, penis curvature surgery, penile implant, urethral strictures. RESULTS: EG surgery is common in urology, it includes scrotal surgeries and penile surgeries, which are performed openly. They expose to complications such as bleeding, infection, scar disunity requiring early reassessment especially in case of ambulatory procedure. Rare complications must be known, some of which must lead to expert management. CONCLUSION: Complications of surgical treatment of EG should be identified and managed. This report should allow a better understanding and management of these complications.

[Complications in urological surgery. The urologist as a player in risk management]. / Les complications en chirurgie urologique. L'urologue acteur de la gestion des risques.

The first part of this article deals with accreditation of the quality of the professional practice of urologists and medical teams working in public or private health care institutions. This is a voluntary national risk management process based on the reporting and analysis of medical risk events and the development and implementation of recommendations. The fundamental objective of the system is to reduce the frequency and severity of adverse events associated with care for the patient. The second part aims to describe the mechanisms and management of surgical complications. The perception of complications by the urologist is discussed, as it may be distorted by cognitive biases leading to inappropriate actions. Two important points were also emphasized: communication with the patient following an injury, therapeutic hazard or complication following an error, and proper maintenance of the medical record. A joint effort to cultivate a culture of safety and quality in urological surgical practice should be encouraged. Collective actions by urologists in the future should help to maintain a proactive attitude: - generalization of quality accreditation of urologic physicians' professional practice; - national registry: which has demonstrated its advantages in the world of aeronautics; - creation of a specific module "Management of complications in urology" in teaching (ECU) and continuing education (SUC, website); - creation of an AFU "Complications" Committee; - management of social networks.

[Radical prostatectomy in patients with Gleason 6 (ISUP 1) prostate cancer: 10-year follow-up]. / Recul à 10 ans des patients opérés pour un cancer de prostate Gleason 6 (ISUP1).

OBJECTIVE: To evaluate extraprostatic extension and 10 years cancer specific survival in a population of patients with Gleason 6 (ISUP 1) prostate cancer (PCa) treated by radical prostatectomy (RP) in two French third referral centers. MATERIALS AND METHODS: The data were extracted from 2 university hospital databases according to the following criteria: PCa classified ISUP 1 following both biopsy (PB) and surgery (RP) between 1998 and 2008. Pathology slides of patients having presented an extraprostatic extension and/or a recurrence were reviewed by a uropathologist. RESULTS: Among the 534 patients who met the inclusion criteria, 66 (12.2%) had a pT3 stage. One patient out of 198 who received lymph node dissection had a positive node. Median follow-up was 10.3 years. Only one patient presented with metastatic progression. No cancer specific death was observed. An independent pathologist reviewed the slides of 58 out of the 70 patients who presented pT3 disease and/or a recurrence (in 12 cases, pathological material was not available). After review, all pT3b stages and 12 pT3a (out of 14) were upgraded to ISUP2 or higher. Similarly, the patient with a positive node and the patient who progressed towards a metastatic disease were both upgraded to ISUP 3. CONCLUSION: No pT3b or pN+stage was associated with ISUP 1 PCa in our study. With a median follow-up of more than 10 years, biological progression was the only type of progression observed.

[Single, immediate postoperative intra-vesical instillation (SI) compared to a single preoperative intra-vesical instillation of mitomycin C in non-muscle invasive bladder cancer (NMIBC). Phase II randomized trial]. / Instillation préopératoire immédiate (IPOI) de mitomycine C comparée à l'instillation postopératoire précoce (IPOP) dans les tumeurs de la vessie. Étude de phase II randomisée.

