Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland最新文献

{"title":"Evaluating core surgical training selection: Associations between the Multi-Specialty Recruitment Assessment (MSRA), interview performance and offer outcomes in the 2025 UK national cohort.","authors":"J K Seehra, R Ellis, B Doleman, E McLarty, J N Lund","doi":"10.1016/j.surge.2026.03.005","DOIUrl":"https://doi.org/10.1016/j.surge.2026.03.005","url":null,"abstract":"<p><strong>Background: </strong>The Multi-Specialty Recruitment Assessment (MSRA) is a national aptitude test increasingly incorporated into selection for Core Surgical Training (CST) in the United Kingdom. Although intended to enhance objectivity and equity, its relationship with subsequent interview performance and final CST offer outcomes remains unexplored.</p><p><strong>Methods: </strong>A retrospective cross-sectional study analysed anonymised data from the 2025 UK CST national selection process. Applicants who completed both the MSRA and structured interview were included. Multivariable linear and logistic regression models examined associations between applicant characteristics (including demographic factors and requests for interview adjustments) and performance across three stages: MSRA, interview, and CST offer outcome. Results are presented as adjusted regression coefficients (β) or adjusted odds ratios (aOR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Of 1154 applicants, 1045 had complete data. Female applicants scored higher on the MSRA (β = 0.13, 95% CI 0.01 to 0.25) and interview (β = 0.18, 95% CI 0.05 to 0.30) than males. Higher MSRA performance was associated with higher interview scores (β = 0.22 per 1 SD, 95% CI 0.12 to 0.32) and greater odds of receiving a CST offer (aOR = 1.42, 95% CI 1.05 to 1.94). Non-UK graduates demonstrated lower MSRA and interview scores and consequently had lower odds of receiving a CST offer. Applicants requesting interview adjustments also had lower odds of an offer.</p><p><strong>Conclusion: </strong>MSRA performance was positively associated with interview and offer outcomes, supporting its role as an objective component of CST selection. Continued monitoring across recruitment cycles is required to ensure the process remains equitable, transparent, and aligned with surgical training needs.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693165","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":"Which benign-appearing impassable sigmoid strictures are safe to manage conservatively? Insights from a multicenter cohort.","authors":"Mohit S Gupta, Ana D Gavrila, Ismail Mallick, Abel Abel, Benjamin M Stubbs","doi":"10.1016/j.surge.2026.03.006","DOIUrl":"https://doi.org/10.1016/j.surge.2026.03.006","url":null,"abstract":"<p><strong>Background: </strong>Impassable sigmoid strictures with benign endoscopic appearance present a clinical dilemma, balancing the risk of missed malignancy against the morbidity of surgical resection. Historical guidelines have recommended resection by default, but contemporary imaging and multidisciplinary team (MDT) input may allow for more selective, conservative management.</p><p><strong>Objective: </strong>To evaluate clinical features and decision-making factors associated with safe non-operative management of benign-appearing impassable sigmoid strictures.</p><p><strong>Methods: </strong>A multicentre retrospective analysis was conducted across three NHS hospitals between 2017 and 2023. Patients with benign-appearing sigmoid strictures at index colonoscopy were included. Data were collected on imaging, biopsy, MDT decisions, management strategy, and long-term outcomes. Patients were stratified by operative vs conservative treatment, and a decision-support framework was developed based on MDT experience.</p><p><strong>Results: </strong>Of 108 impassable sigmoid strictures, 51 were benign-appearing. Among these, 37 (72.5%) were managed conservatively and 14 (27.5%) underwent surgery. No cases of colorectal cancer were identified in the conservatively managed group over a minimum follow-up of two years. Malignancy was confirmed in 3 of 14 (21.4%) resected patients. Conservative decisions were supported by reassuring imaging, absence of red-flag symptoms, and benign or unobtainable biopsies. A practical framework was developed to guide MDT case selection.</p><p><strong>Conclusion: </strong>Selected patients with benign-appearing impassable sigmoid strictures can be safely managed without surgery, particularly when supported by modern imaging, clinical judgment, and MDT review. These findings challenge the need for routine resection and support a tailored, risk-adapted approach.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619008","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":"Trans-anal minimally invasive surgery (TAMIS): Case series on short-term outcomes and systematic review of the literature.","authors":"Osama Zaman, Shafquat Zaman, Mohamed Ebraheem, Aaminah Chaudhry, Ali Yasen Mohamedahmed, Akinfemi Akingboye, Stelios Vakis, Najam Husain, Georgios Kakaniaris","doi":"10.1016/j.surge.