Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Unmeasured Confounding and Selection Bias in Pancreatic Duct Stent-Assisted Cannulation: A Call for Multivariate Adjustment.","authors":"Koji Takahashi","doi":"10.1097/SLE.0000000000001456","DOIUrl":"10.1097/SLE.0000000000001456","url":null,"abstract":"","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified Management of Giant Hiatal Hernia: Laparoscopic Hiatoplasty With Sac Excision and Posterior Mediastinal Drainage.","authors":"Haicheng Yuan, Guoqiang Dong, Nan Zhang","doi":"10.1097/SLE.0000000000001427","DOIUrl":"10.1097/SLE.0000000000001427","url":null,"abstract":"<p><strong>Background: </strong>The standard laparoscopic hiatoplasty with Toupet fundoplication is widely regarded as a safe treatment for giant hiatal hernia; however, it is often associated with a high incidence of posterior mediastinal seroma. To address this issue, a modified approach combining sac excision and negative pressure posterior mediastinal drainage has recently been introduced. This study compares clinical outcomes between the conventional and modified techniques to identify the optimal surgical strategy for managing giant hiatal hernia.</p><p><strong>Methods: </strong>Patients who underwent laparoscopic hiatoplasty with sac excision and posterior mediastinal drainage between January 2013 and September 2020 were included. Demographic information, operative time, intraoperative blood loss, complication rates, length of hospital stay, and treatment outcomes were prospectively collected and assessed during follow-up.</p><p><strong>Results: </strong>A total of 68 patients with giant hiatal hernia underwent the modified procedure without any conversions to open surgery or intraoperative complications. Compared with a historical cohort of 66 patients treated with the conventional approach (laparoscopic hiatoplasty with Toupet fundoplication), the modified group had significantly lower rates of postoperative posterior mediastinal seroma, as well as shorter overall and postoperative hospital stays. No significant differences were observed between the 2 groups regarding operative time, blood loss, ICU transfers, or incidence of postoperative pulmonary atelectasis. Median duration of long-term follow-up was comparable between the groups. There were no significant differences in the rates of early satiety, anatomic recurrence, diarrhea, acid regurgitation, or proton pump inhibitor (PPI) usage. In addition, no cases of dysphagia or reoperation occurred in either group.</p><p><strong>Conclusions: </strong>Laparoscopic hiatoplasty with sac excision and posterior mediastinal drainage is a safe and effective minimally invasive technique for treating giant hiatal hernia. This approach significantly reduces the risk of mediastinal seroma without increasing complication rates.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desmoplastic Small Round Cell Tumor Presenting as Bloody Ascites: A Case Report and Literature Review.","authors":"Hsin-Yi Chen, Bo-Yan Chen, Heng-Hui Lien, Shi-Hong Huang, Jui-Ting Hu","doi":"10.1097/SLE.0000000000001452","DOIUrl":"10.1097/SLE.0000000000001452","url":null,"abstract":"<p><strong>Background: </strong>Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive malignancy that predominantly affects young male patients. Its nonspecific clinical presentation and low diagnostic yield from ascitic fluid cytology pose a significant diagnostic challenge, particularly when presenting as ascites of unknown origin.</p><p><strong>Case presentation: </strong>A 30-year-old previously healthy young man presented with a 4-week history of progressive abdominal distention, intermittent fullness, unexplained weight gain, and bloody ascites. Cytology from paracentesis and tumor markers were nondiagnostic. Imaging revealed omental caking and multiple peritoneal nodules, suggestive of peritoneal carcinomatosis. Diagnostic laparoscopy identified extensive tumor seeding, and biopsy confirmed DSRCT based on histopathology, immunohistochemistry, and the presence of an EWS-WT1 fusion transcript on cytogenetic analysis, establishing the diagnosis of DSRCT. Chemotherapy was recommended; however, the patient's condition deteriorated rapidly, and he died within a few weeks before receiving treatment.</p><p><strong>Conclusions: </strong>DSRCT, although rare, is noted for aggressiveness and rapid progression and therefore should ideally be considered in the differential diagnosis of bloody ascites in young male patients, even when initial cytology is negative. Early application of diagnostic laparoscopy and biopsy may facilitate timely tissue diagnosis, particularly when imaging mimics peritoneal carcinomatosis.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Close or Not to Close? A Meta-Analysis on Fascial Closure of Port Sites in Laparoscopic Metabolic and Bariatric Surgery.","authors":"Chenglou Zhu, Wenhan Liu","doi":"10.1097/SLE.0000000000001449","DOIUrl":"10.1097/SLE.0000000000001449","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to systematically evaluate the effectiveness of fascial closure (FC) compared with nonfascial closure (NFC) in reducing trocar-site hernia (TSH) and improving postoperative outcomes in laparoscopic metabolic and bariatric surgery (LMBS).