Evidence map›Paper›PMID 42319429›Full record

Trial reportSurgical endoscopy2026

Comparison of learning curves and cross-over effects using articulating laparoscopic instruments versus standard laparoscopic instruments.

Jean-Paul Bereuter, Maximiliano Emmanuel Ceron Malpica, Mark Enrik Geissler, Josephine Runge, Jasmin Hasanovic, Anne Selbmann, Rona Berit Geissler, Grit Krause-Jüttler, Alexander Kern, Jürgen Weitz and 4 more

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Jean-Paul BereuterDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany. jean-paul.bereuter@ukdd.de.ORCID http://orcid.org/0009-0003-2981-1448
Maximiliano Emmanuel Ceron MalpicaSurgical Skills Lab Dresden, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Mark Enrik GeisslerDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
Josephine RungeDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
Jasmin HasanovicDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
Anne SelbmannDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
Rona Berit GeisslerDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
Grit Krause-JüttlerDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
Alexander KernDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
Jürgen WeitzDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
Marius DistlerDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
Felix von BechtolsheimDepartment of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.
Jakob Dobroschke *Department of General, Visceral and Thoracic Surgery, Proctology, Helios Klinikum Pirna, Pirna, Germany.
Florian Oehme *Department of Visceral, Thoracic and Vascular Surgery, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Fetscherstraße 74, 01307, Dresden, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMinimally invasive surgery evolves continuously with novel tools complementing standard laparoscopic instruments (SLI). Articulating laparoscopic instruments (ALI) provide enhanced dexterity resembling robotic systems while remaining more affordable and accessible. However, comparative data on their learning curve and performance are limited. This study investigated ALI training and performance in a controlled simulator setting.

methodsFifty-three medical students participated. After baseline measurement, all participants underwent the same modified Fundamentals of Laparoscopic Surgery (FLS) training curriculum but were randomized in either using ALI or SLI. Learning curves were tracked for the Peg transfer and suture and knot tasks until a predefined proficiency level was reached. All participants then completed final assessments using both instrument types. The primary endpoint was peak force; secondary endpoints included instrument motion metrics, task time, error rate, and SURG-TLX workload scores.

resultsThe ALI group demonstrated a slower learning curve in the Peg transfer task compared to the SLI group based on task time (p < 0.001), peak force (p = 0.02), and path length (p < 0.001). In the final assessment, peak force was comparable between groups (Peg: p = 0.17; Suture: p = 0.28), while ALI use resulted in greater path length (Peg: p < 0.001; Suture: p = 0.01) and longer task time (p < 0.001). Error rates and SURG-TLX scores did not differ. In the crossover assessment, prior ALI training resulted in comparable results for SLI for most parameters, including peak force (Peg: p = 0.97, suture: p = 0.05), instrument speed (Peg: p = 0.13, suture: p = 0.27) or error rate (Peg: p = 0.06; suture: p = 0.21).

conclusionAlthough ALI require a longer learning curve, training with these instruments transfers effectively to standard laparoscopic skills. Their robotic-like motion and accessibility support incorporating ALI into surgical education.

Indexed as

LaparoscopesLaparoscopyLearning CurveClinical CompetenceCross-Over StudiesFemaleHumansMaleSimulation TrainingSuture TechniquesArticulating instrumentsLaparoscopic skill analysisMinimally invasive surgery

Identifiers

PMID42319429
PMCPMC13457440

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.