Objective: to describe the initial experience and evaluate the learning curve of Thulium Fiber Laser Enucleation of the Prostate (ThuFLEP) in a training program. Methods: an ambispective study included consecutive patients with benign prostatic enlargement who underwent ThuFLEP between March 2024 and January 2025. Collected variables included demographics, operative times, enucleation and morcellation efficiency, perioperative complications, and functional outcomes at 3 months. Learning progression was assessed using linear regression of enucleation efficiency and operative time across consecutive cases, and by stratifying patients into quartiles according to case order. Results: thirty‑eight patients were included. Mean prostate volume was 74.5 ± 19.6 g, and mean operative time was 83.6 ± 40.3 minutes. Mean enucleation efficiency was 0.75 ± 0.30 g/min. Total operative time decreased by approximately 3 minutes per case (p < 0.01). Most complications were low grade (Clavien-Dindo grade I–II). Significant improvement at 3 months was observed in PSA, IPSS, QoL, and PVR (all p < 0.0001). Operative proficiency reached around case 10-20. Limitations of this study: small sample size, ambispective design, and lack of a comparative group. Originality: this is the first Mexican study describing early experience and the learning curve of ThuFLEP in a training program. Conclusions: ThuFLEP shows a reproducible learning curve in a supervised training environment. Its safety profile, hemostatic properties, and predictable tissue interaction support its use as a technique for surgical education.

Objective: To address the insufficient integration of theory and practice in surgical clinical clerkship teaching, the limited availability of authentic clinical cases, and the limitations of traditional standardized patients (SPs) in terms of consistency and organizational cost, this study aimed to develop an artificial intelligence-based standardized patient (AI-SP) teaching framework grounded in structured clinical case data. Lumbar disc herniation was used as a representative condition for application and exploratory implementation. Methods: An exploratory teaching application design was adopted. Based on the learning objectives of the lumbar disc herniation chapter in standard surgery textbooks, a layered AI-SP system was developed, comprising a case data layer, a clinical rules and teaching logic layer, and an AI interaction layer. Clinical case data were derived from a single-center spine surgery practice and were de-identified and structured into teaching-oriented data units. Diagnostic and therapeutic principles from textbooks, together with expert consensus and clinical guidelines, were abstracted into rule constraints and scenario evolution logic. The interaction layer employed a large language model to support multi-turn dialogue, with standardization ensured through role restriction, rule-based control, and consistency validation. The system was embedded into three stages of clerkship teaching—pre-clerkship preparation, in-clerkship guidance, and post-clerkship consolidation—and representative interaction workflows were developed. Results: A layered AI-SP architecture and information flow model tailored for surgical clinical clerkship teaching was established. Under predefined rule constraints, the system was able to generate stable patient narratives consistent with textbook content and clinical reasoning, enabling reproducible and controllable standardized teaching scenarios. An exploratory application suggested that the AI-SP facilitated the formation of a more structured disease understanding before students entered real clinical settings, improved the consistency and focus of clerkship discussions, and supported repeated practice under conditions of limited clinical resources. Quantitative evaluation of learning outcomes was not conducted in this study. Conclusion: The AI-SP framework, developed using artificial intelligence and structured clinical case data, may serve as an auxiliary tool for surgical clinical clerkship teaching by providing a controlled and standardized interactive training environment without replacing students’ clinical judgment. Future studies should incorporate multicenter case data and employ controlled designs with quantitative outcome measures to systematically evaluate the educational effectiveness.

Neurosurgical education requires innovative approaches to meet the demands of an evolving field and adequately train the next generation of surgeons. The Sonntag Virtual Reality Laboratory (SVRL) was established to transform neurosurgical education by harnessing immersive technologies such as virtual reality (VR), augmented reality (AR), and mixed reality (MR). Inspired by the legacy of Dr Volker K. H. Sonntag, the SVRL aims to enhance skill acquisition and knowledge retention through high-fidelity simulations, interactive anatomic modules, and advanced spine procedure training. A multidisciplinary team of neurosurgeons, medical educators, and technology experts collaborated to align SVRL development with core educational goals. The initial phase focused on curriculum design and assessment metrics, followed by the creation of customized VR, AR, and MR modules targeting essential neurosurgical procedures and concepts. All of these modules underwent iterative testing and refinement to ensure educational value and clinical relevance. The SVRL has produced innovative applications, including a VR-based freehand pedicle screw placement application, an MR scoliosis module, an ultrarapid artificial intelligence-driven spine model, and a comprehensive VR pathology library. Trainee feedback has been positive, citing improvements in decision-making, technical proficiency, and conceptual understanding. Engagement with SVRL tools has been associated with an increased interest in neurosurgical topics and enhanced learner confidence. The SVRL represents a forward-thinking approach to neurosurgical training. By offering immersive, scalable, and globally accessible educational experiences, the SVRL breaks down traditional learning barriers. Its early success highlights the potential to reshape surgical education and improve the preparedness of future neurosurgeons worldwide.

