Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Feb;33(2):353-365.
doi: 10.1007/s00464-018-6473-9. Epub 2018 Sep 28.

A systematic review of the learning curve in robotic surgery: range and heterogeneity

I Kassite  1   2 , T Bejan-Angoulvant  3 , H Lardy  4 , A Binet  4
Affiliations

A systematic review of the learning curve in robotic surgery: range and heterogeneity

I Kassite et al. Surg Endosc. 2019 Feb.

Abstract

Background: With the rapid adoption of the robotic surgery, more and more learning curve (LC) papers are being published but there is no set definition of what should constitute a rigorous analysis and represent a true LC. A systematic review of the robotic surgical literature was undertaken to determine the range and heterogeneity of parameters reported in studies assessing the LC in robotic surgery.

Methods: The search was conducted in July 2017 in PubMed. All studies reporting a LC in robotic surgery were included. 268 (25%) of the identified studies met the inclusion criteria.

Results: 102 (38%) studies did not define nor explicitly state the LC with appropriate evidence; 166 studies were considered for quantitative analysis. 46 different parameters of 6 different outcome domains were reported with a median of two parameters (1-8) and 1 domain (1-5) per study. Overall, three domains were only technical and three domains were both technical and clinical/patient-centered outcomes. The two most commonly reported domains were operative time [146 studies (88%)] and intraoperative outcomes [31 studies (19%)]. Postoperative outcomes [16 studies (9%)] and surgical success [11 studies (7%)] were reported infrequently. Purely technical outcomes were the most frequently used to assess LC [131 studies (79%)].

Conclusions: The outcomes reported in studies assessing LC in robotic surgery are extremely heterogeneous and are most often technical indicators of surgical performance rather than clinical and patient-centered outcomes. There is no single outcome that best represents the surgical success. A standardized multi-outcome approach to assessing LC is recommended.

Keywords: Learning curve; Proficiency; Robotic surgery; Surgical outcomes.

PubMed Disclaimer

References

    1. Catchpole K, Perkins C, Bresee C, Solnik MJ, Sherman B, Fritch J et al (2016) Safety, efficiency and learning curves in robotic surgery: a human factors analysis. Surg Endosc 30(9):3749–3761 - DOI - PubMed
    1. de la Fuente SG, Weber J, Hoffe SE, Shridhar R, Karl R, Meredith KL (2013) Initial experience from a large referral center with robotic-assisted Ivor Lewis esophagogastrectomy for oncologic purposes. Surg Endosc 27(9):3339–3347 - DOI - PubMed
    1. Kaul S, Shah NL, Menon M (2006) Learning curve using robotic surgery. Curr Urol Rep 7(2):125–129 - DOI - PubMed
    1. Alemozaffar M, Duclos A, Hevelone ND, Lipsitz SR, Borza T, Yu H-Y et al (2012) Technical refinement and learning curve for attenuating neurapraxia during robotic-assisted radical prostatectomy to improve sexual function. Eur Urol 61(6):1222–1228 - DOI - PubMed
    1. Sharma NL, Papadopoulos A, Lee D, McLoughlin J, Vowler SL, Baumert H et al (2011) First 500 cases of robotic-assisted laparoscopic radical prostatectomy from a single UK centre: learning curves of two surgeons. BJU Int 108(5):739–747 - PubMed

Publication types

LinkOut - more resources