Markar SR, Ni M, Mackenzie H, et al. - Given the association of complex surgical procedures including minimally invasive esophagectomy (MIE) with a period of proficiency gain, researchers here examined the effect of reduced procedural interval upon the number of cases needed to gain proficiency and adverse patient outcomes during this period from MIE. From Hospital Episode Statistics database, they assessed 1,696 adult patients undergoing MIE for esophageal cancer in England from 2002 to 2012. The procedures were carried out by 148 surgeons. They identified following thresholds for procedural interval using change-point modeling: 60 days for conversion, 80 days for 30-day re-intervention, 80 days for 30-day mortality and 110 days for 90-day mortality. Observations revealed no influence of procedural interval of MIEs on the number of cases needed for proficiency gain. However, there was correlation of reduction in MIE procedural interval with significant reductions in conversions, re-interventions, 30-day and 90-day mortality during the period of proficiency gain.