OBJECTIVE: A single immediate instillation of mitomycin C is recommended after a complete transurethral resection of the bladder (TURB) in low- and intermediate-risk patients with NMIBC. Actually, post-TURB instillation is seldom used due to logistical difficulties and surgical contraindications. Our aim was to compare patients with single pre-TURB intra-vesical instillation and patients with a single, immediate post-TURB intra-vesical instillation of mitomycin C. METHODS: We performed a multicenter randomized trial between February 17, 2014 and November 24, 2016 (registration number 2012-004341-32). Sixty patients with two or less, primary or recurrent papillary bladder tumors and a negative urinary cytology were planned. Cystoscopy was performed at 3, 6 and 12 months after TURB. Our primary endpoint was disease-free interval. Secondary endpoints were recurrence rate at 3 and 12 months, rate of patients in whom instillation could not be performed and tolerance 1 month after TURB using BCI-Fr score. RESULTS: Among 35 eligible participants, 20 were randomly assigned in the pre-TURB instillation group and 15 in the post-TURB instillation group. Follow-up was comparable: 12,3±1,6 months in the SI group and 10,2±4,5 months in the pre-TURB instillation group. In the post-TURB instillation group, 2 patients didn't have any instillation. We did not identify significant differences in disease-free interval. Tolerance at 1 month after TURB was similar in both groups. CONCLUSION: Tolerance and efficacy were not significantly different. As expected, logisitics were easier for the health providers in the pre-TURB group where all patients had their instillation conversely to the post-TURB group. These results suggest that the advantages of a single immediate pre-TURB instillation warrant further evaluation of this strategy in a phase III randomized trial.

Smooth muscle of the male pelvic floor: An anatomic study.

Knowledge of the anatomy of the male pelvic floor is important to avoid damaging the pelvic floor muscles during surgery. We set out to explore the structure and innervation of the smooth muscle (SM) of the whole pelvic floor using male fetuses. We removed en-bloc the entire pelvis of three male fetuses. The specimens were serially sectioned before being stained with Masson's trichrome and hematoxylin and eosin, and immunostained for SMs, and somatic, adrenergic, sensory and nitrergic nerve fibers. Slides were digitized for three-dimensional reconstruction. We individualized a middle compartment that contains SM cells. This compartment is in close relation with the levator ani muscle (LAM), rectum, and urethra. We describe a posterior part of the middle compartment posterior to the rectal wall and an anterior part anterior to the rectal wall. The anterior part is split into (1) a centro-levator area of SM cells localized between the right and left LAM, (2) an endo-levator area that upholsters the internal aspect of the LAM, and (3) an infra-levator area below the LAM. All these areas are innervated by autonomic nerves coming from the inferior hypogastric plexus. The core and the infra-levator area receive the cavernous nerve and nerves supplying the urethra. We thus demonstrate that these muscular structures are smooth and under autonomic influence. These findings are relevant for the pelvic surgeon, and especially the urologist, during radical prostatectomy, abdominoperineal resection and intersphincteric resection. Clin. Anat., 2019. © 2019 Wiley Periodicals, Inc.

[Is sarcopenia a morbi-mortality factor in the treatment of localized muscle-invasive bladder cancer?] / La sarcopénie est-elle un facteur de morbi-mortalité dans le traitement des tumeurs localisées de la vessie infiltrant le muscle ?

INTRODUCTION: Sarcopenia evaluated from the measurement of skeletal muscle index (SMI) has been evaluated as a predictive factor of morbidity and mortality after surgery. The objective of this study was to evaluate whether it was predictive of morbidity and mortality in patients managed by cystectomy or tri-modality therapy (TMT), combining radiotherapy and chemotherapy after endoscopic resection of the tumour, for localized muscle-invasive bladder cancer. MATERIALS AND METHODS: In all, 146 consecutive patients from 2 university hospital centres treated by cystectomy between January 2012 and April 2017 or TMT between October 2008 and October 2014 were included. The SMI was measured on axial computed-tomography at the level of the transverse process of L3, before treatment. Sarcopenia was assessed in two ways: either by SMI without muscle mass adjustment or according to the definition by Martin and al. based on gender and patient BMI, then called "adjusted sarcopenia". The primary endpoint was overall survival (OS) for sarcopenia. The secondary endpoints were OS, progression-free survival (PFS) and survival without re-admission (SRH) for the total population and for each treatment group. Survival analyses were performed using the Cox model. The association between sarcopenia and complications has been investigated by the Chi2 test. RESULTS: The characteristics of sarcopenic (n=67) and non-sarcopenic (n=79) patients were comparable except for 2 criteria: older patients in the sarcopenic group and a higher proportion of neo-adjuvant chemotherapy in non-sarcopenic patients. Sarcopenia was not significantly associated with any type of survival. Sarcopenia was not associated with the proportion or severity of complications. CONCLUSION: Unlike unadjusted SMI, sarcopenia was not associated with survival or complications. LEVEL OF EVIDENCE: 3.