The Space Child Neonatal Trainer (SCNT), a Novel 3D-Printed Simulator for Neonatal Laparoscopy.

Position statement from the society of University surgeons, surgical education committee: Artificial intelligence in surgical training for medical students, residents, and fellows.

Anomaly changes in the functional connectome of post-operative neurosurgical patients: A case series.

Integrating Surgical Education and Patient Care: The Impact of a Student-Led Spine Patient Navigator Program.

EQIP 2023-2025: Increased Usability and Sustainability.

Differential Attainment in Higher Surgical Training: A Systematic Review of Contributing Factors And Interventions.

Pilot study of the use of a voice-controlled robotic scope holder for laparoscopic learning by residents in supervised autonomy.

How I Do It: Video-Based Self-Assessment as a Method of Open Surgical Education for Vascular Surgery Trainees.

Objective selection of bone mimetic materials using impact microindentation.

Development of Nontechnical Skills Assessment Tool and The Validation Study for Laparoscopic Inguinal Hernia Repair.

Learning Curves of Gynecologic Residents Preparing for the Essential in Minimally Invasive Gynecologic Surgery (EMIGS) Manual Skills Exam.

This study sought to evaluate disparities in operative autonomy among young neurosurgical trainees in Andean Latin America. It also explored the distribution of operative resources in the Andean Community and their association with neuroanatomic excellence and operative autonomy. Neurosurgical residents from training programs in Andean Latin America participated in a comprehensive survey to assess demographic information and their experiences with operative autonomy. The survey included inquiries regarding the cases performed autonomously, the availability of operative resources, and the locations of practice. Data were collected at 2 distinct time points: at the beginning and at the conclusion of the different educational interventions. A total of 132 neurosurgery residents participated in this study, with the majority being residents (108; 81.8%). Surgical autonomy varied significantly, with chief residents in capital programs performing 351 of 1108 (31.7%) reported cases independently (mean [SD], 11 [11] cases per chief resident) compared with only 23 of 185 (12.4%) in urban programs (mean [SD], 2.5 [1.3] cases per chief resident). In addition, access to functional operative resources correlated with autonomy; residents with working surgical microscopes (n = 59) and powered drills (n = 110) reported higher autonomy, emphasizing the critical role of these resources in enhancing operative experiences. This study highlights the importance of surgical autonomy in neurosurgical training within low- and middle-income countries, particularly in the Andean region. Moreover, there is a clear disparity in operative resources distribution among different locations of practice. Addressing these barriers can promote greater autonomy, ultimately improving surgical outcomes and education in global neurosurgery.

The sural nerve (SN) is a sensory nerve in the lower limb with notable variability in its origin, course, and branching patterns. This variability has important implications for diagnostic procedures, nerve grafting, and surgical planning, yet it remains underexplored in Southern African populations. This cadaveric study examined 90 lower limbs from 45 embalmed adult human cadavers (24 males, 21 females) at the University of Pretoria in South Africa. Each specimen was assessed for SN formation type, anatomical location, and morphometric data, including its contributing branches (medial sural cutaneous nerve [MSCN] and lateral sural cutaneous nerve [LSCN]). Measurements were recorded, and bilateral symmetry and sex-based differences were analyzed. Four SN formation types were identified, with Type 1 (union of MSCN and LSCN) being most common (62.2%). Formation most frequently occurred in the middle third of the leg (38.9%), although distribution across the middle, lower, and ankle levels was more evenly spread than in other populations. Bilateral symmetry in SN formation was seen in only 40% of cadavers. The average SN length was 100.1 mm and the mean distance from the lateral malleolus was 27.2 mm. This study confirms high anatomical variability of the SN among South African cadavers, and understanding such variation is crucial for clinicians performing nerve grafting or procedures in the distal leg. These findings may enhance surgical planning and education by emphasizing region-specific anatomical variation.

BackgroundTo deliver and evaluate two Emergency Urology Skills Training (EUST) courses in Ethiopia, aimed at equipping surgical and urology residents with hands-on skills and confidence in managing urological emergencies in resource-limited settings.MethodsTwo one-day, practical training courses were held in Hawassa and Addis Ababa in November 2024 and May 2025. Pre-course questionnaires assessed delegates' baseline confidence, prior training and the utility of a pre-course manual. A blended curriculum comprising didactic lectures, skill stations and one-to-one mentorship was delivered by a collaborative team of local and international faculty. Post-course evaluations measured improvements in knowledge, confidence and satisfaction.ResultsTwenty-three participants from each centre completed matched pre- and post-course multiple-choice questionnaires assessing knowledge of emergency urology procedures. Pre-course exposure to structured skills training was limited (≤30%). Both groups showed statistically significant improvements in post-course scores (Hawassa: p = 0.002; Addis Ababa: p = 0.007). Self-rated confidence and knowledge improved significantly (p < 0.05) in six of eight core procedures.ConclusionsThe EUST model effectively improved trainees' confidence and procedural competence in emergency urology. With adequate support, this model is scalable and applicable to other resource-limited countries seeking to strengthen urological emergency care and their training capacity.