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.surge.2026.03.004","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer is the third most common malignancy worldwide with rectal cancer accounting for approximately 30% of all new cases. Surgery is the standard of care in the treatment of localised malignancy and can be performed through open and various minimally invasive approaches. Trans-anal minimally invasive surgery (TAMIS) represents a rectal-sparing hybrid technique between single-port laparoscopy and trans-anal endoscopic microsurgery (TEM) for resection of benign and early-stage rectal cancers. We present our initial experience with TAMIS including short-term outcomes and provide an updated systematic review.</p><p><strong>Methods: </strong>A retrospective case series of patients with rectal lesions who underwent TAMIS between February 2022 to June 2024 at a district general hospital in the UK was performed. Basic patient demographics, intra- and postoperative outcomes including complications were collected and analysed. A comprehensive search of various electronic databases for the systematic review was conducted including PubMed, Embase, MEDLINE, and Web of Knowledge. Studies (excluding case reports) including patients diagnosed with rectal malignancy or benign polyps and treated with TAMIS were included. Analysed outcome measures were excision quality and complications.</p><p><strong>Results: </strong>Our case series cohort included a total of 25 patients with a mean age of 70.7 years (SD = 14.3). Mean distance of lesion from the anal verge was 5.8 cm (SD = 3.2), with intra-operative blood loss of 6.0 mls (SD = 10.5), and an operative duration of 67.0 min (SD = 38.9). Final histopathological analysis showed adenocarcinoma in 20%, morbidity rate of 12%, R0 resections in 72%, and 30-day re-admission rate of 16%. The mean length of stay was 2.4 days (SD = 1.8). A total of 48 studies, with 1964 patients were included in the systematic review, with a mixture of case series, comparative studies and published abstracts. Average age was 64.4 years (SD = 6.4) and 42.8% were female. Mean distance of lesion from the anal verge was 6.9 cm (SD = 1.3) with an operative duration of 71.2 min (SD = 18.5). Length of stay was 1.5 days (SD = 1.3), R0 resection rates of 91.8%, morbidity rate of 11.6%, and recurrence rate of 4.7%, respectively.</p><p><strong>Conclusion: </strong>Although TAMIS is a safe and feasible option in the treatment of benign polyps and early-stage malignancy, outcomes remain similar in the decade since the first published review. TAMIS is still a relatively new technique and it is anticipated that outcomes will likely improve with time.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595792","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":"New consultant syndrome: authority without dominance.","authors":"Michael El Boghdady","doi":"10.1016/j.surge.2026.03.003","DOIUrl":"https://doi.org/10.1016/j.surge.2026.03.003","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595777","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":"Comparing diverting and primary repair/anastomotic techniques for managing colorectal trauma: A systematic review and meta-analysis.","authors":"Abdullah Y Ali, Saaniyah Sajed, Annaliisa S Cordova, Ahmed Adham R Elsayed, Marc D Basson","doi":"10.1016/j.surge.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.surge.2026.03.002","url":null,"abstract":"<p><strong>Purpose: </strong>Colorectal trauma management has evolved significantly, with ongoing debate regarding optimal surgical approach between fecal diversion and primary repair/anastomotic techniques. This systematic review and meta-analysis compared diverting and non-diverting operative management strategies for colorectal trauma.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines, searching for four databases through October 2024. Studies comparing fecal diversion to primary repair/anastomosis in colorectal trauma were included. Meta-analysis was performed using R software.</p><p><strong>Results: </strong>Forty-nine studies comprising 7201 patients were included (7 randomized trials, 40 observational studies, 2 case series). Of these, 4007 (55.6%) patients underwent non-diverting procedures, while 3090 (42.9%) received fecal diversion. Penetrating injury was the most common mechanism. Patients in the diverting group had higher injury severity scores, greater fecal contamination, and more associated injuries. Meta-analysis of 5397 patients demonstrated significantly lower mortality for non-diverting procedures compared to fecal diversion (OR 0.46, CI 0.29-0.75, p < 0.0001). Infectious complications were also significantly lower in the non-diverting group (OR 0.49, CI 0.3-0.8, p < 0.0001) among 4078 patients analyzed.</p><p><strong>Conclusions: </strong>Non-diverting operative procedures are a feasible choice for the management of civilian penetrating and blunt colon trauma. Previously established criteria for mandatory fecal diversion do not independently predict poor outcomes and should not be the sole guide in clinical decision-making. On the other hand, diverting ostomy should be conducted in the setting of rectal trauma.