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The Learning Curve in Minimally Invasive Right Colectomy: Challenges, Metrics, and Future Perspectives, a Systematic
Reitano Elisa1,2, Granieri Stefano3, Badessi Giorgio4
1Department of Digestive and Endocrine Surgery, Nouvel Hospital Civil, University of Strasbourg, Strasbourg, France.
ANZ Journal of Surgery
|August 8, 2026
Summary
Mastering minimally invasive right colectomy (MIRC) requires overcoming a learning curve (LC). Studies show significant reductions in operative time and morbidity after achieving proficiency, but standardization is needed for surgical training.
Area of Science:
- Colorectal Surgery
- Surgical Education
- Minimally Invasive Procedures
Background:
- Minimally invasive right colectomy (MIRC) is the standard for right-sided colonic diseases, especially cancer.
- A significant learning curve (LC) exists for mastering MIRC, impacting surgical outcomes.
- This systematic review synthesizes current evidence on the LC in MIRC.
Purpose of the Study:
- To analyze the existing evidence on the learning curve (LC) in minimally invasive right colectomy (MIRC).
- To determine the number of cases required to overcome the LC for MIRC.
- To evaluate the impact of achieving proficiency on surgical outcomes.
Main Methods:
- Systematic review conducted following PRISMA guidelines.
- Searched PubMed, Scopus, EMBASE, and Cochrane Library databases up to June 2024.
- Assessed risk of bias using ROBINS-I and certainty of evidence using GRADE.
Main Results:
- Nine cohort studies (2005-2022) were included.
- Median cases to overcome LC: 26 (laparoscopic: 25, robotic: 27).
- Proficiency significantly reduced operative time (p=0.0027) and morbidity (p=0.043), with high heterogeneity (I²=68.8%).
Conclusions:
- Lack of standardized LC definition and assessment leads to heterogeneous findings.
- Standardized guidelines are crucial for improving colorectal surgical training and MIRC proficiency.
