Journal of Clinical Medicine
The Learning Curve in Robotic HPB Surgery: Myth, Metrics, and Misinterpretations
By Silvio Caringi, Antonella Delvecchio, Annachiara Casella and 7 others.
Abstract
Background
The evolution of robotic surgery has widened the indications for minimally invasive hepatopancreatobiliary (HPB) surgery, making possible the execution of more complicated cases. Within this context, the learning curve concept is now an essential factor when assessing surgical training and expertise, as well as patient safety within a robotic HPB program. Nevertheless, existing methodologies often make use of procedure volume and surrogate intraoperative measures, which may be an insufficient way to define surgical competence.
Methods
This narrative review examines the learning curve concept in robotic HPB surgery, focusing on existing performance metrics, methodological limitations, procedural complexity, risk adjustment, and the influence of team-related and institutional factors.