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Surgical Endoscopy
Published in: Surgical Endoscopy 2/2019

01-02-2019 | Review Article

A systematic review of the learning curve in robotic surgery: range and heterogeneity

Authors: I. Kassite, T. Bejan-Angoulvant, H. Lardy, A. Binet

Published in: Surgical Endoscopy | Issue 2/2019

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Abstract

Background

With the rapid adoption of the robotic surgery, more and more learning curve (LC) papers are being published but there is no set definition of what should constitute a rigorous analysis and represent a true LC. A systematic review of the robotic surgical literature was undertaken to determine the range and heterogeneity of parameters reported in studies assessing the LC in robotic surgery.

Methods

The search was conducted in July 2017 in PubMed. All studies reporting a LC in robotic surgery were included. 268 (25%) of the identified studies met the inclusion criteria.

Results

102 (38%) studies did not define nor explicitly state the LC with appropriate evidence; 166 studies were considered for quantitative analysis. 46 different parameters of 6 different outcome domains were reported with a median of two parameters (1–8) and 1 domain (1–5) per study. Overall, three domains were only technical and three domains were both technical and clinical/patient-centered outcomes. The two most commonly reported domains were operative time [146 studies (88%)] and intraoperative outcomes [31 studies (19%)]. Postoperative outcomes [16 studies (9%)] and surgical success [11 studies (7%)] were reported infrequently. Purely technical outcomes were the most frequently used to assess LC [131 studies (79%)].

Conclusions

The outcomes reported in studies assessing LC in robotic surgery are extremely heterogeneous and are most often technical indicators of surgical performance rather than clinical and patient-centered outcomes. There is no single outcome that best represents the surgical success. A standardized multi-outcome approach to assessing LC is recommended.
Appendix
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Literature
1.
Catchpole K, Perkins C, Bresee C, Solnik MJ, Sherman B, Fritch J et al (2016) Safety, efficiency and learning curves in robotic surgery: a human factors analysis. Surg Endosc 30(9):3749–3761CrossRefPubMed
2.
de la Fuente SG, Weber J, Hoffe SE, Shridhar R, Karl R, Meredith KL (2013) Initial experience from a large referral center with robotic-assisted Ivor Lewis esophagogastrectomy for oncologic purposes. Surg Endosc 27(9):3339–3347CrossRefPubMed
3.
4.
Alemozaffar M, Duclos A, Hevelone ND, Lipsitz SR, Borza T, Yu H-Y et al (2012) Technical refinement and learning curve for attenuating neurapraxia during robotic-assisted radical prostatectomy to improve sexual function. Eur Urol 61(6):1222–1228CrossRefPubMed
5.
Sharma NL, Papadopoulos A, Lee D, McLoughlin J, Vowler SL, Baumert H et al (2011) First 500 cases of robotic-assisted laparoscopic radical prostatectomy from a single UK centre: learning curves of two surgeons. BJU Int 108(5):739–747PubMed
6.
Dal Moro F, Secco S, Valotto C, Artibani W, Zattoni F (2012) Specific learning curve for port placement and docking of da Vinci(®) Surgical System: one surgeon’s experience in robotic-assisted radical prostatectomy. J Robot Surg 6(4):323–327CrossRefPubMed
7.
Gumus E, Boylu U, Turan T, Onol FF (2011) The learning curve of robot-assisted radical prostatectomy. J Endourol 25(10):1633–1637CrossRefPubMed
8.
Hashimoto T, Yoshioka K, Gondo T, Kamoda N, Satake N, Ozu C et al (2013) Learning curve and perioperative outcomes of robot-assisted radical prostatectomy in 200 initial Japanese cases by a single surgeon. J Endourol 27(10):1218–1223CrossRefPubMed
9.
Lebeau T, Rouprêt M, Ferhi K, Chartier-Kastler E, Bitker M-O, Richard F et al (2012) The role of a well-trained team on the early learning curve of robot-assisted laparoscopic procedures: the example of radical prostatectomy. Int J Med Robot Comput Assist Surg MRCAS 8(1):67–72CrossRef
10.
