SynthesisJournal of robotic surgery2026
The learning curve of robotic pancreatoduodenectomy: a systematic review of learning curve assessment methodologies, proficiency thresholds, training pathways and clinical outcomes.
Synthesis in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Robotic pancreatoduodenectomy (RPD) is one of the most technically challenging procedures in hepatopancreatobiliary surgery. Its adoption continues to grow, but the learning pathway to competency and mastery is still not fully defined. This systematic review aims to analyze the learning curve assessment methodologies, proficiency thresholds, training pathways, and influence of experience on perioperative and oncologic outcomes. This systematic review was conducted in accordance with PRISMA guidelines. PubMed/MEDLINE, Scopus and The Cochrane Library were systematically searched, from inception to June 2026. Due to large heterogeneity in study design, learning curve methodologies and outcome reporting, the data were synthesized narratively. Forty-two studies were included. The learning curve thresholds were 6-8 cases for initial competency and 250 + cases for mastery. Operative time suggested proficiency after 20-40 cases, whereas risk-adjusted results, textbook outcomes and composite quality measures suggested proficiency required 56-120 cases, with mastery only after 176-263 cases. Higher experience was associated with lower conversion rates, postoperative pancreatic fistula, delayed gastric emptying, major complications and mortality. Oncologic outcomes were stable or improved, with R0 resection rates generally exceeding 90% and lymph node harvest increasing from 17 to 26, 16 to 33, and 38 to 45.5 nodes in each phase despite increasing case complexity. The learning curve of RPD is a staged advancement and is affected by surgeon experience, institutional expertise, mentorship, training structure, and outcome definitions. Technical competence emerges after 20-40 cases, but achieving consistently high-quality outcomes and procedural mastery demands substantially broader surgical experience. Implementation of RPD is safe within competency-based assessment frameworks and structured training pathways.
Indexed as
Identifiers
42828633What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.