[Renal Trauma]. / Traumatismes du rein.

INTRODUCTION: Renal traumas are common, observed in 10% of patients with abdominal trauma. Most renal traumas are blunt, resulting from a direct hit or from an abrupt deceleration. MATERIAL AND METHODS: We realized a synthesis of renal trauma management for nurses. RESULTS: Clinical presentation often encompasses gross hematuria and lumbar pain. The best diagnostic tool is computed tomography (CT) urogram. Based on CT urogram images, renal traumas are classified according to the American Association for the Surgery of Trauma (AAST) classification in five grades of increasing severity. The management is conservative in the vast majority of cases and has been largely simplified over the past few years, being now mostly based on observation. Radiological interventional and endoscopic procedures are used only in very selected cases and surgical exploration has become extremely rare. CONCLUSION: The prognosis has also considerably improved and renal trauma rarely result in death or loss of the kidney nowadays.

[Is it necessary to perform urine culture systematically prior to double J ureteral stent removal?] / Est-il nécessaire de faire systématiquement un ECBU avant l'ablation d'une sonde double J ?

OBJECTIVE: To assess the value of systematic urine culture before ureteric double j removal. MATERIAL AND METHODS: This prospective audit was performed to assess the validity of our current clinical practice. A cohort of informed patients without clinical signs of urinary tract infection and without predefined risk factors were programmed for ureteral double j stent removal in an outpatient setting. Urine was sampled for culture immediately before the procedure. Patients had to complete a self-questionnaire 15 days following stent removal, inquiring about tolerance and complications which were to be analyzed according to the culture results. The primary endpoint was the occurrence of febrile urinary tract infection. RESULTS: Among the 56 participants, immediate preoperative urine culture revealed colonization in 9 patients (16.1%) and contamination in 6 patients (10.7%). A significant association was found between bacteriuria and double j placement following surgery with urinary tract injury (P<0.02) and diabetes (P<0.009). Two patients had fever including a man with sterile urine and a woman with Staphylococcus Aureus infection. No hospitalization was necessary. Twelve patients reported functional signs with lumbar pain being the most common. There was no significant association between functional signs and patients' clinical characteristics. CONCLUSION: This evaluation was not in favor of modifying our protocol of care i.e. the lack of performing neither antibiotic prophylaxis nor systematic urine culture before JJ ureteral stent removal in a selected population. LEVEL OF EVIDENCE: 4.

[Prognostic value of testosterone during androgene deprivation therapy]. / Valeur pronostique de la testostéronémie lors de l'hormonothérapie intermittente du cancer de la prostate.

INTRODUCTION: The concept of intermittent androgen deprivation therapy (IADT) for prostate cancer (PCa) was introduced in order to improve treatment tolerance with the same carcinological efficiency as continuous androgen deprivation therapy (CADT). Furthermore, studies have shown that PCa prognosis during CADT was correlated to the extent of testosterone collapse. The aim of this study was to assess the link between testosterone levels at the end of the first off-treatment phase and time to occurrence of castrate-resistant prostate cancer. METHODS: We retrospectively analyzed the files of 69 patients having undergone IADT. Intermittence was offered to the patients showing PSA<4ng/mL after at least six months of androgen deprivation therapy (ADT) using a LHRH analog. CRPC was defined according to the AFU oncological guidelines. Patients were sorted into three groups according to their testosterone levels at the end of the first off-treatment phase T<0.5ng/mL, 0.53.4ng/mL. CRPC free-survival, metastasis-free survival and overall survival as well as adverse events frequency were compared between the groups. The impact of initial ADT duration on CRPC occurrence, mean off-treatment phase duration and IADT duration was also studied. RESULTS: Testosterone levels at the end of the first and second off-treatment phases were not linked to time to CRPC occurence (p=0.5), mestastasis occurence (p=0.4) or death (p=0.3). It was associated neither with adverse effects frequency (p=0.2) nor with cancer-related complications (p=0.6). Initial ADT duration was not linked to CRPC occurrence (p=0.6), mean off-treatment phase duration (p=0.5) or mean IADT duration (p=0.6). CONCLUSION: This study did not show any link between testosterone levels at the end of the first off-treatment phase (before reintroducing ADT) and overall survival, metastasis-free survival and CRPC-free survival. Likewise, it was not associated with the frequency of adverse events or cancer-related complications. Initial ADT duration was not linked to CRPC occurrence or IADT chronological parameters.

