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A significant decrease in complication-free rates (p < 0.001) and rates of Clavien 1–2 complications (p < 0.001) between the first and last 200 patients shows the institutional learning curve. There was no significant change in Clavien 3–4 complications. Arrows mark the following events: (A) start of second-generation surgeon 1, (B) start of second-generation surgeon 2, (C) start of third-generation surgeon 1, (D) running anastomosis replaces interrupted anastomosis, (E) start of third-generation surgeon 2, (F) extraperitoneal access replaces transperitoneal access.
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