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. 2022 May 2;407(4):1–11. doi: 10.1007/s00423-022-02520-w

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Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 3 — CUSUM analysis of the operative time. A CUSUM analysis including all five centers. The inflection point after the 22nd procedure marks the end of the learning curve. B CUSUM analysis including the three centers with >22 RAMIE cases. C The CUSUM analysis for the leading surgeons of the three most experienced centers