Surgical video review is increasingly used to support self-reflection and technical skill development. However, little is known about which aspects of video review are the most effective for general surgery residents. We hypothesize that senior residents would find self-review most helpful while junior residents would benefit more from guided review with an attending coach. In this single institution prospective cohort study, residents reviewed hepatocystic triangle dissection videos cropped from laparoscopic cholecystectomy operations captured on OR Black Box where the resident was the primary surgeon during this portion of the case. Over one-hour sessions, residents completed four structured video review modalities: standardized public video, peer video, self-review, and attending coach-guided review. Attending coaches were fellowship-trained MIS faculty with surgical education training. Outcomes included perceived usefulness (5-point Likert-type scale) and modified Objective Structured Assessment of Technical Skills (mOSAT) scores. Thirteen residents (5 seniors, 38.5
Incisional hernias represent a significant source of morbidity for patients following liver transplantation, and repair of these defects remains challenging. Transversus abdominis release (TAR) is a posterior component separation technique enabling wide sublay prosthetic reinforcement which is suitable for the treatment of complex incisional hernias. TAR can be used with the enhanced view totally extraperitoneal (eTEP) approach, with favorable outcomes in non-transplant patients being reported. This is a single center retrospective review of adult liver transplant recipients with incisional hernias who underwent robotic-assisted eTEP with bilateral TAR between December 2022 and July 2026. A comprehensive description of the surgical technique is included. Patient demographics, hernia characteristics, as well as clinical outcomes are also described. Twenty-six liver transplant patients who underwent incisional hernia repair with eTEP and bilateral TAR met the inclusion criteria. Median age was 60 (IQR 55–65) and patients were predominately male (81
Minimally invasive surgery (MIS) videos support education and quality review, but raw recordings contain non-informative frames that impede review and increase storage. We retrospectively analyzed 300,832 frames from 120 MIS videos performed by 30 surgeons. An EndoViT-initialized Vision Transformer (ViT) was evaluated using leave-six-surgeons-out cross-validation and compared with conventional vision models. GPT-4o-mini, LLaVA, and Doubao were separately evaluated under zero- and few-shot prompting on a balanced 400-frame subset that was not sample-size matched to the ViT evaluation. We also explored the association between surgeon experience and non-informative-frame ratio. In the within-dataset comparison of trained vision models, the EndoViT-initialized ViT achieved an aggregate accuracy and F1-score of 0.942. In an exploratory few-shot analysis within a separate 400-frame balanced benchmark, GPT-4o-mini achieved an accuracy of 0.890 and F1-score of 0.880; exemplar-test disjointness could not be confirmed. Because the ViT and LMM evaluations used different test sets and sample sizes, these estimates do not support a direct comparison of model superiority. The surgeon-level analysis showed no statistically significant association between experience and the non-informative-frame ratio (r = − 0.421, 95
Pediatric-onset Crohn’s disease (CD) is associated with a more severe disease course than adult-onset CD, with earlier progression to complications, and frequent need for surgery. Ileocecal resection (ICR) is the most commonly performed surgery. Postoperative intra-abdominal (IAA) abscess is a frequent and potentially severe complication following ICR in children. The aim of this study was to identify independent risk factors associated with postoperative IAA following minimally invasive ICR in children with CD. We conducted a retrospective single-center study including patients < 18 years who underwent laparoscopic or robotic ICR for CD between January 2000 and December 2023. Clinical, surgical, and postoperative data were collected. The primary outcome was the occurrence of IAA within 30 days of surgery. Univariate and multivariate logistic regression were performed to identify independent predictors. Seventy-eight patients were included. The overall incidence of postoperative IAA was 19
Gastroparesis is a debilitating disease for which therapeutic strategies achieve variable success. This systematic review and consensus statements address the surgical management of medically refractory gastroparesis. A systematic review was conducted, with a literature search through December 31, 2024, addressing the surgical treatment of gastroparesis, including gastric electrical stimulation (GES), gastric per-oral endoscopic myotomy (GPOEM), pyloroplasty and pyloromyotomy, and gastrectomy. Studies assessing symptom resolution and changes in gastric emptying were extracted. The findings were subsequently presented to a panel of surgeons and gastroenterologists, some of whom are members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), with the patient partner perspective considered. Consensus statements were generated from the presented data and subsequent discussion for each of the four treatment options. All consensus statements were based on expert opinion due to poor and heterogeneous datasets for each intervention. The panel judged GES, pyloroplasty, and pyloromyotomy, including gastric per-oral endoscopic myotomy, to be reasonable treatments for patients with medically refractory gastroparesis. The panel does not suggest surgical resection as a standard treatment option for medically refractory gastroparesis, but acknowledges that in specific patient cases, it may be reasonable. The consensus views achieved provide guidance for surgical approaches to medically refractory gastroparesis. The panel also highlighted evidence gaps that warrant research to strengthen the evidence base for surgical treatment strategies for gastroparesis.