Armed conflicts pose severe challenges to healthcare workforce pipelines, with specialized surgical training being particularly vulnerable. The war in Sudan, which began in April 2023, has led to a complex humanitarian crisis, damaging health infrastructure and displacing medical professionals. The impact on postgraduate urological surgical training requires detailed assessment. A national, descriptive quantitative cross-sectional study was conducted from September to December 2024. A structured online questionnaire was distributed to the complete national cohort of urology specialty trainees (n = 40, 100% census) and to surgical trainees in general and pediatric surgery programs who undertake mandatory urology rotations (high-response sub-cohorts, n = 60). Data on demographics, displacement, mental health, training quality, resource access, and adaptations were collected. Descriptive statistics were analyzed using SPSS v26.0. Among 100 trainees in the urological training pipeline-representing all current urology specialists-in-training in Sudan and a majority of surgical trainees with urology exposure-the majority (68%) were displaced to Port Sudan. A profound psychological burden was evident: 57% reported significant war-related mental health impacts, and 72% described severe training-related stress. Critically, only 24% accessed mental health services. Surgical training experienced major disruptions, with 84% reporting a decline in procedural participation and 86% a reduction in case diversity. Resource shortages affected 68%, and while 67% of programs underwent curriculum changes, remote learning was deemed ineffective by 51% of trainees. Confronting these systemic challenges, trainees proposed actionable solutions, prioritizing enhanced remote education (71%), secure funding for supplies (69%), and curriculum modification (66%). The Sudan conflict has profoundly disrupted urological surgical education, creating a mental health crisis and threatening future surgical capacity. Trainees are not passive victims but architects of a potential hybrid-resilience model. Their insights point to the urgent need for a collaborative, internationally supported "Surgical Training Support Framework" that integrates psychological support, a structured blended-learning curriculum, and guaranteed resource funding.

This randomized controlled trial evaluates an innovative interdisciplinary teaching model co-led by radiologists and vascular surgeons within China's standardized residency training program. Forty trainees were randomized into two groups: one receiving collaborative teaching, which included joint lectures, radiologist-attended ward rounds, and interdisciplinary case conferences; and the other undergoing traditional vascular single-discipline training. The experimental group exhibited superior performance in CT interpretation accuracy (92.0% vs. 71.0%, P < 0.01), diagnostic accuracy (87.0% vs. 67.0%, P < 0.01), treatment plan rationality (mean 4.40 ± 0.75 vs. 3.65 ± 0.88, P < 0.01), and communication skills (median 43.00 vs. 33.00, P < 0.0001). These findings validate that structured interdisciplinary collaboration effectively bridges the gap between radiology and clinical practice, suggesting a paradigm shift in vascular surgical education.

Human cadaver simulation is vital in medical training, offering realistic experience crucial for skill development, especially in laparoscopic surgery. Traditional cadaver types, like fresh frozen and embalmed, have limitations. Fix4Life (F4L), a novel embalming technique, aims to overcome these drawbacks by providing flexible, pliable tissue without discoloration. This study evaluates the realism and face validity of the F4L embalmed cadaver model for laparoscopic training, aiming to enhance surgical education and patient safety. Surgical residents and expert surgeons from Amsterdam UMC participated in a hands-on laparoscopy course, performing laparoscopic appendectomy, cholecystectomy, and totally extraperitoneal (TEP) hernia repair on Fix4Life cadavers. Prior to this, residents completed questionnaires immediately after training, while experts reviewed procedure videos and provided evaluations. Ethical approval was obtained, and written consent was acquired from participants. Procedures were supervised, recorded, and securely shared for assessment. Face validation forms were filled by both novices and experts, assessing realism and key aspects of laparoscopic surgery. Statistical analysis included non-parametric tests due to non-normal data distribution. Both residents and experts rated the laparoscopic procedures positively, with the TEP receiving particularly high scores. Residents rated the laparoscopic appendectomy and cholecystectomy as "Good" for all assessment points, while the TEP was frequently rated as "Very Good". The experts also rated the procedures in the majority of cases as "Good". Furthermore, novices tended to rate the procedures more favorably than experts, particularly in terms of lifelike tissue manipulation (p < 0.001), tissue color (p = 0.014), and comparability to reality (p = 0.046). The Fix4Life embalming method provides a realistic training modality for laparoscopic appendectomy, laparoscopic cholecystectomy, and TEP.