Junior academic surgeons may initially face challenges independently performing pediatric open pyeloplasty due to a lack of experience. Surgical mentorship programs have been proposed to accelerate skill development and enhance patient outcomes. This study aims to evaluate the impact of mentorship on case outcomes and the learning curves of early-career surgeons.

Using an institutional electronic health record system, we retrospectively analyzed all initial open pyeloplasty cases consecutively performed by an index junior academic surgeon with the mentorship of a senior surgeon from April 2020 to May 2023. Data collected included case characteristics, operative times, follow-up durations, and surgical complications within a two-year postoperative period. A Cumulative Sum (CUSUM) analysis was employed to identify peaks, plateaus, and trends for complications (defined as Clavien–Dindo classification ≥3b) and operative time.

We analyzed 54 open pyeloplasty cases performed under surgical mentorship, categorizing them into four phases using CUSUM analysis (Figure). Based on this, the junior surgeon reached the competency-proficiency phase between the 11th and 26th case, demonstrating consistent technical skill development, reduced operative times, and satisfactory outcomes under mentorship. In the case-mix phase (45th to 54th case), a slight increase in operative time was noted, coinciding with more complex cases and increased trainee involvement.

This analysis demonstrates that surgical mentorship for junior academic surgeons facilitates early technical proficiency in pediatric open pyeloplasty, enabling them to safely achieve comparable outcomes early in their careers. These findings suggest that mentorship is a key ingredient to ensure satisfactory surgical outcomes during the initial stages of a surgeon’s learning curve.