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The following is a summary of “Competency, Proficiency, and Mastery Learning Curves for Robotic Distal Pancreatectomy at 16 International Expert Centers,” published in the November 2024 issue of Surgery by Müller et al.
Robotic distal pancreatectomy (RDP) is a minimally invasive surgery with limited data on its safe implementation and learning curve across expert centers globally.
Researchers conducted a retrospective study to assess the learning curve for RDP across 16 international expert centers.
They analyzed data from 1109 of 2403 consecutive patients undergoing elective RDP, 3 cutoffs were used to define competency (operative time), proficiency (major complications, Clavien-Dindo grade ≥III), and mastery (textbook outcomes), with comparisons before and after each phase.
The results showed competency, proficiency, and mastery were reached after 46, 63, and 73 procedures, respectively. After achieving competency, operative time decreased from 245 to 235 minutes (P=0.002). Proficiency was associated with a reduction in major complications from 20% to 15% (P=0.012), and mastery led to an increase in the rate of textbook outcomes from 63% to 71% (P=0.028). The postoperative pancreatic fistula rate remained stable, ranging between 18.5% and 21.5%. Previous laparoscopic experience accelerated the learning process by reducing operative time and decreasing major complications earlier.
They concluded that competency, proficiency, and mastery for RDP were reached after 46, 63, and 73 procedures, respectively, and extensive experience is required to master RDP.