Ou Y-C, Yang C-R, Wang J, Yang C-K, Cheng C-L, Patel VR et al (2011) The learning curve for reducing complications of robotic-assisted laparoscopic radical prostatectomy by a single surgeon. BJU Int 108(3):420–425CrossRefPubMed
11.
Sammon J, Perry A, Beaule L, Kinkead T, Clark D, Hansen M (2010) Robot-assisted radical prostatectomy: learning rate analysis as an objective measure of the acquisition of surgical skill. BJU Int 106(6):855–860CrossRefPubMed
12.
Hong YM, Sutherland DE, Linder B, Engel JD (2010) “Learning curve” may not be enough: assessing the oncological experience curve for robotic radical prostatectomy. J Endourol 24(3):473–477CrossRefPubMed
13.
Doumerc N, Yuen C, Savdie R, Rahman MB, Pe Benito R, Stricker P (2010) Robot-assisted laparoscopic prostatectomy: analysis of an experienced open surgeon’s learning curve after 300 procedures. J Robot Surg 3(4):229–234CrossRefPubMed
14.
Doumerc N, Yuen C, Savdie R, Rahman MB, Rasiah KK, Pe Benito R et al (2010) Should experienced open prostatic surgeons convert to robotic surgery? The real learning curve for one surgeon over 3 years. BJU Int 106(3):378–384CrossRefPubMed
15.
Jaffe J, Castellucci S, Cathelineau X, Harmon J, Rozet F, Barret E et al (2009) Robot-assisted laparoscopic prostatectomy: a single-institutions learning curve. Urology 73(1):127–133CrossRefPubMed
16.
Mayer EK, Winkler MH, Aggarwal R, Karim O, Ogden C, Hrouda D et al (2006) Robotic prostatectomy: the first UK experience. Int J Med Robot Comput Assist Surg MRCAS 2(4):321–328CrossRef
17.
Samadi D, Levinson A, Hakimi A, Shabsigh R, Benson MC (2007) From proficiency to expert, when does the learning curve for robotic-assisted prostatectomies plateau? The Columbia University experience. World J Urol 25(1):105–110CrossRefPubMed
18.
Good DW, Stewart GD, Laird A, Stolzenburg J-U, Cahill D, McNeill SA (2015) A critical analysis of the learning curve and postlearning curve outcomes of two experience- and volume-matched surgeons for laparoscopic and robot-assisted radical prostatectomy. J Endourol 29(8):939–947CrossRefPubMed
19.
Sivaraman A, Sanchez-Salas R, Prapotnich D, Yu K, Olivier F, Secin FP et al (2017) Learning curve of minimally invasive radical prostatectomy: comprehensive evaluation and cumulative summation analysis of oncological outcomes. Urol Oncol 35(4):149.e1-149.e6CrossRefPubMed
20.
Thompson JE, Egger S, Böhm M, Haynes A-M, Matthews J, Rasiah K et al (2014) Superior quality of life and improved surgical margins are achievable with robotic radical prostatectomy after a long learning curve: a prospective single-surgeon study of 1552 consecutive cases. Eur Urol 65(3):521–531CrossRefPubMed
21.
Pierorazio PM, Patel HD, Feng T, Yohannan J, Hyams ES, Allaf ME (2011) Robotic-assisted versus traditional laparoscopic partial nephrectomy: comparison of outcomes and evaluation of learning curve. Urology 78(4):813–819CrossRefPubMedPubMedCentral
22.
Lavery HJ, Small AC, Samadi DB, Palese MA (2011) Transition from laparoscopic to robotic partial nephrectomy: the learning curve for an experienced laparoscopic surgeon. JSLS 15(3):291–297CrossRefPubMedPubMedCentral
23.
Haseebuddin M, Benway BM, Cabello JM, Bhayani SB (2010) Robot-assisted partial nephrectomy: evaluation of learning curve for an experienced renal surgeon. J Endourol 24(1):57–61CrossRefPubMed
24.
