ArticleBMC surgery2026
Learning curve for the abdominal procedure in total robot-assisted minimally invasive esophagectomy with simultaneous cervical approach: an initial experience.
Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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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.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- The learning curve of robotic esophagectomy: a systematic review with a proposed training and competency assessment framework.Frontiers in oncology · 2026Pooled it
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Authors and funding
19 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundRobot-assisted minimally invasive esophagectomy (RAMIE) is increasingly being implemented; however, the feasibility and learning process of total RAMIE using robotic approaches for thoracic and abdominal phases remain to be fully evaluated, particularly with a dual-docking technique enabling simultaneous cervical and abdominal approaches.
methodsWe retrospectively analyzed 50 consecutive patients who underwent total RAMIE with retrosternal gastric conduit reconstruction and cervical anastomosis at a single institution between September 2024 and August 2025. Cumulative sum (CUSUM) analysis of abdominal operative time was used to assess the learning curve. Perioperative outcomes were compared between the phases.
resultsCUSUM analysis identified three phases: phases I (patients 1-6, learning phase), II (7-18, competence phase), and III (19-50, proficiency phase). Median abdominal operative time decreased from 139 min (124-154) in phase I to 104 min (80-137) and 87 min (66-146) in phases II and III, respectively (P < 0.001). Initially, this procedure was applied to cStage I patients without abdominal nodal involvement, and was gradually expanded to advanced disease. The number of harvested abdominal lymph nodes was 15 (6-27) in phases I and II and 17 (6-26) in phase III. Postoperative complications (Clavien-Dindo grade ≥ 2) occurred in 14% of patients, with no abdominal procedure-related morbidity observed.
conclusionsProcedural proficiency for the abdominal operative procedure was achieved in approximately 18 patients, after which operative efficiency improved without compromising oncologic thoroughness or patient safety. Total RAMIE with a two-team approach can be safely implemented in centers with experience.
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