Robotic curriculum and development strategies in robotic abdominal surgery

The rapid adoption of robotic abdominal surgery has necessitated structured training programs to ensure surgeon competence and patient safety. The da Vinci TR 100-200-300-400-500 training system represents a comprehensive pathway for developing robotic surgical skills, yet its effectiveness on learning curves remains incompletely characterized.

A systematic review was conducted following PRISMA guidelines, searching PubMed, Embase, and Cochrane databases from inception to October 2025. Studies evaluating learning curves associated with the TR training system in robotic abdominal surgery were included. Data extraction focused on training methodologies, assessment parameters, learning curve patterns, and clinical outcomes.

The search identified 1,591 records, with 17 studies meeting inclusion criteria. The TR training system demonstrates a progressive learning curve across its modules: TR 100 (technical skills foundation), TR 200 (technical-clinical integration), TR 300 (procedure application), TR 400 (procedure refinement), and TR 500 (mastery). Significant learning occurs within 5-10 repetitions for basic skills, with 90% expert-level performance achieved by 53% of novices after 10 repetitions. Key parameters showing improvement include overall score, time to completion, instrument collision, and critical errors.

The TR 100-200-300-400-500 training system provides an effective structured pathway for developing robotic abdominal surgery skills. However, standardization of assessment methods and validation of skill transfer to clinical performance require further investigation.