ArticleInternational journal of surgery (London, England)2025
Evaluating the learning curve for flexible ureteroscopic thulium fiber laser lithotripsy using CUSUM analysis.
Article in International journal of surgery (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Robot-assisted total hip arthroplasty (THA) was associated with a shorter learning curve, greater implant accuracy, and reduced team stress than conventional THA when performed by a junior surgeon: a comparative study.Journal of robotic surgery · 2026Article
- A novel robot-assisted flexible ureteroscope system(RAFUS): design, learning curve, ergonomics, and preclinical feasibility.Journal of robotic surgery · 2026Article
- The Comprehensive Complication Index for Assessing Short-Term Complications of Urothelial Carcinoma with Variant Histology: A Patient-Based Study.Annals of surgical oncology · 2026Article
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8 authors.
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Abstract
objectivesEffective training methods and learning curve (LC) assessment are crucial for more difficult endoscopic procedures. The present study sought to assess the LC of flexible ureteroscopes (fURS) for thulium fiber laser (TFL) lithotripsy and determine the effectiveness of using a porcine kidney model in training modality, to inform future training.
methodsPostgraduate medical students without experience in ureteroscopy were recruited, and surgical data were collected from 10 consecutive flexible ureteroscopic lithotripsy (fURL) procedures performed on our homemade porcine kidney training model. Cumulative sum (CUSUM) analysis and pooled mean CUSUM curves were applied to determine the LC turning points (TPs), and pre-LC and post-LC data were compared with that of an experienced attending physician.
resultsData from 110 surgeries were included in the analysis. The mean number of surgical units to overcome the LC for the duration of fURS TFL lithotripsy was 4. The operation time, number of tissue damage, and number of central visual shifts were significantly lower in students after the TP than before. No statistically significant difference in operation time was found between the students after the LC (817.50 [703.75-964.75]) and the surgeon group (732.50 [51.00-822.25]).
conclusionOvercoming the LC of fURS TFL lithotripsy requires four surgeries, and the developed ex vivo porcine kidney is a conveniently accessible and effective clinical training model.
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