ArticleSurgical endoscopy2026
MyIntuitive telemetry identifies proficiency thresholds in robotic pancreaticoduodenectomy.
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 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 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
- Reply to: Surgical scene understanding and the emerging challenge of independent validation in an industry-led AI ecosystem.NPJ digital medicine · 2026Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundQuantifying learning in robotic pancreaticoduodenectomy (RPD) can be challenging because case selection and conversions complicate the interpretation of full-procedure metrics. MyIntuitive intraoperative telemetry provides objective, process-level signals that may help to capture proficiency gains.
methodsWe analysed 100 consecutive RPD attempts by a single surgeon (January 2022-August 2025). The primary outcome was Full-Case idle time from MyIntuitive telemetry among completed robotic cases. Key secondary telemetry outcomes included console time, active time, arm-specific activity, and instrument exchanges. As secondary corroboration on an intention-to-treat (ITT) basis, the probability of robotic completion (no conversion) was modelled across case order with risk-adjusted (RA)-CUSUM and spline logistic regression; conversions were characterised by timing and reason on video review.
resultsTelemetry demonstrated marked efficiency gains across the curve. Idle time fell from 42 to 32 min (P = 0.001), console time from 470 to 395 min (P < 0.001), and active time from 428 to 365 min (P < 0.001) between the initial (cases 1-60) and proficiency (> 60) phases; Arm-4 active time decreased from 40 to 17 min (P = 0.027). The RA-CUSUM of idle time showed a proficiency inflection near cases 50-60. Supportive resection-phase telemetry showed shorter time to complete mesopancreas dissection (from 323 to 215 min, P = 0.002). On ITT analysis, conversion occurred in 17% overall, declining from 23.3 to 7.5% after case 60 (P = 0.033); no emergency conversions occurred. Perioperative outcomes included POPF 29%, postpancreatectomy haemorrhage 8%, ≥ Clavien-Dindo III 22%, reoperation 9%, 90-day readmission 9%, 90-day mortality 2%, and median length of stay 16 days.
conclusionA telemetry-based primary endpoint (MyIntuitive idle time) sensitively tracks the RPD learning curve and, with risk-adjusted CUSUM, identifies a proficiency threshold around ~ 60 cases. Secondary ITT completion trends and conversion mapping corroborate the telemetry signal. This telemetry-first framework provides objective, phase-specific insight to guide coaching and programme maturation in complex robotic pancreatic surgery.
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