</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO. Five major databases were searched up to November 2025. Randomized controlled trials and high-quality observational studies comparing FC versus NFC in LMBS were included. Primary outcome was TSH incidence; secondary outcomes included trocar-site bleeding, wound healing, operative time, and postoperative weight loss. Effect sizes were calculated using odds ratios (OR) and mean differences (MD) with 95% CI.</p><p><strong>Results: </strong>Four studies (1 RCT and 3 observational studies) involving 1127 patients were included. Pooled analysis showed no significant increase in TSH with NFC compared with FC (OR: 1.72, 95% CI: 0.81-3.65, P =0.16). FC did not significantly decrease trocar-site bleeding (OR: 1.67, 95% CI: 0.41-6.72, P =0.47) or improve wound healing (OR: 1.10, 95% CI: 0.53-2.28, P =0.79). No differences were observed in operative time (MD: -6.96 min, 95% CI: -35.51 to 21.59, P =0.63) or postoperative weight loss. One RCT reported substantially increased postoperative pain associated with FC.</p><p><strong>Conclusions: </strong>Current evidence does not support a clear clinical advantage of FC in reducing TSH or improving postoperative outcomes in LMBS. Considering the potential for increased postoperative pain and substantial interstudy heterogeneity, decisions regarding FC should be individualized. Larger multicenter RCTs with standardized techniques and longer follow-up are warranted.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Factors for Prolonged Length of Stay for Non-Elective Laparoscopic Cholecystectomy.","authors":"Nandita N Mahajan, Gustavo Romero-Velez, Kenneth Shapiro","doi":"10.1097/SLE.0000000000001446","DOIUrl":"10.1097/SLE.0000000000001446","url":null,"abstract":"<p><strong>Background: </strong>There are ∼750,000 laparoscopic cholecystectomies performed annually in the United States. Of these, at least 280,000 cases are nonelective laparoscopic cholecystectomies (LC). There is limited data on factors affecting LOS in patients undergoing nonelective LC. This study aims to determine the factors affecting LOS in patients undergoing nonelective LC.</p><p><strong>Study design: </strong>The National Surgical Quality Improvement Program (NSQIP) database was queried for all patients who underwent nonelective LC without concomitant procedures from 2010 to 2020 (n=115,142). A total of 55,481 patients without significant cardiopulmonary disorders, with a body mass index (BMI) of 18.5 to 60, and with LOS outcome data were included. Prolonged LOS was defined as >2 days. A sensitivity analysis was conducted with prolonged LOS defined as >1 day. All analyses were performed using SAS v9.4.</p><p><strong>Results: </strong>A total of 18,094 patients (33%) had LOS >2 days, and 33,292 patients (60%) had LOS >1 day. On logistic regression analysis, prolonged LOS was found in 31% of patients with ASA class 1 and 2 versus 44% of patients with ASA class >2 (OR: 1.67; 95% CI: 1.58-1.76), 33% of patients with independent functional status versus 72% of patients with partially dependent functional status (OR: 3.94; 95% CI: 2.76-5.63), and 79% of patients with dependent functional status (OR: 4.45; 95% CI: 2.17-9.12). In logistic regression, age, BMI category, smoking status, and race/ethnicity were also associated with prolonged LOS.</p><p><strong>Conclusion: </strong>This study showed that a significant percentage of female patients, patients with ASA class 1 and 2, with independent functional status, and belonging to minority ethnicities who underwent nonelective LC had prolonged LOS. Our study highlights the need to evaluate nonclinical factors with further institutional studies.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Iatrogenic Colonoscopic Perforations: A 5-Year Retrospective Analysis of Predictive Factors and Outcomes With Emphasis on Endoscopic Clip Closure.","authors":"Gökay Çetinkaya, Ahmet Başkent, Mehmet F Başkent, Osman Bardakçi, Hasan F Küçük","doi":"10.1097/SLE.0000000000001445","DOIUrl":"10.1097/SLE.0000000000001445","url":null,"abstract":"<p><strong>Background: </strong>Iatrogenic colonic perforation (ICP) is a rare but serious complication of colonoscopy. Its incidence varies according to whether the procedure is diagnostic or therapeutic. Although surgery has traditionally been the cornerstone of treatment, advances in endoscopic techniques-particularly clip application-have provided less invasive alternatives. This study aimed to present the clinical characteristics, management strategies, and outcomes of ICP in a high-volume tertiary center, with a particular focus on the efficacy and limitations of endoscopic clip closure.</p><p><strong>Methods: </strong>In this retrospective study, all patients diagnosed with ICP between 2019 and 2024 at Kartal Dr. Lutfi Kirdar City Hospital were evaluated. Among 87,526 colonoscopies performed during this period, 42 patients with ICP were included. Patients were classified according to whether colonoscopy was performed for diagnostic or therapeutic indications. Endoscopic clip closure was attempted in 14 patients and was successful in 8 of them (57.1%). Surgical intervention was performed in 34 patients, either after failed endoscopic management or as the primary treatment.