There is increasing availability of operative video for use in surgical training. Emerging technologies can now assess video footage and automatically generate metrics that could be harnessed to improve the assessment of operative performance. However, a comprehensive understanding of which technology features are most impactful in surgical training is lacking. The aim of this scoping review was to explore the current use of automated video analytics in surgical training. PubMed, Scopus, the Web of Science, and the Cochrane database were searched, to 29 September 2023, following PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. Search terms included ‘trainee’, ‘video analytics’, and ‘education’. Articles were screened independently by two reviewers to identify studies that applied automated video analytics to trainee-performed operations. Data on the methods of analysis, metrics generated, and application to training were extracted. Of the 6736 articles screened, 13 studies were identified. Computer vision tracking was the common method of video analysis. Metrics were described for processes (for example movement of instruments), outcomes (for example intraoperative phase duration), and critical safety elements (for example critical view of safety in laparoscopic cholecystectomy). Automated metrics were able to differentiate between skill levels (for example consultant versus trainee) and correlated with traditional methods of assessment. There was a lack of longitudinal application to training and only one qualitative study reported the experience of trainees using automated video analytics. The performance metrics generated from automated video analysis are varied and encompass several domains. Validation of analysis techniques and the metrics generated are a priority for future research, after which evidence demonstrating the impact on training can be established.

Enterobius vermicularis infection is uncommon in adults, compared to children, and rarely causes significant illness. Adult infection is usually colonic in nature and found incidentally at colonoscopy. Worm migration to other tissues is rare. We here-in describe the case of a 73-year-old woman found to have biliary tree E. vermicularis—an as yet undescribed site of migration.

In order to identify opportunities to streamline hepatopancreaticobiliary (HPB) multidisciplinary teams (MDT) for cancer care, it is important to first document variability in MDT team practices worldwide. We aimed to develop a comprehensive checklist of parameters to evaluate existing practices and guide the development of MDTs for new cancer services. Participants were recruited via the International Hepato-Pancreato-Biliary Association (IHPBA) and European-African HPB Association (E-AHPBA) and emailed an anonymised online survey. The survey comprised 29 questions, including a combination of closed-ended and open-ended questions. Responses were analysed using descriptive statistics and inductive content analysis. Analysing 72 responses from 31 countries, we found substantial variations in HPB MDT practices across regions. Notable variability was found in core team composition, chairing practices, caseload planning, information practices and MDT audit practices. Issues impacting efficiency were common to many MDTs. MDT care is understood and applied differently across the world. There is a lack of standardisation of practice, and an apparent need for better case preparation, effective specialist contribution, improved audit frequency and metrics to improve performance. It may be valuable to consider human factors while designing MDTs to support team decision processes, minimise errors, and enhance efficiency.

Technology-enhanced assessment of operative performance offers greater objectivity and reliability than traditional methods. However, consensus on the most critical metrics for informing the future of surgical training is lacking, and guidance on optimal application of these analytics to enhance feedback is needed. This study aimed to establish consensus on advanced operative performance metrics in surgical training and identify applications to enhance feedback. Data-driven 3-round Delphi method, where experts iteratively rated performance metrics derived from the surgical literature on a 7-point Likert scale. Statements reaching the a priori consensus threshold [round 1: > 75% rating => 6; round 2 + 3 > 50% rating => 6] were included in the final consensus statement. Electronic survey, using the research electronic data capture (REDCap) system. A pan-specialty, international panel of 57 surgical trainers, trainees and researchers. Twenty-two statements met the consensus threshold, of which 10 represented individual training specific metrics. Technical metrics were: dissection in the correct tissue plane (58.1% consensus); economy of motion (58.1%); and technical errors (53.5%). Non-technical metrics were: situation awareness (60.5%); communication (55.8%); decision -making (51.2%); and cognitive load (51.2%). Outcome metrics included: a safety score (60.5%); duration to react to adverse events (60.5%); and a global performance score (53.5%). Suggested applications to surgical training included: comparing individual metrics over time (65.1%); benchmarking against the average performance of trainees with similar experience (55.8%); and guiding formative assessments (51.2%). This Delphi study established international consensus on advanced operative performance metrics, providing a foundation for improved feedback in surgical training. Demonstrating validity of existing metrics and developing novel ones that were highly ranked are the critical next steps to integrate advanced technologies into surgical training curricula, enhancing trainee development and patient safety.