Evidence map›Paper›PMID 42324436›Full record

ArticleJournal of robotic surgery2026

Robotic cholecystectomy during surgical training: learning curve and perioperative outcomes of 441 consecutive cases in a high-volume teaching center.

Gianpiero Gravante, Maria Teresa Mita, Amedeo Altamura, Vittoria Barbieri, Gianfranco Bianco, Sara Benedicenti, Alberto Catamerò, Lavinia Clemente, Gloria Giaracuni, Giorgia Grillea and 7 more

Abstract read
In one paragraph

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. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–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

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. 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

17 authors.

Gianpiero GravanteDepartment of General Surgery, Azienda Sanitaria Locale ASL Lecce, Casarano, Italy.
Maria Teresa MitaDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.
Amedeo AltamuraDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.
Vittoria BarbieriDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.
Gianfranco BiancoDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.
Sara BenedicentiDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.
Alberto CatameròUniversità Campus Bio-Medico di Roma, Roma, Italy.
Lavinia ClementeUniversità degli studi di Bari Aldo Moro, Bari, Italy.
Gloria GiaracuniDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.
Giorgia GrilleaDepartment of General Surgery, Azienda Sanitaria Locale ASL Lecce, Scorrano, Italy.
Barbara LeoneDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.
Giulia MorelliDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.
Arcangelo PicciarielloDepartment of Experimental Medicine, University of Salento, Lecce, Italy. arcangelo.picciariello@unisalento.it.
Giuliana PuglisiDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.
Roberto SorgeDepartment of Human Physiology, Laboratory of Biometry, University of Tor Vergata, Rome, Italy.
Francesco RubichiDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.
Massimo Giuseppe ViolaDepartment of General, Robotic and Oncologic Surgery, G. Panico Hospital, Tricase, Lecce, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Robotic cholecystectomy (RC) has been increasingly adopted in general surgery; however, evidence on its role and performance within structured training programs remains limited. This study aimed to evaluate the learning curve and perioperative outcomes of RC in a high-volume teaching center. A single-center retrospective study was conducted in a high-volume teaching hospital including all consecutive RCs performed between October 2019 and April 2025 by surgeons and trainees without prior robotic experience. All procedures were carried out within a structured training program under senior supervision. The primary outcome was the learning curve, assessed using cumulative sum (CUSUM) analysis of operative time. Secondary outcomes included perioperative results and subgroup analyses according to operator type and patient-related factors. Multivariable regression analysis was performed to identify factors influencing operative time. A total of 441 patients were included. Mean operative time was 64 ± 21 min. No intraoperative injuries or conversions to open or laparoscopic surgery occurred. Postoperative complications were observed in 6 patients (1.4%), with a readmission rate of 0.9%. CUSUM analysis identified four phases: an initial variability phase (1-13 cases), a stabilization phase (14-30), a performance improvement phase (30-50), and a late plateau. Operative time was independently associated with adhesiolysis (B = 9.382; p < 0.001) and male sex (B = 7.139; p < 0.001), whereas operator type was not significant. Outcomes were consistent across subgroups, including obesity and ASA class. Comparable learning patterns were observed between surgeons and trainees. In high volume training centers, RC can be safely implemented within surgical training programs, showing a relatively short learning curve and low complication rates. These findings support its use as a reproducible platform for robotic training and suggest its suitability as an entry-level procedure in robotic surgery.

Indexed as

CholecystectomyLearning CurveRobotic Surgical ProceduresSurgeonsAdultAgedCholecystectomy, LaparoscopicClinical CompetenceFemaleHospitals, High-VolumeHospitals, TeachingHumansMaleMiddle AgedOperative TimePostoperative ComplicationsGallbladder diseaseLaparoscopic cholecystectomyLearning curveMinimally invasive surgeryPerioperative outcomesRobotic surgeryRobotic training programSurgical education

Identifiers

PMID42324436
PMCPMC13284018

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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.