{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:50:41Z","timestamp":1792612241316,"version":"4.5.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001782","name":"University of Melbourne","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001782","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The learning curve for robotic colorectal surgery is increasingly characterised. However, the specific learning curve for intracorporeal anastomosis (IA) remains poorly defined. This review compares robotic and laparoscopic IA with respect to operative time, cases required for proficiency, complication rates, and conversion to extracorporeal anastomosis (EA). A systematic review was conducted in accordance with PRISMA guidelines. The protocol was registered on Open science framework (\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"10.17605\/OSF.IO\/K4MYZ\" ext-link-type=\"doi\">https:\/\/doi.org\/10.17605\/OSF.IO\/K4MYZ<\/jats:ext-link>\n                    ). On March 18, 2025, OVID and PubMed were searched using the search terms; \u201claparoscopic,\u201d \u201crobotic,\u201d \u201canastomosis,\u201d \u201clearning,\u201d \u201ceducation,\u201d and \u201ctraining.\u201d Yielding a total of 273 results from PubMed (179) and OVID (94). After screening a total of thirteen studies were included. Thirteen studies met inclusion criteria, including eight comparative analyses and six directly comparing robotic and laparoscopic techniques. Four studies evaluated robotic learning curves without a comparator group, while one was a literature review incorporating institutional experience. Most studies were retrospective (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20098), with two prospective clinical studies and two experimental simulation-based studies. Hybrid approaches (robotic mobilisation with laparoscopic EA) contributed to heterogeneity (Reitz et al. 2018,\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"10.1007\/s00464-018-6074-7\" ext-link-type=\"doi\">https:\/\/doi.org\/10.1007\/s00464-018-6074-7<\/jats:ext-link>\n                    ). Learning curve assessment was heterogeneous, with most studies using cumulative sum (CUSUM) or risk-adjusted CUSUM (RA-CUSUM) analyses based on operative time or technical performance metrics. Proficiency in robotic IA was reported after approximately 11\u201329 cases in some series and around 20 cases in others, although larger studies of robotic colorectal surgery demonstrated broader ranges of up to 100 cases. Robotic right hemicolectomy with IA demonstrated a shorter learning curve and reduced anastomosis time compared with laparoscopic IA. Complication rates, conversion rates, and oncological outcomes were comparable between approaches (Gachabayov et al. 2019, Surg Technol Int, 34:163-168). Robotic intracorporeal anastomosis, particularly in right hemicolectomy, appears to have a shorter and less technically demanding learning curve compared with laparoscopic techniques, without compromising safety or oncological outcomes. These findings support a potential role for robotic platforms in facilitating adoption of intracorporeal anastomosis. However, current evidence is limited by retrospective design, small cohorts, and inconsistent definitions of proficiency (Gachabayov et al. 2019, Surg Technol Int, 34:163\u2013168; Van Eetvelde et al. 2022,\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"10.1007\/s11701-022-01514-6\" ext-link-type=\"doi\">https:\/\/doi.org\/10.1007\/s11701-022-01514-6<\/jats:ext-link>\n                    ).\n                  <\/jats:p>","DOI":"10.1007\/s11701-026-03468-5","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T06:49:14Z","timestamp":1778654954000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Robotic versus laparoscopic intracorporeal anastomosis learning curve: a systematic review"],"prefix":"10.1007","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1502-7607","authenticated-orcid":false,"given":"Sunny","family":"Dhadlie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7173-259X","authenticated-orcid":false,"given":"Kirsten","family":"Larkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9051-5582","authenticated-orcid":false,"given":"Tayla","family":"Fay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Proud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Warrier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Heriot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Mohan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"3468_CR1","doi-asserted-by":"publisher","unstructured":"Reitz ACW, Lin E, Rosen SA (2018) A Single Surgeon\u2019s Experience Transitioning to Robotic-Assisted Right Colectomy with Intracorporeal Anastomosis. Surgical Endoscopy 32, no. 8: 3525\u201332. https:\/\/doi.org\/10.1007\/s00464-018-6074-7","DOI":"10.1007\/s00464-018-6074-7"},{"key":"3468_CR2","unstructured":"Gachabayov M, Angelos G, Bergamaschi R (2019) Tying and Tearing in Robotic and Laparoscopic Intracorporeally Hand-Sewn Ileocolic Anastomoses. A Propensity Score-Matched Prospective Study. Surg Technol Int. 15. 34:163\u2013168"},{"key":"3468_CR3","doi-asserted-by":"publisher","unstructured":"Van Eetvelde E, Violon S, Poortmans N, Stijns J, Duinslaeger M, Vanhoeij M, Buyl R, Jacobs-Tulleneers-Thevissen D (2022) Safe Implementation of Robotic Right Colectomy with Intracorporeal Anastomosis. 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A Herriot and Warrier are faculty at IMRA. S Warrier is also a proctor for Intuitive.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable. This study is a systematic review of previously published literature and did not involve human participants or identifiable patient data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}],"article-number":"487"}}