Xie Y, Ma X, Gu L, Li H, Lv X, Gao Y et al (2016) Associating the learning curve and tumor anatomical complexity with the margins, ischemia, and complications rate after robot-assisted partial nephrectomy. Int J Surg Lond Engl 36(Pt A):219–224CrossRef
25.
Dube H, Bahler CD, Sundaram CP (2015) The learning curve and factors affecting warm ischemia time during robot-assisted partial nephrectomy. Indian J Urol 31(3):223–228CrossRefPubMedPubMedCentral
26.
Hanzly M, Frederick A, Creighton T, Atwood K, Mehedint D, Kauffman EC et al (2015) Learning curves for robot-assisted and laparoscopic partial nephrectomy. J Endourol 29(3):297–303CrossRefPubMed
27.
Sorensen MD, Delostrinos C, Johnson MH, Grady RW, Lendvay TS (2011) Comparison of the learning curve and outcomes of robotic assisted pediatric pyeloplasty. J Urol 185(6 Suppl):2517–2522CrossRefPubMed
28.
29.
Cundy TP, Gattas NE, White AD, Najmaldin AS (2015) Learning curve evaluation using cumulative summation analysis-a clinical example of pediatric robot-assisted laparoscopic pyeloplasty. J Pediatr Surg 50(8):1368–1373CrossRefPubMed
30.
Kuo L-J, Lin Y-K, Chang C-C, Tai C-J, Chiou J-F, Chang Y-J (2014) Clinical outcomes of robot-assisted intersphincteric resection for low rectal cancer: comparison with conventional laparoscopy and multifactorial analysis of the learning curve for robotic surgery. Int J Colorectal Dis 29(5):555–562CrossRefPubMed
31.
Jiménez-Rodríguez RM, Díaz-Pavón JM, de la Portilla de Juan F, Prendes-Sillero E, Dussort HC, Padillo J (2013) Learning curve for robotic-assisted laparoscopic rectal cancer surgery. Int J Colorectal Dis 28(6):815–821CrossRefPubMed
32.
Sng KK, Hara M, Shin J-W, Yoo B-E, Yang K-S, Kim S-H (2013) The multiphasic learning curve for robot-assisted rectal surgery. Surg Endosc 27(9):3297–3307CrossRefPubMed
33.
Raimondi P, Marchegiani F, Cieri M, Cichella A, Cotellese R, Innocenti P (2018) Is right colectomy a complete learning procedure for a robotic surgical program? J Robot Surg 12(1):147–155CrossRefPubMed
34.
Parisi A, Scrucca L, Desiderio J, Gemini A, Guarino S, Ricci F et al (2017) Robotic right hemicolectomy: analysis of 108 consecutive procedures and multidimensional assessment of the learning curve. Surg Oncol 26(1):28–36CrossRefPubMed
35.
Odermatt M, Ahmed J, Panteleimonitis S, Khan J, Parvaiz A (2017) Prior experience in laparoscopic rectal surgery can minimise the learning curve for robotic rectal resections: a cumulative sum analysis. Surg Endosc 31(10):4067–4076CrossRefPubMed
36.
Guend H, Widmar M, Patel S, Nash GM, Paty PB, Guillem JG et al (2017) Developing a robotic colorectal cancer surgery program: understanding institutional and individual learning curves. Surg Endosc 31(7):2820–2828CrossRefPubMed
37.
Morelli L, Guadagni S, Lorenzoni V, Di Franco G, Cobuccio L, Palmeri M et al (2016) Robot-assisted versus laparoscopic rectal resection for cancer in a single surgeon’s experience: a cost analysis covering the initial 50 robotic cases with the da Vinci Si. Int J Colorectal Dis 31(9):1639–1648CrossRefPubMed
38.
Foo CC, Law WL (2016) The learning curve of robotic-assisted low rectal resection of a novice rectal surgeon. World J Surg 40(2):456–462CrossRefPubMed
39.
