{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:52:29Z","timestamp":1777877549742,"version":"3.51.4"},"reference-count":53,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>The learning curve for robotic thyroid surgery (RTS) remains incompletely characterized when considering the surgical approaches (axillary, transoral, transareolar, and facelift).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review investigated the learning curves and required case volumes for achieving proficiency according to the surgical approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>PubMed, Scopus, and Cochrane Library systematic review using the PRISMA statements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Published clinical studies investigating learning curve outcomes related to the implementation of RTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Practitioners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>RTS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Learning curve outcomes related to the implementation of RTS. The bias analysis was conducted with the MINORS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 450 identified studies, 34 studies met our inclusion criteria (6438 patients). The mean minimum number of cases for achieving proficiency in axillary robotic partial and total thyroidectomies was 46 cases (range: 20-66) and 34 cases (range: 20-50), respectively. The minimum number of cases for reaching proficiency of transoral robotic and facelift approaches were 31 (15-55) and 32 (15-50) cases, respectively, with limited evidence for facelift approaches based on only 4 studies. Learning curves of facelift and transoral robotic approaches may be faster than the axillary one. While operative time significantly reduced in most approaches, the reduction of complication rates is inconsistent, with complications occurring in 16.7% of axillary, 11.1% of transoral, and 16.2% of facelift approaches throughout the learning process. There was substantial heterogeneity across studies for inclusion criteria, surgeon experience, and surgical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The number of cases required to achieve proficiency in robotic thyroid surgeries may depend on the surgical approach, with facelift and transoral approaches suggested as faster than axillary ones. Future prospective studies are needed to standardize learning definitions and analyze how surgeon-specific factors (experience, age, prior training) impact the learning curves.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216261421877","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T12:08:20Z","timestamp":1772021300000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Learning Curves in Robotic Thyroid Surgery: A Systematic Review Comparing Transoral, Axillary, and Facelift Approaches"],"prefix":"10.1177","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-0845","authenticated-orcid":false,"given":"J\u00e9r\u00f4me R.","family":"Lechien","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium"},{"name":"Department of Otolaryngology, Elsan Hospital, Poitiers, France"},{"name":"Department of Otolaryngology-Head Neck Surgery, Foch Hospital, UFR Simone Veil, University Versailles Saint-Quentin-en Yvelines (University Paris Saclay), Paris, France"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2025.107406"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2021.105463"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2017.06.001"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/oto2.70120"},{"key":"e_1_3_3_6_2","unstructured":"Intuitive. 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