Learning curve in robotic surgery for ureteropelvic junction obstruction in children: how to best define a reliable learning process through CUSUM analysis

This study highlights how CUSUM LC analysis in RALP varies depending on both the parameter evaluated and the reference value used. Composite metrics revealed a longer LC than operative time alone, highlighting the influence of postoperative outcomes in assessing surgical competency. These findings emphasize the need for standardized, multidimensional LC assessments in pediatric RALP to better capture the complexity of the learning process.