Global Outcomes and Learning Curve for Clinical Outcomes and Proficiency of Robotic Pancreatoduodenectomy

The Feasibility, Proficiency, and Mastery Learning Curves in 635 Robotic Pancreatoduodenectomies Following a Multicenter Training Program

“…Thus, the cutoff of 15 RPDs in the present study is considerably earlier, including the cutoff of 22 RPDs in centers without LPD experience. Second, a systematic review found a proficiency learning curve (ie, risk-adjusted major complications decreased by 46%, of which POPF decreased by 48%) cutoff of 100 RPDs 17,36,40 . Again, the cutoff of 62 RPD in this present study is considerably earlier and showed no negative impact on outcome in patients who were included before the learning curve cutoff.…”

“…Second, a systematic review found a proficiency learning curve (ie, riskadjusted major complications decreased by 46%, of which POPF decreased by 48%) cutoff of 100 RPDs. 17,36,40 Again, the cutoff of 62 RPD in this present study is considerably earlier and showed no negative impact on outcome in patients who were included before the learning curve cutoff. Third, this is the first multicenter study to report a CUSUM analysis learning curve for the mastery learning curve (ie, textbook outcome).…”

“…Previous studies have reported on the feasibility 2,11,37–44 , proficiency 7,11,36 , and mastery 7,36 learning curves of RPD. For the feasibility learning curve (ie, operative time), a meta-analysis reported an average cutoff of 25 RPD 17 .…”

“…RA-CUSUM analysis assessed the proficiency learning curve (major complications) and mastery learning curve (textbook outcome). For risk-adjusting, a regression analysis was performed with variables identified from the I-MIPS RPD cohort (age, BMI, American Society of Anesthesiologists; center), 36 pancreatic anastomosis classification, and pancreatoduodenectomy difficulty score.…”