{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:13Z","timestamp":1789535053506,"version":"build-2803163510"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Three-dimensional (3D) laparoscopy offers stereoscopic depth perception, but moving from conventional two-dimensional (2D) systems calls for a period of visuomotor adaptation. How this learning curve unfolds in complex oncological procedures like laparoscopic radical cystectomy (LRC) has not been well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-surgeon retrospective cohort study included 140 consecutive patients who underwent LRC by an experienced surgeon (&amp;gt;300 prior 2D procedures). Cases were divided chronologically into one 2D group (the last 50 2D cases) and three consecutive 3D groups (3D-1 to 3D-3, 30 cases each). The primary endpoint was pelvic-phase operative time- the vision-dependent part of dissection. Secondary outcomes included estimated blood loss (EBL), lymph node yield, positive margin rate, major complications (Clavien-Dindo \u2265II), and surgeon-rated stereoscopic comfort and hand-eye coordination (visual analogue scales).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were similar across groups. Change-point analysis identified a single significant transition point at case 31 (95% CI: 28-34). Pelvic-phase time in 3D-1 group (median 198 min) was comparable to the 2D reference (185 min,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05), marking an adaptation phase. After that, time fell sharply to 155 min in 3D-2 group and 152 min in 3D-3 group (both\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001\n                      <jats:italic>vs.<\/jats:italic>\n                      groups 2D and 3D-1). EBL dropped from 450 mL (3D-1) to 250 mL (3D-3) (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05). Lymph node yield, positive margin rates, and major complications remained stable. Subjective comfort and coordination scores improved steadily across the 3D groups (both\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001) and correlated negatively with pelvic-phase time (\n                      <jats:italic>\n                        r\n                        <jats:sub>s<\/jats:sub>\n                      <\/jats:italic>\n                      \u00a0=\u00a0-0.68,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Transitioning from 2D to 3D LRC involves a distinct learning curve of about 30 cases. Once visuomotor recalibration is achieved, operative efficiency and intraoperative safety improve substantially without compromising pathological quality. These findings offer an evidence-based framework for structured training and technology adoption in complex pelvic oncology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1811010","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:30:04Z","timestamp":1789533004000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A structured learning curve for visuomotor recalibration and surgical performance during transition from two-dimensional to three-dimensional laparoscopic radical cystectomy"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiaodong","family":"Qing","sequence":"first","affiliation":[{"name":"Department of Surgery, Ningbo Integrated Traditional Chinese and Western Medicine Hospital","place":["Ningbo, Zhejiang, 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