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534115","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":"Risk factors for adverse outcomes in first-time renal parathyroid surgery: an analysis of the United Kingdom Registry of Endocrine and Thyroid Surgeons.","authors":"Amy Campbell, Izhar Khan, James Kirby-Bott, Sebastian Aspinall","doi":"10.1016/j.surge.2026.01.003","DOIUrl":"https://doi.org/10.1016/j.surge.2026.01.003","url":null,"abstract":"<p><strong>Background: </strong>Recommendations for surgery in patients with renal hyperparathyroidism lack evidence. This study analysed outcomes of first-time renal parathyroidectomy in United Kingdom Registry of Endocrine and Thyroid Surgery (UKRETS) to establish risk factors for adverse outcomes.</p><p><strong>Methods: </strong>Data from 2005 to 2020 was analysed. Entries with missing data, age <15 and >85 years, and length of stay (LOS) >28 days were excluded. Outcome variables included temporary hypocalcaemia, persistent disease, re-operation for bleeding, general complications, readmission and LOS. Persistent disease was only analysed in tertiary hyperparathyroidism. Four gland excision was categorised as total, 3.5 subtotal and <3.5 less than subtotal (LTST).</p><p><strong>Results: </strong>2135 patients underwent first-time surgery, 67.6% (1443/2477) were analysed, 54.0% (779) total, 18.4% (266) sub-total 27.6% (398) LTST. Temporary hypocalcaemia occurred in 47.5% (685/1443), reoperation for bleeding 0.5% (9/1443), complications 5.6% (81/1443), readmission 2.6% (37/1443), and mean LOS 3.5 days. Temporary hypocalcaemia 59.2% (461/779, p < 0.001) and complications 6.8% (53/779, P = 0.033) were significantly higher in total parathyroidectomy. Multivariable analysis showed LTST (OR 0.317 95% CI 0.243-0.415 p < 0.001), increasing age (OR 0.985 95% CI 0.977-0.992 p < 0.001), imaging (OR 0.632 95% CI 0.494-0.809 p < 0.001), and tertiary hyperparathyroism (OR 0.789 95% CI 0.628-0.991 p = 0.042) significantly decreased the risk of temporary hypocalcaemia. Persistent disease occurred in 4.9% (28/576) of patients with tertiary hyperparathyroidism. Multivariable analysis found this was significantly higher (OR 5.35 95% CI 2.253-12.703 p < 0.001) in LTST.</p><p><strong>Conclusions: </strong>Total parathyroidectomy was the commonest operation. The incidence of temporary hypocalcaemia was high, and although this was reduced in LTST, this operation was associated with an unacceptably high incidence of persistent disease in tertiary hyperparathyroidism.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147482343","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":"Can we reduce the residual use of Hartmann's procedure in generalized peritonitis due to perforated colonic diverticulitis ?","authors":"J Pinson, T Pressat Laffouilhere, E Roussel, A Zago, E Papet, V Bridoux, J J Tuech","doi":"10.1016/j.surge.2026.03.001","DOIUrl":"https://doi.org/10.1016/j.surge.2026.03.001","url":null,"abstract":"<p><strong>Aim of the study: </strong>Primary anastomosis (PA) is now recommended for most cases of diverticular peritonitis. However, recent studies have shown that Hartmann's Procedure (HP) is still included in the majority of practice patterns. The aim of this study was to analyze situations wherein HP was carried out and to define its remaining place among current treatment options for generalized peritonitis.</p><p><strong>Methods: </strong>We performed a retrospective cohort study of patients who underwent sigmoidectomy for diverticular peritonitis at Rouen University Hospital between 2004 and 2020. Logistic regression was computed to evaluate the predictive factors of treatment attribution.</p><p><strong>Results: </strong>257 patients were included in this study, of whom 154 patients (59.9%) were managed with HP and 103 (40,1%) were managed with PA. The rate of PA progressively increased and represented the majority from 2018. PA was performed by a fellow surgeon in 28% of cases and during the night shift in 60% of cases. A procedure performed by a colorectal specialist surgeon or by a senior surgeon was significantly associated with PA, with ORs of 3.43 (p = 0.017) and 2.06 (p = 0.041), respectively. Night surgery, a medical history of immunosuppression, an ASA score = 3, and age above 75 years were significantly associated with HP, with ORs of 0.33 (p = 0.002), 0.31 (p = 0.023), 0.25 (p = 0.005), and 0.31 (p = 0.011), respectively.</p><p><strong>Conclusion: </strong>Over time, the use of primary anastomosis progressively increased and became the predominant strategy in our institution. These findings suggest that, in appropriately selected patients and when performed by experienced surgeons, primary anastomosis is a safe and increasingly applicable strategy in generalized diverticular peritonitis.