ArticleAnnals of surgery2026
Competency, Proficiency, and Mastery: Learning Curves for Robotic Distal Pancreatectomy at 16 International Expert Centers.
Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative Analysis of Open, Laparoscopic, and Robotic Pancreaticoduodenectomy: A Systematic Review of Randomized Controlled Trials.Medicina (Kaunas, Lithuania) · 2025Pooled it
- ASO Author Reflections: Reassessing the Value of Additional Proximal Margin Resection for Perihilar Cholangiocarcinoma.Annals of surgical oncology · 2026Article
- When should the robot step aside?-conversion in robotic distal pancreatectomy: lessons from an international multicenter study.Gland surgery · 2026Article
- Robotic hepatopancreatobiliary surgery using the Toumai® system: initial experience and technical considerations from a single center.Updates in surgery · 2025Article
- Learning curve and perioperative outcomes of robotic-assisted distal pancreatectomy: a single-center study.Journal of robotic surgery · 2025Article
- From open to robotic distal pancreatectomy: the learning curve and mastering benchmark outcomes in a Scandinavian high volume center.Langenbeck's archives of surgery · 2025Article
- Perioperative Outcomes in Robotic, Laparoscopic, and Open Distal Pancreatectomy: A Network Meta-Analysis and Meta-Regression.Cancers · 2025Article
- International validation of the distal pancreatectomy fistula risk score: evaluation in minimally invasive and open surgery.Surgical endoscopy · 2025Article
- Clinical efficacy and learning curve analysis of 101 robotic-assisted Warshaw procedures: a retrospective study.Surgical endoscopy · 2025Article
- Robotic distal pancreatectomy using two-surgeon technique (TAKUMI-4): a technical note and initial outcomes.Langenbeck's archives of surgery · 2025Article
- Impact of visceral fat area on surgical difficulty during robotic distal pancreatectomy (TAKUMI-2).Surgical endoscopy · 2025Article
- A Composite Endpoint of Liver Surgery (CELS): Development and Validation of a Clinically Relevant Endpoint Requiring a Smaller Sample Size.Annals of surgical oncology · 2025Article
- Robotic versus open pancreatoduodenectomy for periampullary neoplasm: a propensity matched analysis of peri-operative and oncologic outcomes.Surgical endoscopy · 2025Article
- Experience-based transition to robotic surgery in an experienced program in minimally invasive hepatobiliary surgery.Surgical endoscopy · 2024Article
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Authors and funding
39 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aim of this study was to evaluate the different phases of the learning curve for robotic distal pancreatectomy (RDP) in international expert centers.
backgroundRDP is an emerging minimally invasive approach; however, only limited, mostly single-center data are available on its safe implementation, including the learning curve.
methodsConsecutive patients undergoing elective RDP from 16 expert centers across 3 continents were included to assess the learning curve. Based on the first 100 RDPs at each center, 3 cutoffs were used to define the learning curve: operative time for competency, major complications (Clavien-Dindo grade ≥III) for proficiency, and textbook outcome for mastery. Clinical outcomes before and after the cutoffs were compared.
resultsThe learning curve analysis was conducted on 1109 of 2403 RDPs. Competency, proficiency, and mastery, respectively, were reached after 46, 63, and 73 RDP procedures. After competency, operative time decreased from 245 to 235 minutes ( P = 0.002). Attaining proficiency was reflected by a reduction in the rate of major complications from 20% to 15% ( P = 0.012), and mastery was associated with a higher proportion of patients with textbook outcomes (71% vs 63%; P = 0.028). The postoperative pancreatic fistula rate remained stable along the learning curve, ranging between 18.5% and 21.5%. Previous laparoscopic experience accelerated the learning process by virtue of reduced operative time and an earlier decrease in major complications.
conclusionsCompetency, proficiency, and mastery for RDP were reached after 46, 63, and 73 procedures, respectively, at international expert centers. The findings highlight that the learning curves for intraoperative parameters are completed earlier; however, extensive experience is needed to master RDP.
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