</p><p><strong>Results: </strong>ICP developed more frequently during diagnostic procedures (69%). The sigmoid colon (57.1%) was the most common site of perforation, and most perforations were intraperitoneal (81%). Baseline demographic and clinical characteristics did not differ significantly between the diagnostic and therapeutic indication groups ( P >0.05). Successful endoscopic clip closure was associated with early diagnosis, good bowel preparation, and perforation size <2 cm. Patients treated endoscopically had shorter times to oral intake and shorter hospital stays compared with those treated surgically.</p><p><strong>Conclusions: </strong>Endoscopic clip application is an effective treatment option for carefully selected ICP cases with early recognition, favorable local conditions, and small, localized defects. However, surgery remains essential in large perforations, delayed diagnoses, or when clip closure fails. Our findings provide real-world data on the role and limitations of standard clip closure in a resource-limited tertiary center and support guideline-based, individualized decision-making for ICP management.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cost-Effectiveness of Conservatively Managed Acute Appendicitis Versus Appendicectomy: A Systematic Review.","authors":"Imran Farhad, Muhammad A Khan, Aaron Kler, Mihir Trivedy, Dale Vimalachandran, Matthew Fok","doi":"10.1097/SLE.0000000000001454","DOIUrl":"10.1097/SLE.0000000000001454","url":null,"abstract":"<p><strong>Background: </strong>Appendicectomy remains the gold standard treatment for acute appendicitis. While there is continued debate as to the clinical benefit of conservative treatment in acute appendicitis, the cost-effectiveness of each treatment is a critical consideration. The aim of this study is to evaluate the current health economic evidence for surgery versus conservative management in acute appendicitis.</p><p><strong>Methods: </strong>A systematic literature search of 3 online databases for evidence pertaining to the economics of appendectomy compared with conservative management was performed according to PRISMA standards. The study protocol was prospectively registered with PROSPERO (study ID: CRD42023412691).</p><p><strong>Results: </strong>A total of 1219 patients were included (639 operative treatment vs. 580 conservative management). A total of 5 studies were included. Surgery was significantly more expensive when compared with conservative treatment (16.5% to 83.0%) percentage cost difference. The average length of hospitalisation was similar between the groups. The majority of studies reported a 12-month follow-up. The CHEERS assessment revealed a considerable risk of bias.</p><p><strong>Conclusion: </strong>Conservative management of appendicitis is the more economically effective treatment of the 2 modalities. This is an important consideration for resource-limited health care systems. However, further research with standardized methodologies and longer-term follow-up is warranted to fully assess the economic implications and clinical effectiveness of both treatment approaches.</p><p><strong>Key statement: </strong>Analysis indicates conservative management as the economically preferable option for acute appendicitis over surgery. This finding underscores its potential significance for resource-constrained health care systems. However, standardized studies with extended follow-up in different global health care settings are required to evaluate the economic and clinical merits of both treatment strategies.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147514949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Nasal Pancreatic Duct Stenting for Localized Resection of Benign Pancreatic Neoplasms Larger Than 2 cm: A Propensity Score Matching Analysis.","authors":"Gong Qiong, Guo Jun, Shi Shenchao, Zhang Zhengle, Shi Qiao, Huang Xu, Zhou Wei, Zhu Zhongchao","doi":"10.1097/SLE.0000000000001447","DOIUrl":"10.1097/SLE.0000000000001447","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of preoperative nasopancreatic duct stent placement on local resection of benign pancreatic tumors, particularly its efficacy in reducing secondary surgeries due to postoperative pancreatic fistula.</p><p><strong>Methods: </strong>The clinical data of 306 patients with benign pancreatic tumors larger than 2 cm who underwent local resection at the Department of Pancreatic Surgery, Hubei Provincial People's Hospital, over the past 6 years were retrospectively analyzed. Propensity score matching was used to minimize the selection bias.</p><p><strong>Results: </strong>The incidence of grade C pancreatic fistula in the nasopancreatic duct placement group was 5% (2/40), significantly lower than the 20% (32/160) observed in the non-nasopancreatic duct placement group, with a statistically significant difference (Fisher exact test, P =0.02). In addition, the rate of secondary surgery in the nasopancreatic duct placement group was 5% (2/40), significantly lower than the 16% (29/160) in the non-nasopancreatic duct placement group (Fisher exact test, P =0.04). However, there was no significant difference in the incidence of postoperative complications such as septic shock, overall pancreatic fistula, and postoperative mortality between the 2 groups.