Learning curve for a surgeon in robotic pancreaticoduodenectomy through a “G”-shaped approach: A cumulative sum analysis

Figure 1 Trocar placement for robotic pancreaticoduodenectomy.

Figure 2 The location of the robot and patient.

Figure 3 The surgical procedure for the “G-shaped” approach. A: Disconnected stomach; B: Dissociated gastric duodenal artery; C: Retrograde removal of the gallbladder; D: Perform the Kocher incision, fully free duodenum; E: Disconnected duodenum; F: Establishment of a pancreatic tunnel and cutting the neck of the pancreas and removal of the uncinate process; G: Dissociated bile duct.

Figure 4 Graph of operative times plotted for all consecutive 60 patients.

Figure 5 Cumulative sum-operation time curve for the two learning phases of “G”-shaped robotic pancreaticoduodenectomy. CUSUM: Cumulative sum; OT: Operative time.

Figure 6 The phases present an upward slope. A: The first phase; B: The second phase. CUSUM: Cumulative sum; OT: Operative time.