Park EJ, Kim CW, Cho MS, Kim DW, Min BS, Baik SH et al (2014) Is the learning curve of robotic low anterior resection shorter than laparoscopic low anterior resection for rectal cancer?: a comparative analysis of clinicopathologic outcomes between robotic and laparoscopic surgeries. Medicine (Baltimore) 93(25):e109CrossRef
40.
Melich G, Hong YK, Kim J, Hur H, Baik SH, Kim NK et al (2015) Simultaneous development of laparoscopy and robotics provides acceptable perioperative outcomes and shows robotics to have a faster learning curve and to be overall faster in rectal cancer surgery: analysis of novice MIS surgeon learning curves. Surg Endosc 29(3):558–568CrossRefPubMed
41.
Park EJ, Kim CW, Cho MS, Baik SH, Kim DW, Min BS et al (2014) Multidimensional analyses of the learning curve of robotic low anterior resection for rectal cancer: 3-phase learning process comparison. Surg Endosc 28(10):2821–2831CrossRefPubMed
42.
Bokhari MB, Patel CB, Ramos-Valadez DI, Ragupathi M, Haas EM (2011) Learning curve for robotic-assisted laparoscopic colorectal surgery. Surg Endosc 25(3):855–860CrossRefPubMed
43.
Yamaguchi T, Kinugasa Y, Shiomi A, Tomioka H, Kagawa H, Yamakawa Y (2016) Robotic-assisted vs. conventional laparoscopic surgery for rectal cancer: short-term outcomes at a single center. Surg Today 46(8):957–962CrossRefPubMed
44.
D’Annibale A, Pende V, Pernazza G, Monsellato I, Mazzocchi P, Lucandri G et al (2011) Full robotic gastrectomy with extended (D2) lymphadenectomy for gastric cancer: surgical technique and preliminary results. J Surg Res 166(2):e113–e120CrossRefPubMed
45.
Ayloo S, Fernandes E, Choudhury N (2014) Learning curve and robot set-up/operative times in singly docked totally robotic Roux-en-Y gastric bypass. Surg Endosc 28(5):1629–1633CrossRefPubMed
46.
Buchs NC, Pugin F, Bucher P, Hagen ME, Chassot G, Koutny-Fong P et al (2012) Learning curve for robot-assisted Roux-en-Y gastric bypass. Surg Endosc 26(4):1116–1121CrossRefPubMed
47.
Eom BW, Yoon HM, Ryu KW, Lee JH, Cho SJ, Lee JY et al (2012) Comparison of surgical performance and short-term clinical outcomes between laparoscopic and robotic surgery in distal gastric cancer. Eur J Surg Oncol 38(1):57–63CrossRefPubMed
48.
Hernandez JM, Dimou F, Weber J, Almhanna K, Hoffe S, Shridhar R et al (2013) Defining the learning curve for robotic-assisted esophagogastrectomy. J Gastrointest Surg 17(8):1346–1351CrossRefPubMed
49.
Kim H-I, Park MS, Song KJ, Woo Y, Hyung WJ (2014) Rapid and safe learning of robotic gastrectomy for gastric cancer: multidimensional analysis in a comparison with laparoscopic gastrectomy. Eur J Surg Oncol 40(10):1346–1354CrossRefPubMed
50.
Renaud M, Reibel N, Zarnegar R, Germain A, Quilliot D, Ayav A et al (2013) Multifactorial analysis of the learning curve for totally robotic Roux-en-Y gastric bypass for morbid obesity. Obes Surg 23(11):1753–1760CrossRefPubMed
51.
Vilallonga R, Fort JM, Gonzalez O, Caubet E, Boleko A, Neff KJ et al (2012) The initial learning curve for robot-assisted sleeve gastrectomy: a surgeon’s experience while introducing the robotic technology in a Bariatric Surgery Department. Minim Invasive Surg 2012:347131PubMedPubMedCentral
52.
Yang SY, Roh KH, Kim Y-N, Cho M, Lim SH, Son T et al (2017) Surgical outcomes after open, laparoscopic, and robotic gastrectomy for gastric cancer. Ann Surg Oncol 24(7):1770–1777CrossRefPubMed
53.
