Learning Curve for Robotic Urologic Procedures: Updated Review on Multi- and Single-Port Surgeries

Robotic surgery has made significant technological advances, with robotic single-port surgery emerging as an innovative approach. However, this technique requires a reassessment of surgical training because its learning curve (LC) may differ from that of standard robotic procedures. In this comprehensive review, the LC of single-port and standard robotic surgeries in different urological procedures is evaluated and compared.

A non-systematic review of robotic surgeries and LCs was performed in September 2024 using relevant articles from PubMed, Scopus and the Cochrane Central Register of Controlled Trials. The review focused on the LCs and structured programmes for robotic procedures. Articles were selected based on their relevance to urological practice and the availability of objective or subjective metrics for assessing the LC. Studies describing institutional protocols, simulation training and modular curricula were also included.

Robotic radical prostatectomy, cystectomy, kidney transplantation, nephrectomy (radical and partial), pyeloplasty and single-port procedures were evaluated in relation to the LCs and structured programmes. Key findings highlight significant variability in LC duration depending on the procedure, surgeon's experience, and type of robotic platform.

Future research should aim to standardise LC metrics, capture surgeons' baseline experiences and explore innovative training methods, such as simulation-based learning, to ensure the safe and efficient mastery of robotic urological surgery. Collaborative efforts between academic centres and robotic training platforms may facilitate more consistent and reproducible surgical education pathways.