Evidence map›Paper›PMID 41430462›Full record

ArticleSurgical endoscopy2026

Defining the learning period for individual steps in robotic pancreatoduodenectomy and factors associated with operative time: analysis of initial 73 cases.

Koichi Tomita, Michael P Kim, Laura R Prakash, Jessica E Maxwell, Rebecca A Snyder, Hop S Tran Cao, Ching-Wei D Tzeng, Jeffrey E Lee, Matthew H G Katz, Naruhiko Ikoma

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Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Koichi TomitaDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.ORCID 0000-0003-2484-6548
Michael P KimDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Laura R PrakashDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Jessica E MaxwellDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Rebecca A SnyderDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Hop S Tran CaoDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Ching-Wei D TzengDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Jeffrey E LeeDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Matthew H G KatzDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
Naruhiko IkomaDepartment of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA. nikoma@mdanderson.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRobotic pancreatoduodenectomy (RPD) is a complex operation consisting of multiple surgical steps and requires significant experience to achieve efficiency. However, no studies have specifically examined the learning curve for individual steps of RPD. Therefore, we investigated the learning curve for each step of RPD in detail. The factors affecting the total operative time in RPD were also evaluated.

methodsData from the initial consecutive RPD cases at our institution were analyzed. Cumulative sum (CUSUM) analysis was used for total and step-specific operative time (6 resection steps and 3 reconstruction steps). Factors associated with total operative time were identified by multivariable linear regression analysis.

resultsAmong 73 cases, the mean total operative time decreased from 539 min for the first 20 cases to 445 min for cases 61 to 73. Almost all individual steps exhibited consistent reductions in duration over time, with hepaticojejunostomy exhibiting the largest decrease (-47%; -19 min). CUSUM analysis demonstrated that 31 cases were required to gain RPD efficiency, with pancreaticojejunostomy requiring the most cases among the individual steps (n = 53). In multivariable analysis, male patients with body mass index ≥ 30 kg/m

conclusionTotal and step-specific operative times improved consistently, with variations in the number of cases required to gain efficiency for each step. These findings can inform the development of a more effective RPD learning program that focuses on each surgical step.

Indexed as

Learning CurveOperative TimePancreaticoduodenectomyRobotic Surgical ProceduresAdultAgedFemaleHumansMaleMiddle AgedPancreatic NeoplasmsRetrospective StudiesCumulative sum (CUSUM) analysisLearning curveOperative timePhase- or step-specific analysisRobotic pancreatoduodenectomy (RPD)

Identifiers

PMID41430462

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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.