Shibasaki S, Suda K, Nakauchi M, Kikuchi K, Kadoya S, Ishida Y et al (2017) Robotic valvuloplastic esophagogastrostomy using double flap technique following proximal gastrectomy: technical aspects and short-term outcomes. Surg Endosc 31(10):4283–4297CrossRefPubMed
54.
Zhou J, Shi Y, Qian F, Tang B, Hao Y, Zhao Y et al (2015) Cumulative summation analysis of learning curve for robot-assisted gastrectomy in gastric cancer. J Surg Oncol 111(6):760–767CrossRefPubMed
55.
Galvani CA, Loebl H, Osuchukwu O, Samamé J, Apel ME, Ghaderi I (2016) Robotic-assisted paraesophageal hernia repair: initial experience at a single institution. J Laparoendosc Adv Surg Tech A 26(4):290–295CrossRefPubMed
56.
Sarkaria IS, Latif MJ, Bianco VJ, Bains MS, Rusch VW, Jones DR et al (2017) Early operative outcomes and learning curve of robotic assisted giant paraesophageal hernia repair. Int J Med Robot Comput Assist Surg MRCAS 13(1):e1730CrossRef
57.
Cundy TP, Rowland SP, Gattas NE, White AD, Najmaldin AS (2015) The learning curve of robot-assisted laparoscopic fundoplication in children: a prospective evaluation and CUSUM analysis. Int J Med Robot Comput Assist Surg MRCAS 11(2):141–149CrossRef
58.
Spinoglio G, Lenti LM, Maglione V, Lucido FS, Priora F, Bianchi PP et al (2012) Single-site robotic cholecystectomy (SSRC) versus single-incision laparoscopic cholecystectomy (SILC): comparison of learning curves. First European experience. Surg Endosc 26(6):1648–1655CrossRefPubMed
59.
D’Annibale A, Lucandri G, Monsellato I, De Angelis M, Pernazza G, Alfano G et al (2012) Robotic adrenalectomy: technical aspects, early results and learning curve. Int J Med Robot Comput Assist Surg MRCAS 8(4):483–490CrossRef
60.
Brunaud L, Ayav A, Zarnegar R, Rouers A, Klein M, Boissel P et al (2008) Prospective evaluation of 100 robotic-assisted unilateral adrenalectomies. Surgery 144(6):995–1001 (discussion 1001)CrossRefPubMed
61.
Vidovszky TJ, Smith W, Ghosh J, Ali MR (2006) Robotic cholecystectomy: learning curve, advantages, and limitations. J Surg Res 136(2):172–178CrossRefPubMed
62.
Efanov M, Alikhanov R, Tsvirkun V, Kazakov I, Melekhina O, Kim P et al (2017) Comparative analysis of learning curve in complex robot-assisted and laparoscopic liver resection. HPB 19(9):818–824CrossRefPubMed
63.
Chen P-D, Wu C-Y, Hu R-H, Chen C-N, Yuan R-H, Liang J-T et al (2017) Robotic major hepatectomy: is there a learning curve? Surgery 161(3):642–649CrossRefPubMed
64.
Napoli N, Kauffmann EF, Perrone VG, Miccoli M, Brozzetti S, Boggi U (2015) The learning curve in robotic distal pancreatectomy. Updat Surg 67(3):257–264CrossRef
65.
Kubat E, Hansen N, Nguyen H, Wren SM, Eisenberg D (2016) Urgent and elective robotic single-site cholecystectomy: analysis and learning curve of 150 consecutive cases. J Laparoendosc Adv Surg Tech A 26(3):185–191CrossRefPubMed
66.
Lee GS, Arghami A, Dy BM, McKenzie TJ, Thompson GB, Richards ML (2016) Robotic single-site adrenalectomy. Surg Endosc 30(8):3351–3356CrossRefPubMed
67.
Bibi S, Rahnemai-Azar AA, Coralic J, Bayoumi M, Khorsand J, Farkas DT et al (2015) Single-site robotic cholecystectomy: the timeline of progress. World J Surg 39(10):2386–2391CrossRefPubMed
68.
