Learning and Relearning After Robotic Platform Transition in Rectal Cancer Surgery

The da Vinci Surgical System has been in widespread clinical use for robot-assisted surgery for more than two decades, whereas the hinotori Surgical Robot System has been introduced more recently. Comparative data between these platforms, particularly regarding learning and relearning processes, remain limited. This study aimed to compare perioperative outcomes and learning curve characteristics between the two systems in rectal cancer surgery.

This retrospective study included 113 patients who underwent robot-assisted rectal cancer surgery at a single institution between September 2019 and May 2025. Ninety-four procedures were performed using the da Vinci system and 19 using the hinotori system. Patient characteristics and perioperative outcomes were compared. Learning curves for console time and setting time were analyzed using cumulative sum methods.

Patient and tumor characteristics and pathological outcomes were comparable between groups. Operative time was significantly shorter in the hinotori group, whereas postoperative complication rates and short-term oncological outcomes did not differ significantly. Cumulative sum analysis of console time demonstrated a consistent three-phase learning pattern-learning, consolidation, and proficiency-in both the overall cohort and the da Vinci group. In contrast, setting time analysis revealed an additional relearning phase in the overall cohort following the introduction of the hinotori system, which transitioned to stabilization after approximately 20 cases.

Both robotic platforms achieved comparable short-term clinical outcomes in rectal cancer surgery. Surgeon console performance appeared transferable across platforms, whereas introduction of a new robotic system was associated with a limited relearning period during the setup phase.