{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T12:12:23Z","timestamp":1794485543879,"version":"4.9.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2015,9,30]],"date-time":"2015-09-30T00:00:00Z","timestamp":1443571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,9,30]],"date-time":"2015-09-30T00:00:00Z","timestamp":1443571200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>With the increasing availability of the surgical robotic system, the young generation colorectal surgeons may learn robotic\u2010assisted rectal surgery upfront. There are currently very limited studies evaluating the learning curve of novice rectal surgeons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to evaluate the learning curve of a surgeon who had limited experience in open and laparoscopic rectal surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010nine consecutive robotic\u2010assisted total mesorectal excisions were performed from March 2013 to October 2014. All cases were performed by a single surgeon whose prior experience in open or laparoscopic low rectal cancer resections was &lt;5 cases. The learning curve was analyzed using the cumulative sum method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010four low anterior resections, four abdomino\u2010perineal resections, and one Hartmann\u2019s operation were performed. The mean total operating time was 397.2 \u00b1 184.3\u00a0min. There was no conversion. The major complication rate was 10.3 %. When total operating time was analyzed with the CUSUM method, three phases could be identified. They are the initial eight cases, middle 17 cases, and the final 14 cases. The first phase consisted of more proximal tumors (86.3 \u00b1 20.7 vs. 58.0 \u00b1 34.9\u00a0mm from anal verge, <jats:italic>p<\/jats:italic> = 0.04) and was associated with a shorter total operating time (243.5 \u00b1 38.0 vs. 540.9 \u00b1 133.4\u00a0min, <jats:italic>p<\/jats:italic> = 0.000) and less estimated blood loss (81.3 \u00b1 25.9 vs. 168.8 \u00b1 99.5\u00a0ml, <jats:italic>p<\/jats:italic> = 0.02) compared to the second phase. When the third phase is compared with the first and second phase, it has shorter total operating time (310.6 \u00b1 164.5 vs. 44 5.7 \u00b1 179.8\u00a0min, <jats:italic>p<\/jats:italic> = 0.03). Complications rate were 12.5, 17.6, and 0 % for phase one, two, and three respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study, the learning curve for a novice rectal surgeon was 25 cases. This is comparable to those who have already mastered the technique with laparoscopic or open approach. Surgical robotic system may have a role in shortening the learning curve for low rectal resection.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-015-3251-x","type":"journal-article","created":{"date-parts":[[2015,9,30]],"date-time":"2015-09-30T16:11:12Z","timestamp":1443629472000},"page":"456-462","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":84,"title":["The Learning Curve of Robotic\u2010Assisted Low Rectal Resection of a Novice Rectal Surgeon"],"prefix":"10.1002","volume":"40","author":[{"given":"Chi Chung","family":"Foo","sequence":"first","affiliation":[{"name":"Division of Colorectal Surgery, Department of Surgery University of Hong Kong, Queen Mary Hospital Pok Fu Lam Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Lun","family":"Law","sequence":"additional","affiliation":[{"name":"Division of Colorectal Surgery, Department of Surgery University of Hong Kong, Queen Mary Hospital 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