Benizri EI, Germain A, Ayav A, Bernard J-L, Zarnegar R, Benchimol D et al (2014) Short-term perioperative outcomes after robot-assisted and laparoscopic distal pancreatectomy. J Robot Surg 8(2):125–132CrossRefPubMed
69.
Pietrabissa A, Sbrana F, Morelli L, Badessi F, Pugliese L, Vinci A et al (2012) Overcoming the challenges of single-incision cholecystectomy with robotic single-site technology. Arch Surg (Chicago Ill 1960) 147(8):709–714CrossRef
70.
Lenihan JP, Kovanda C, Seshadri-Kreaden U (2008) What is the learning curve for robotic assisted gynecologic surgery? J Minim Invasive Gynecol 15(5):589–594CrossRefPubMed
71.
Lopez S, Mulla ZD, Hernandez L, Garza DM, Payne TN, Farnam RW (2016) A comparison of outcomes between robotic-assisted, single-site laparoscopy versus laparoendoscopic single site for benign hysterectomy. J Minim Invasive Gynecol 23(1):84–88CrossRefPubMed
72.
El Hachem L, Momeni M, Friedman K, Moshier EL, Chuang LT, Gretz HF (2016) Safety, feasibility and learning curve of robotic single-site surgery in gynecology. Int J Med Robot Comput Assist Surg MRCAS 12(3):509–516CrossRef
73.
Mäenpää M, Nieminen K, Tomás E, Luukkaala T, Mäenpää JU (2015) Implementing robotic surgery to gynecologic oncology: the first 300 operations performed at a tertiary hospital. Acta Obstet Gynecol Scand 94(5):482–488CrossRefPubMed
74.
Cela V, Freschi L, Simi G, Ruggiero M, Tana R, Pluchino N (2013) Robotic single-site hysterectomy: feasibility, learning curve and surgical outcome. Surg Endosc 27(7):2638–2643CrossRefPubMed
75.
Lim PC, Kang E, Park DH (2010) Learning curve and surgical outcome for robotic-assisted hysterectomy with lymphadenectomy: case-matched controlled comparison with laparoscopy and laparotomy for treatment of endometrial cancer. J Minim Invasive Gynecol 17(6):739–748CrossRefPubMed
76.
Lim PC, Kang E, Park DH (2011) A comparative detail analysis of the learning curve and surgical outcome for robotic hysterectomy with lymphadenectomy versus laparoscopic hysterectomy with lymphadenectomy in treatment of endometrial cancer: a case-matched controlled study of the first one hundred twenty two patients. Gynecol Oncol 120(3):413–418CrossRefPubMed
77.
Woelk JL, Casiano ER, Weaver AL, Gostout BS, Trabuco EC, Gebhart JB (2013) The learning curve of robotic hysterectomy. Obstet Gynecol 121(1):87–95CrossRefPubMed
78.
Yim GW, Kim SW, Nam EJ, Kim S, Kim YT (2013) Learning curve analysis of robot-assisted radical hysterectomy for cervical cancer: initial experience at a single institution. J Gynecol Oncol 24(4):303–312CrossRefPubMedPubMedCentral
79.
Lowe MP, Johnson PR, Kamelle SA, Kumar S, Chamberlain DH, Tillmanns TD (2009) A multiinstitutional experience with robotic-assisted hysterectomy with staging for endometrial cancer. Obstet Gynecol 114(2 Pt 1):236–243CrossRefPubMed
80.
Seamon LG, Cohn DE, Richardson DL, Valmadre S, Carlson MJ, Phillips GS et al (2008) Robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer. Obstet Gynecol 112(6):1207–1213CrossRefPubMed
81.
Seamon LG, Fowler JM, Richardson DL, Carlson MJ, Valmadre S, Phillips GS et al (2009) A detailed analysis of the learning curve: robotic hysterectomy and pelvic-aortic lymphadenectomy for endometrial cancer. Gynecol Oncol 114(2):162–167CrossRefPubMed
82.