[Deep infiltrating endometriosis surgical management and pelvic nerves injury]. / Identification des sites anatomiques à risque de lésion nerveuse lors de chirurgie pour endométriose pelvienne profonde.

OBJECTIVES: Deep pelvic endometriosis surgery may need substantial excisions, which in turn expose to risks of injury to the pelvic nerves. To limit functional complications, nerve-sparing surgical techniques have been developed but should be adapted to the specific multifocal character of endometriotic lesions. The objective was to identify the anatomical areas where the pelvic nerves are most at risk of injury during endometriotic excisions. METHODS: The Medline and Embase databases have been searched for available literature using the keywords "hypogastric nerve or hypogastric plexus [Mesh] or autonomic pathway [Mesh], anatomy, endometriosis, surgery [Mesh]". All relevant French and English publications, selected based on their available abstracts, have been reviewed. Five female adult fresh cadavers have been dissected to localize the key anatomical areas where the pelvic nerves are most at risk of injury. RESULTS: Six anatomical areas of high risk for pelvic nerves have been identified, analysed and described. Pelvic nerves can be damaged during the dissection of retrorectal space and the anterolateral rectal excision. Furthermore, before an uterosacral ligament excision, a parametrial excision, a colpectomy or a dissection of the vesico-uterine ligament, the hypogastric nerves, splanchnic nerves, inferior hypogastric plexus and its efferent pathways must be mapped out to avoid injury. The distance between the deep uterin vein and the pelvic splanchnic nerves were measured on four cadavers and varied from 2.5cm to 4cm. CONCLUSION: Six key anatomical pitfalls must be known in order to limit the functional complications of the endometriotic surgical excision. Applying nerve-sparing surgical techniques for endometriosis would lead to less urinary functional complications and a better short-term postoperative satisfaction.

[French resident's performance on laparoscopic surgery box trainer: 7-year results of pelvitrainer contests]. / Performance des internes français sur simulateur de chirurgie laparoscopique : les résultats de 7 ans d'olympiades du pelvitrainer.

OBJECTIVES: The study objectives were to analyze the resident's laparoscopic surgery performance in order to build a self-assessment data set, to identify discriminatory exercises and to investigate the suturing time changes. METHODS: From 2007 to 2014, the French Association of Urologist in Training (AFUF) organized 7 pelvitrainer contests. Participant scores on 11 laparoscopic surgery exercises were evaluated. RESULTS: Sixty-six residents participated to these contests and performed 11 exercises each. Twenty-two (33.3 %) participants were beginners, 26 (39.4 %) intermediates et 18 (27.3 %) experienced. The participant scores were gathered into a data set including the average time per exercise. We found a time scoring improvement related to the resident experience for all exercises. A significant decline in time was noted for exercise 8 and 9 between beginners and intermediates (139s [±71]), (173.9s [±118.3]) and between beginners and experienced (80.6s [±26.7]), (94,1s [±42.7]) with a P<0.05. The correlation coefficient for the exercise 11 duration (vesico-uretral anastomosis) was 0.04 over a 7-year period (P=0.44). CONCLUSION: The study provided a data set on 11 laparoscopic surgery tasks which can be consulted by all residents as a reference in a self-assessment process. Two exercises (8 and 9) discriminated beginners from intermediates and experienced groups and could be used as a benchmark ahead of an operating room procedure. The vesico-uretral anastomosis duration (exercise 11) did not improve significantly between 2006 and 2014. LEVEL OF EVIDENCE: 4.