Authors
Yang Yang Lee, Nur Hafizah Mohamed Nor, Vidyadhar Padmakar Mali, Zong Jie Koh, Yoke Lin Nyo, Mohan S Gundeti
Published in
Journal of robotic surgery. Volume 20. Issue 1. Nov 13, 2026. Epub Nov 13, 2026.
Abstract
Robotic surgery in children continues to expand, but the evidence guiding it is generated almost exclusively in high-volume institutions. Learning curves for paediatric robot-assisted pyeloplasty indicate competence at 13-30 cases and consolidation at 40-100. It is challenging for a unit undertaking eight to 15 index operations a year to accumulate that experience at an acceptable rate, and deferring adoption until caseload rises merely lengthens the intervals across which skill decays. We propose that such units uncouple skill acquisition from clinical caseload and import operative experience instead, and we set out an eight-phase roadmap anchored to the first proctored case. We illustrate each phase with the first 12 consecutive robotic operations of a restarted paediatric programme in an adult-paediatric tertiary hospital, performed across five proctor visits over 15 months, with no conversions and one complication. We report the performance data monitored against published benchmarks, the time and resources the approach required, and lower-cost alternatives, including proctorship by adult robotic surgeons within the same institution. The roadmap presupposes access to an established robotic platform and a caseload sufficient to maintain two console surgeons; units below that threshold may be better served by regional collaboration than by an independent programme.
PMID:
43024171
Bibliographic data and abstract were imported from PubMed on 14 Nov 2026.
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