This single-center retrospective observational study aimed to characterize the early surgeon-level and institutional learning process during adoption of da Vinci robot-assisted urological surgery. The primary focus was chronological analysis of console time in robot-assisted radical prostatectomy (RARP) and complementary reporting of perioperative metrics, complications, and pathological outcomes.
The study included 60 robotic procedures performed by one principal surgeon between June 2024 and June 2026. The principal learning cohort comprised 38 chronologically ordered RARP procedures for which complete console-time data were available. The remaining 22 cases represented other robotic urological procedures and were included in the overall caseload description but not in the primary console-time regression.
Analytical methods reported in the source included linear regression of console time by case order and a block comparison between the first 10 and last 10 RARP cases using Welch's t test with 95% confidence intervals (CIs). Complications were classified using the Clavien-Dindo system when treatment details were sufficiently documented. The authors stated that missing variables were not imputed.
The 60-procedure series consisted of 38 RARP procedures (63.3%) and 22 other robotic urological operations (details of the non-RARP procedures were not reported in the abstract). No conversions to open surgery occurred in the series as reported.
For the 38 RARP cases with complete console-time data, the mean console time was 197.1 ± 56.8 minutes (median 189; range 83–400). The mean console time in the first 10 RARP cases was 191.2 ± 66.9 minutes and in the last 10 RARP cases was 171.6 ± 37.1 minutes. The difference between these two temporal blocks was 19.6 minutes (95% CI −32.3 to 71.5), which did not reach statistical significance (p = 0.431).
Chronological linear regression of console time on case order produced a slope of −0.76 minutes per case (95% CI −2.47 to 0.95), with an R² of 0.022 and p = 0.373. These results indicate a numerical trend toward shorter console times over the early series but no statistically significant change by the reported metrics.
Among the RARP cases, complications classified by Clavien-Dindo (when treatment documentation permitted) were distributed as follows: grade I in 4 cases (10.5%), grade II in 7 cases (18.4%), and grade IIIa in 1 case (2.6%). No grade IIIb, IV, or V complications were documented in the available series. The abstract does not provide further perioperative details such as estimated blood loss, length of stay, or transfusion rates.
Pelvic lymph-node dissection was documented in 33 of 38 RARP cases (86.8%). Positive surgical margins were reported in 9 of 38 RARP specimens (23.7%). The abstract does not report oncologic outcomes beyond margin status, nor does it provide details on pathological stage, grade, or follow-up oncologic endpoints.
The authors describe a numerical decrease in console time during the early RARP experience, reflected in both block comparison and regression analyses. However, neither the chronological regression nor the comparison of first-versus-last blocks achieved statistical significance. Consequently, the reported findings are presented as a description of an early surgeon-team-institution learning process rather than evidence that the surgeon reached a defined proficiency or completed the formal learning curve.
Key limitations reported in the abstract include the retrospective observational design and the fact that missing variables were not imputed. The analysis was limited to a single principal surgeon at one institution, and the abstract does not present patient-level covariates, detailed operative metrics beyond console time, or longer-term oncologic and functional outcomes. Information about the 22 non-RARP robotic procedures and whether those contributed to cross-training or team learning was not detailed in the abstract.
The retrospective institutional project was authorized by Clínica Internacional, San Borja (authorization No. 041-TI-D-UDID-CI-2026, valid from 25 May 2026 to 25 November 2026). Individual informed consent was waived because the analysis used anonymized routine-care data. The authors declared no competing interests. The abstract notes computational tools supported statistical analysis, figure/table organization, manuscript formatting, and language editing; the authors reviewed and verified the clinical data and conclusions.
Note: This rewrite is limited to facts as reported in the article abstract. Details not reported in the source (for example, breakdown of non-RARP procedures, specific perioperative metrics beyond what is stated, or long-term oncologic and functional outcomes) were not available in the abstract and therefore are not included.