ArticleJournal of robotic surgery2026
Beware of the plateau trap: a multidimensional analysis redefining the learning curve of robotic lobectomy in non-small cell lung cancer.
Article in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
Current definitions of the learning curve for robotic lobectomy are derived from small cohorts and lack standardized criteria for proficiency. Whether these series can accurately distinguish true surgical mastery from improved operative efficiency remains uncertain.We analyzed 300 consecutive patients with non-small cell lung cancer who underwent robotic portal lobectomy with four arms (RPL-4) between June 2018 and July 2023, using a prospectively maintained database. Learning phases were determined using cumulative sum and multivariable analyses. Perioperative outcomes were compared across phases. Three phases were identified: learning (cases 1-81), plateau (82-137), and mastery (> 137). Median console time declined significantly across phases (88.0 vs. 69.0 vs. 66.0 min, P < 0.001). Median blood loss also decreased (50.0 vs. 50.0 vs. 40.0 mL, P < 0.001). Despite improved efficiency, postoperative complication rates remained elevated during the plateau phase (10.7%), primarily due to Clavien-Dindo Grade II events (8.9%), before decreasing to 3.1% in the mastery phase (P = 0.016). Furthermore, sustained reductions in chest tube duration and length of stay were observed only after > 137 cases. RPL-4 demonstrates a prolonged 3-phase learning curve with a deceptive plateau. During this phase, gains in efficiency obscure persistently high postoperative complication rates, leading to underestimation of the true learning process. Training benchmarks should prioritize comprehensive surgical quality rather than operative speed alone.
Indexed as
Identifiers
42322386What 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.