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436894","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":"'Keeping kids close to home for surgery': The environmental impact of Ireland's newest surgical subspecialty.","authors":"Niamh Quinn, Nicola Brindley, J Calvin Coffey, Brice Antao, Tara M Connelly","doi":"10.1016/j.surge.2026.02.005","DOIUrl":"https://doi.org/10.1016/j.surge.2026.02.005","url":null,"abstract":"","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367068","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":"Predicting postoperative risk in adult men undergoing ankle fracture surgery: Development of a novel composite frailty score.","authors":"Cameron J Sabet, Bhav Jain, Bara M Hammadeh, Jiaqi Liu","doi":"10.1016/j.surge.2026.02.009","DOIUrl":"https://doi.org/10.1016/j.surge.2026.02.009","url":null,"abstract":"<p><strong>Background: </strong>Ankle fractures represent one of the most common orthopedic injuries, with over five million cases annually in the United States. As surgical populations age, comprehensive preoperative risk stratification becomes increasingly critical for optimizing patient outcomes and resource allocation. While individual frailty indices such as the Risk Analysis Index (RAI), Geriatric Nutritional Risk Index (GNRI), and American Society of Anesthesiologists (ASA) classification have demonstrated predictive value for postoperative complications, no composite scoring system has been validated for ankle fracture surgery.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 10,626 adult male patients who underwent surgical treatment for isolated ankle injuries between 2015 and 2021 using the ACS NSQIP database. Patients were stratified using RAI (robust ≤20, normal 21-30, frail 31-40, very frail ≥41), GNRI nutritional risk categories, ASA classification, and a novel Combined ASA-RAI-Preoperative Acute Severe Condition (CARP) score. Primary outcomes included 30-day mortality, major complications, extended length of stay, non-home discharge, unplanned readmission, and reoperation. Model discrimination was assessed using receiver operating characteristic curve analysis with internal validation via bootstrap resampling.</p><p><strong>Results: </strong>The cohort demonstrated low overall mortality (0.16%) but significant morbidity across frailty tiers. CARP demonstrated superior discriminative performance compared to individual indices for major complications (AUC 0.757 vs RAI 0.701, p = 0.025), minor complications (AUC 0.879 vs ASA 0.793, p = 0.002), and extended length of stay (AUC 0.735 vs mFI-5 0.669, p < 0.001). Bootstrap validation confirmed model stability with bias-corrected AUCs maintaining statistical significance.</p><p><strong>Conclusions: </strong>The novel CARP score provides enhanced risk stratification for ankle fracture surgery compared to traditional individual indices, enabling more precise preoperative counseling and perioperative optimization in this high-volume surgical population.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147349552","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":"National trends in general surgical trainees' operative numbers (2013-2022).","authors":"Lara Jane Rimmer, Jessica Tan, Nayaab Abdul-Kader, Matthew Boal, TanA H Arulampalam, TamsinE M Morrison","doi":"10.1016/j.surge.2026.02.007","DOIUrl":"https://doi.org/10.1016/j.surge.2026.02.007","url":null,"abstract":"<p><strong>Introduction: </strong>Over the past two decades, surgical training in the United Kingdom has evolved, driven by cultural change, laparoscopic and robotic technologies, healthcare reforms and a pandemic. Anecdotally, all of these have potentially contributed to a decline in trainee operative volume and independence.</p><p><strong>Objectives: </strong>This study aimed to examine trends in operative numbers and supervision levels of UK General Surgery trainees from 2013 to 2022 across a range of index procedures.</p><p><strong>Design: </strong>Anonymous logbook data was requested from JCST for trainees on a general surgical programme at CT1 to ST8 level between 2013 and 2022. Differences over time were compared using Spearman's and Pearson's rank correlation.</p><p><strong>Results: </strong>The total number of procedures recorded across all training grades declined significantly from 209,661 in 2013 to 147,026 in 2022 (Spearman's r = -0.9758, p < 0.0001∗∗∗∗, Pearson's r = -0.9188, p = 0.0002). There was a greater shift over time to consultant presence, with reduced levels of supervised-trainer unscrubbed (STU) and above being recorded. For ST6 trainees, the number of inguinal hernias recorded as STU and above decreased by 47% (Spearman's r = -0.9758 p < 0.0001∗∗∗∗, Pearson's r = -0.9722 p < 0.0001∗∗∗∗). For ST8 trainees, cholecystectomies recorded as STU and above decreased by 46% (Spearman's r = -0.9273 p = 0.0003∗∗∗, Pearson's r = -0.9191 p = 0.0002∗∗∗).</p><p><strong>Conclusion: </strong>A significant decline in total operative procedures was recorded across all General Surgery training levels, with senior trainees particularly affected by reduced operating. These findings underscore the need to adapt training to ensure trainees attain sufficient surgical expertise to become the consultants of the future.</p>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328017","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}