ArticleInternational journal of colorectal disease2023
Assessing the learning curve of robot-assisted total mesorectal excision: a multicenter study considering procedural safety, pathological safety, and efficiency.
Article in International journal of colorectal disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- EAES, ESCP, and ESGAR clinical practice guideline update on taTME for rectal cancer.Surgical endoscopy · 2026Guideline
- Robotic Beyond Total Mesorectal Excision (bTME) for locally advanced and recurrent anorectal cancer: a systematic review.Journal of robotic surgery · 2025Pooled it
- Multidimensional institutional learning curve of ultrasound-guided percutaneous transthoracic lung biopsy: a cumulative sum analysis with case-mix assessment.Quantitative imaging in medicine and surgery · 2026Article
- Structured robotic colorectal training in a non-tertiary NHS hospital: a 502-case consecutive cohort implementation study.Journal of robotic surgery · 2026Article
- Learning curve for robot-assisted rectal resection using the hinotori™ surgical robot system: a risk-adjusted cumulative sum analysis in a surgical team without prior robotic surgery experience.Journal of robotic surgery · 2026Article
- Learning curves and outcomes of robotic colorectal surgery: A single-surgeon experience within a structured dual-console training program.Journal of robotic surgery · 2026Article
- Surgeon- and procedure-specific variability in operative-time learning curves during parallel implementation of robotic colorectal surgery.Frontiers in oncology · 2026Article
- Article
- Comment on "Robotic beyond total mesorectal excision (bTME) for locally advanced and recurrent anorectal cancer: a systematic review".Journal of robotic surgery · 2025Article
- Assessing the learning curve in robot-assisted intracorporeal colorectal anastomosis and transrectal extraction (NICE) procedure: from Initial Learning to Mastery.Journal of robotic surgery · 2025Article
- Global trends and hotspots in the learning curves of robotic-assisted surgery: a bibliometric and visualization analysis.Journal of robotic surgery · 2025Review
- Article
- Article
- Article
- Total Mesorectal Excision with New Robotic Platforms: A Scoping Review.Journal of clinical medicine · 2024Article
- Outcomes of robotic surgery for inflammatory bowel disease using the Medtronic Hugo™ Robotic-Assisted Surgical platform: a single center experience.International journal of colorectal disease · 2024Article
- Learning Curve for Robotic Colorectal Surgery.Cancers · 2024Review
- An Institutional Shift from Routine to Selective Diversion of Low Anastomosis in Robotic TME Surgery for Rectal Cancer Patients Using the KHANS Technique: A Single-Centre Cohort Study.Journal of personalized medicine · 2024Article
- [Robotic rectal surgery].Chirurgie (Heidelberg, Germany) · 2024Review
- Long-Term Outcomes of Robotic Versus Laparoscopic Total Mesorectal Excisions: A Propensity-Score Matched Cohort study of 5-year survival outcomes.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeEvidence regarding the learning curve of robot-assisted total mesorectal excision is scarce and of low quality. Case-mix is mostly not taken into account, and learning curves are based on operative time, while preferably clinical outcomes and literature-based limits should be used. Therefore, this study aims to assess the learning curve of robot-assisted total mesorectal excision.
methodsA retrospective study was performed in four Dutch centers. The primary aim was to assess the safety of the individual and institutional learning curves using a RA-CUSUM analysis based on intraoperative complications, major postoperative complications, and compound pathological outcome (positive circumferential margin or incomplete TME specimen). The learning curve for efficiency was assessed using a LC-CUSUM analysis for operative time. Outcomes of patients before and after the learning curve were compared.
resultsIn this study, seven participating surgeons performed robot-assisted total mesorectal excisions in 531 patients. Learning curves for intraoperative complications, postoperative complications, and compound pathological outcome did not exceed predefined literature-based limits. The LC-CUSUM for operative time showed lengths of the learning curve ranging from 12 to 35 cases. Intraoperative, postoperative, and pathological outcomes did not differ between patients operated during and after the learning curve.
conclusionThe learning curve of robot-assisted total mesorectal excision based on intraoperative complications, postoperative complications, and compound pathological outcome did not exceed predefined limits and is therefore suggested to be safe. Using operative time as a surrogate for efficiency, the learning curve is estimated to be between 12 and 35 procedures.
Indexed as
Identifiers
What OpenQuestion 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 OpenQuestion graph.