Favre A, Huberlant S, Carbonnel M, Goetgheluck J, Revaux A, Ayoubi JM (2016) Pedagogic approach in the surgical learning: the first period of “assistant surgeon” may improve the learning curve for laparoscopic robotic-assisted hysterectomy. Front Surg 3:58CrossRefPubMedPubMedCentral
83.
Yaribakht S, Guillemin F, Harter V, Malartic C, Marchal F (2015) [New approach of learning curve for robotic-assisted gynecologic oncology surgery]. Gynecol Obstet Fertil 43(5):348–355CrossRefPubMed
84.
Akdemir A, Zeybek B, Ozgurel B, Oztekin MK, Sendag F (2015) Learning curve analysis of intracorporeal cuff suturing during robotic single-site total hysterectomy. J Minim Invasive Gynecol 22(3):384–389CrossRefPubMed
85.
Sharma S, Calixte R, Finamore PS (2016) Establishing the learning curve of robotic sacral colpopexy in a start-up robotics program. J Minim Invasive Gynecol 23(1):89–93CrossRefPubMed
86.
Linder BJ, Anand M, Weaver AL, Woelk JL, Klingele CJ, Trabuco EC et al (2016) Assessing the learning curve of robotic sacrocolpopexy. Int Urogynecol J 27(2):239–246CrossRefPubMed
87.
Geller EJ, Lin F-C, Matthews CA (2013) Analysis of robotic performance times to improve operative efficiency. J Minim Invasive Gynecol 20(1):43–48CrossRefPubMed
88.
Ciabatti PG, Burali G, D’Ascanio L (2012) Single-incision robot-assisted transaxillary surgery for early-stage papillary thyroid cancer. Ann Otol Rhinol Laryngol 121(12):811–815CrossRefPubMed
89.
Kandil EH, Noureldine SI, Yao L, Slakey DP (2012) Robotic transaxillary thyroidectomy: an examination of the first one hundred cases. J Am Coll Surg 214(4):558–564 (discussion 564–566)CrossRefPubMed
90.
Lee J, Yun JH, Choi UJ, Kang S-W, Jeong JJ, Chung WY (2012) Robotic versus endoscopic thyroidectomy for thyroid cancers: a multi-institutional analysis of early postoperative outcomes and surgical learning curves. J Oncol 2012:734541PubMedPubMedCentral
91.
Kim WW, Jung JH, Park HY (2015) A single surgeon’s experience and surgical outcomes of 300 robotic thyroid surgeries using a bilateral axillo-breast approach. J Surg Oncol 111(2):135–140CrossRefPubMed
92.
Park JH, Lee J, Hakim NA, Kim HY, Kang S-W, Jeong JJ et al (2015) Robotic thyroidectomy learning curve for beginning surgeons with little or no experience of endoscopic surgery. Head Neck 37(12):1705–1711CrossRefPubMed
93.
Albergotti WG, Gooding WE, Kubik MW, Geltzeiler M, Kim S, Duvvuri U et al (2017) Assessment of surgical learning curves in transoral robotic surgery for squamous cell carcinoma of the oropharynx. JAMA Otolaryngol—Head Neck Surg 143(6):542–548CrossRefPubMedPubMedCentral
94.
Hu X, Lieberman IH (2014) What is the learning curve for robotic-assisted pedicle screw placement in spine surgery? Clin Orthop 472(6):1839–1844CrossRefPubMed
95.
Schatlo B, Martinez R, Alaid A, von Eckardstein K, Akhavan-Sigari R, Hahn A et al (2015) Unskilled unawareness and the learning curve in robotic spine surgery. Acta Neurochir 157(10):1819–1823 (discussion 1823)CrossRefPubMed
96.
Novotný T, Dvorák M, Staffa R (2011) The learning curve of robot-assisted laparoscopic aortofemoral bypass grafting for aortoiliac occlusive disease. J Vasc Surg 53(2):414–420CrossRefPubMed
97.
Hemli JM, Henn LW, Panetta CR, Suh JS, Shukri SR, Jennings JM et al (2013) Defining the learning curve for robotic-assisted endoscopic harvesting of the left internal mammary artery. Innov Phila Pa 8(5):353–358
98.
