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Phase-specific learning curves in robot-assisted rectal surgery: implications for surgical training.
Ryota Ito1, Takeru Matsuda2,3, Hiroshi Hasegawa1
1Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
International Journal of Colorectal Disease
|October 10, 2025
Summary
Robot-assisted rectal surgery (RRS) learning curves differ between abdominal and pelvic phases. Abdominal manipulation requires a shorter learning period than pelvic manipulation, suggesting targeted training improvements.
Area of Science:
- Surgical Oncology
- Robotic Surgery
- Gastrointestinal Surgery
Background:
- Robot-assisted rectal surgery (RRS) techniques for abdominal and pelvic manipulation vary.
- The comparative learning periods for these distinct surgical phases in RRS are not well-defined.
Purpose of the Study:
- To analyze and compare the learning curves for abdominal and pelvic manipulation phases in robot-assisted rectal surgery.
- To determine if differences exist in the learning period required for abdominal versus pelvic phases during RRS.
Main Methods:
- Retrospective analysis of 75 patients undergoing RRS for rectal malignancy (September 2019 - May 2024).
- Utilized the cumulative sum method to evaluate learning curves for total console time, abdominal phase, and pelvic phase.
- Compared the number of cases required to reach learning, consolidation, and maturing phases for each manipulation type.
Main Results:
- The overall RRS learning curve showed three phases: learning (1-25), consolidation (26-55), and maturing (56-71).
- The abdominal phase learning curve comprised two phases: learning (1-23) and maturing (24-71), lacking a distinct consolidation phase.
- The pelvic phase learning curve included learning (1-27), consolidation (28-59), and maturing (60-75) phases.
Conclusions:
- The learning period for abdominal manipulation in RRS is shorter than for pelvic manipulation, evidenced by the absence of a consolidation phase.
- Educational strategies for RRS should consider the distinct learning trajectories of abdominal and pelvic phases for enhanced surgical training efficiency.
