ArticleSurgical endoscopy2023
Initial 50 consecutive full-robotic pancreatoduodenectomies without conversion by a single surgeon: a learning curve analysis from a tertiary referral high-volume center.
Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The learning curve of robotic pancreatoduodenectomy: a systematic review of learning curve assessment methodologies, proficiency thresholds, training pathways and clinical outcomes.Journal of robotic surgery · 2026Pooled it
- Conversion to open surgery during robotic pancreatoduodenectomy in surgical high-risk groups: patterns, risk factors, and outcomes in elderly and/or obese patients.Surgical endoscopy · 2026Observational
- Enhancing the Workflow of Full Robotic Pancreatoduodenectomy: A Counterclockwise Step-by-Step Approach to Resection and Reconstruction.Annals of surgical oncology · 2026Article
- Robotic pancreaticoduodenectomy: a structured narrative review of learning curve, patient selection, and program readiness.Journal of robotic surgery · 2026Review
- Single-institution experience of 500 consecutive pancreatoduodenectomies: case-matched outcomes of the da Vinci Xi robotic versus open procedures.Surgical endoscopy · 2026Article
- Barbed sutures for hepaticojejunostomy in robotic pancreatoduodenectomy: a case-matched analysis.Surgical endoscopy · 2026Article
- Safety and learning curve analysis of robotic-assisted pancreaticoduodenectomy: experience of a single surgeon.Journal of robotic surgery · 2024Article
- Robotic Hepatectomy plus Biliary Reconstruction for Bismuth Type III and Type IV Hilar Cholangiocarcinoma: State of the Art and Literature Review.Journal of personalized medicine · 2023Review
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral studies report on a learning curve for robotic pancreatoduodenectomy (R-PD) ranging between 20 and 80 operations, with conversion rates varying between 1.1 and 35%. However, as these publications mostly refer to initial robotic experiences and do not take into account the previous surgical background in pancreatic surgery (PS) and in robotic-assisted surgery (RAS), the center's volume, as well as the platform used, we aimed to perform a surgical outcomes analysis with a particular view to these aspects.
methodsIntraoperative and perioperative outcomes of the first 50 consecutive R-PD performed with the da Vinci Xi by the same surgeon, within a tertiary referral high-volume center, between January 2018 and March 2022, were analyzed. The surgeon was previously experienced in both PS and RAS. Shewhart control chart and cumulative sum (CUSUM) analysis were used to evaluate the learning curve of R-PD.
resultsAll the operations were performed with a full-robotic technique, without any conversion to open surgery. Twenty of 50 patients (40%) had a BMI ≥ 25 kg/m
conclusionsAn extensive prior experience in both PS and RAS, within a tertiary referral high-volume center with availability of the da Vinci Xi platform, can significantly flatten the learning curve and, therefore, enable safe performance of challenging operations, i.e., pancreatoduodenectomies with a minimally invasive approach, with very low risk of conversion to open surgery, even in the first 50 operations.
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