Sudan R, Bennett KM, Jacobs DO, Sudan DL (2012) Multifactorial analysis of the learning curve for robot-assisted laparoscopic biliopancreatic diversion with duodenal switch. Ann Surg 255(5):940–945CrossRefPubMed
99.
Paulucci DJ, Abaza R, Eun DD, Hemal AK, Badani KK (2017) Robot-assisted partial nephrectomy: continued refinement of outcomes beyond the initial learning curve. BJU Int 119(5):748–754CrossRefPubMed
100.
101.
Al-Hathal N, El-Hakim A (2013) Perioperative, oncological and functional outcomes of the first robotic prostatectomy program in Quebec: single fellowship-trained surgeon’s experience of 250 cases. Can Urol Assoc J 7(9–10):326–332CrossRefPubMedPubMedCentral
102.
Philippou P, Waine E, Rowe E (2012) Robot-assisted laparoscopic prostatectomy versus open: comparison of the learning curve of a single surgeon. J Endourol 26(8):1002–1008CrossRefPubMed
103.
Wagenhoffer R, Gruner M, Schymik J, Schachtner L, Neagoe L, Berg C et al (2015) Switching from endoscopic extraperitoneal radical prostatectomy to robot-assisted laparoscopic prostatectomy: comparing outcomes and complications. Urol Int 95(4):380–385CrossRefPubMed
104.
Schreuder HWR, Wolswijk R, Zweemer RP, Schijven MP, Verheijen RHM (2012) Training and learning robotic surgery, time for a more structured approach: a systematic review. BJOG Int J Obstet Gynaecol 119(2):137–149CrossRef
105.
Yao A, Iwamoto H, Masago T, Morizane S, Honda M, Sejima T et al (2015) Anatomical dimensions using preoperative magnetic resonance imaging: impact on the learning curve of robot-assisted laparoscopic prostatectomy. Int J Urol 22(1):74–79CrossRefPubMed
106.
Park S-S, Kim M-C, Park MS, Hyung WJ (2012) Rapid adaptation of robotic gastrectomy for gastric cancer by experienced laparoscopic surgeons. Surg Endosc 26(1):60–67CrossRefPubMed
107.
Bareeq RA, Jayaraman S, Kiaii B, Schlachta C, Denstedt JD, Pautler SE (2008) The role of surgical simulation and the learning curve in robot-assisted surgery. J Robot Surg 2(1):11–15CrossRefPubMed
108.
Dindo D, Demartines N, Clavien P-A (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRefPubMedPubMedCentral
109.
Macdonald AL, Haddad M, Clarke SA (2016) Learning curves in pediatric minimally invasive surgery: a systematic review of the literature and a framework for reporting. J Laparoendosc Adv Surg Tech A 26(8):652–659CrossRefPubMed
110.
Cook JA, Ramsay CR, Fayers P (2007) Using the literature to quantify the learning curve: a case study. Int J Technol Assess Health Care 23(2):255–260CrossRefPubMed
111.
Xu R, Carty MJ, Orgill DP, Lipsitz SR, Duclos A (2013) The teaming curve: a longitudinal study of the influence of surgical team familiarity on operative time. Ann Surg 258(6):953–957CrossRefPubMed
112.
Harrysson IJ, Cook J, Sirimanna P, Feldman LS, Darzi A, Aggarwal R (2014) Systematic review of learning curves for minimally invasive abdominal surgery: a review of the methodology of data collection, depiction of outcomes, and statistical analysis. Ann Surg 260(1):37–45CrossRefPubMed
113.
Noyez L (2013) Cumulative sum analysis: a simple and practical tool for monitoring and auditing clinical performance. Health Care Curr Rev 2(1):1–3
114.
Metadata
Title
A systematic review of the learning curve in robotic surgery: range and heterogeneity
Authors
I. Kassite
T. Bejan-Angoulvant
H. Lardy
A. Binet
Publication date
01-02-2019
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 2/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-018-6473-9

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