Learning curves in robotic and laparoscopic colorectal surgery: a systematic review

To evaluate and compare learning-curve assessment in laparoscopic and robotic colorectal surgery and to develop a standardized framework for future learning-curve reporting.

Learning curves in minimally invasive colorectal surgery are widely reported, but inconsistent definitions limit interpretability and comparability. This systematic review analyzed learning-curve assessment in laparoscopic and robotic colorectal surgery and proposes a standardized framework.

MEDLINE, Web of Science, and CENTRAL were systematically searched according to PRISMA guidelines (registered in PROSPERO, CRD42026128860). Included were randomized, prospective, and retrospective studies on learning curves in colorectal surgery. Primary outcome was the number of procedures required to reach the initial learning phase. Secondary outcomes included definitions of learning curves, analytical methods, and classification of learning phases. Analyses were stratified by procedure type (colon vs. rectal resections), and pooled breakpoint regression was used to identify learning phases.