</p><p><strong>Conclusion: </strong>Preoperative nasopancreatic duct stent placement is a safe and effective procedure that significantly reduces the incidence of grade C pancreatic fistula following surgery for benign pancreatic tumors. Consequently, this decreases the necessity for secondary interventions related to grade C pancreatic fistula, ultimately enhancing patient prognosis and quality of life.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposal of a Risk Scoring System to Assist in Preoperative Radiographic Decision-Making for Gastroscopic Foreign Body Extraction.","authors":"Jinqing Wu, Xue Li","doi":"10.1097/SLE.0000000000001448","DOIUrl":"10.1097/SLE.0000000000001448","url":null,"abstract":"<p><strong>Background and aims: </strong>Esophageal foreign body (FB) impaction demands timely gastroscopic extraction, yet the need for preoperative radiographic imaging (PORI) varies by patient. To date, no validated risk-stratification tools exist to guide clinicians in determining the necessity of PORI before gastroscopic FB extraction. This study aims to fill this gap by developing a novel esophageal FB symptom score (EFBSS) to stratify patients at risk of severe complications, thereby providing a personalized approach to PORI decision-making.</p><p><strong>Methods: </strong>Patients with suspected FBs were retrospectively categorized into PORI or non-PORI groups. Gastroscopic success rate, complications, and survival prognosis were compared and analyzed between the 2 groups. Logistic regression was used to identify risk factors for FB-related perforation or surgical complications. A risk stratification system (low-risk: 0 to 3; moderate-risk: 4 to 6; high-risk: 7 to 9 points) was then built based on the likelihood of such complications to guide PORI decision-making.</p><p><strong>Results: </strong>There was no statistically significant difference between the PORI group (n=749) and the non-PORI group (n=1751) in the main outcome indicators, such as disease characteristics, FB types, incidence of complications, gastroscopic success rate, and survival prognosis (P>0.05). However, the PORI group had a longer duration of FB impaction and higher outpatient costs than the non-PORI group (P<0.05). The EFBSS includes swallowing FBs with pain, intentional ingestion of FBs, and cervical/chest/abdominal pain, with good discriminative power. The total score had an area under the receiver operating characteristic curve (AUC) of 0.822 (95% CI: 0.736-0.908), while the AUCs for the 3 components were 0.716, 0.699, and 0.894, respectively. The EFBSS system stratified the risk of FB-related perforation or surgical complications into 3 tiers: low (0.41%), moderate (2.95%), and high (39.29%). A significantly increasing risk trend was observed across tiers (P<0.001).</p><p><strong>Conclusions: </strong>We developed a risk scoring system incorporating swallowing FBs with pain, intentional ingestion of FBs, and cervical/chest/abdominal pain. This system preoperatively stratifies patients by the risk of FB-related perforation or surgical complications to facilitate PORI decision-making and maximize benefits.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":"36 3","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Gender, Videogaming and Music Playing on Robotic Surgery Simulation Performance.","authors":"Giovanni D Tebala, Francesca Duro, Isabella Tató, Chiara De Bonis Cristalli, Luca Properzi, Stefano Avenia, Roberto Cirocchi","doi":"10.1097/SLE.0000000000001420","DOIUrl":"10.1097/SLE.0000000000001420","url":null,"abstract":"<p><strong>Introduction: </strong>Virtual reality simulation is a fundamental adjunct to robotic surgery training. It is not clear if individual performance at the simulator can be affected by predisposing factors such as gender, video gaming, and instrument playing.</p><p><strong>Methods: </strong>Sixty-three volunteering medical students performed five times the same exercise at the DaVinci Simulator, and performance scores were collected for each participant (Overall Score, Time to Complete, Economy of Motion, Penalty Score) along with their demographics. Data were collected and analyzed within an electronic database. The difference (delta) between the highest score obtained in tests 2 to 5 and the score obtained in test 1 was calculated for each of the 4 scores and for each participant.</p><p><strong>Results: </strong>All participants showed a significant improvement in their scores with practice (deltas were always positive). Median PS was significantly lower in women, but PSdelta was significantly higher in women than in men. Median TC and median PS were significantly lower in non-video game users. No significant difference of performance scores was found between music players and non-music players. Multivariable analysis confirmed that female gender was an independent prognostic variable towards PSdelta, that is, women showed a steeper improvement in their performance.</p><p><strong>Conclusion: </strong>Repeated simulation improves the performance of surgically naïve medical students. Women and non-video gamers had higher penalty scores, but women tend to improve their skills quickly. As videogaming is much more frequent within the group of men, it is possible that videogaming itself, and not gender, can have a positive effect by enhancing eye-hand coordination.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}