Open research questions in Surgical Simulation and Training
432 gap statements mined from Surgical Simulation and Training papers in our 7.9M-paper local library, which holds 2,613 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.
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What the literature leaves open
One challenge is the need for further research to establish standardized treatment protocols and evaluate long-term effectiveness. Another challenge is the limited data on the use of VR in otolaryngology nursing, particularly in areas such as dysphagia. A technical challenge is the need for precise control of acoustic parameters in VR environments to provide standardized and reproducible training conditions.
Virtual Reality Technology in Otolaryngology Patient Care Management: A Narrative Review of Current Evidence and Future Prospects · 2026 · DOIThe gap is the need for further research to establish standardized treatment protocols and evaluate long-term effectiveness. The current evidence is primarily derived from stroke rehabilitation studies with small sample sizes and short follow-up periods. Data specific to dysphagia in otolaryngology remain extremely limited.
Virtual Reality Technology in Otolaryngology Patient Care Management: A Narrative Review of Current Evidence and Future Prospects · 2026 · DOILack of a standardized framework for assessing intraoperative visualization in endoscopic spine surgery. Need for a reliable and reproducible method for evaluating visualization quality.
Validation of the VIEW score: a novel intraoperative grading scale for visualization in endoscopic spine surgery · 2026 · DOIThe paper identifies a gap in the need for effective training methods and programs for MISP. The current methods may not provide sufficient training for residents, leading to potential risks for patients.
Evaluation of a mixed reality navigation simulator for training of minimally invasive interventions of the spine: a pilot didactic plan · 2026 · DOILimited insight into how surgeons execute and adapt techniques in real time. Poor understanding of the evolution of micromotor strategies across training levels. Lack of objective, competency-based milestones for technical competency.
Defining surgical strokes in lumbar laminectomy: toward objective skill assessment and robotic integration · 2026 · DOIThe study identifies several challenges associated with robotic surgery, including the potential negative impact on situational awareness and the need for access to robotic surgical training. The results highlight the importance of careful planning and implementation of robotic surgery programs to ensure successful adoption and minimize negative impacts on surgeons.
Robotic Surgery from a Gynaecological Oncology Perspective: A Global Gynaecological Oncology Surgical Outcomes Collaborative Led Study (GO SOAR3) · 2025 · DOIThe effect of physical training on surgical performance is unclear. There is a need to investigate the impact of physical training on simulated laparoscopic performance in gynecologic surgery. The relationship between physical capacity and surgical performance is not well understood.
Effect of a physical training program on simulated laparoscopic performance in gynecologic surgery: a randomized controlled trial · 2026 · DOIAutomating surgical suturing requires reliable computer vision systems, yet annotated real surgical datasets remain scarce, costly, and difficult to obtain.
Generative AI pipeline with model-guided filtering for sim-to-real transfer in surgical imaging · 2026 · DOIAs orthopedic surgery residency programs increasingly integrate VR-based simulation, evidence regarding trainee satisfaction and self-perceived confidence remains scarce.
Virtual reality training is associated with high satisfaction and self-perceived surgical confidence in anterior cruciate ligament reconstruction: Experience from an orthopedic residency pilot study · 2026 · DOIConsidering added time and platform-associated costs, the clinical settings in which robotic assistance may provide a meaningful benefit remain to be defined.
Learning Curve in Robotic-Assisted Microsurgery: A Systematic Review of Skill Acquisition · 2026 · DOIThe American Association for the Surgery of Trauma (AAST) Acute Care Surgery (ACS) fellowship includes a dedicated operative year with high-volume trauma and emergency general surgery exposure that could offer insights for how to accelerate procedural readiness, but its performance against KSA-CA standards has not been evaluated.
Readiness accelerators for military general surgeons: Insights from acute care surgery fellowship programs · 2026 · DOIWhile automated capture through virtual platforms or video-based tracking can enhance reproducibility, automation alone does not compensate for poorly defined metrics or inconsistent scoring frameworks.
Simulation‐based assessment in laparoscopic urology: Model design and validation challenges · 2026 · DOIImportantly, exploratory post hoc analysis suggested that completion time alone was insufficient to characterise performance quality at this level.
Simulation‐based assessment in laparoscopic urology: Model design and validation challenges · 2026 · DOIWhile validity evidence for data-driven assessments increases, strategies for implementation in surgical training remain scarce.
Development of a stakeholder-informed framework for the implementation of surgical sabermetrics to enhance training and education · 2026 · DOISimulator-based training has already been shown to improve subsequent operating room performance, but objective benchmarks to assess skill proficiency are lacking.
Expert Performance on a Hip Wire Navigation Simulator Provides a Basis for Establishing Benchmarks to Define Skill Proficiency · 2026 · DOITime constraints limited the tasks to the left side of the spine. Small sample size. The study was limited to a pilot training program.
Evaluation of a mixed reality navigation simulator for training of minimally invasive interventions of the spine: a pilot didactic plan · 2026 · DOIThe study identifies the challenge of comparing two independently designed surveys with different questionnaires and populations. The study highlights the difficulty of calculating the response rate for the YEARS survey due to the unknown number of individuals who received the survey invitation. The study notes the limitation of excluding responses from obstetricians and reproductive doctors in the JSGRS survey.
Comparison of European regionwide and Japanese nationwide surveys on gynecologic robotic surgery · 2026 · DOIInvestigation of differences in training structures and opportunities between Europe and Japan, - Analysis of the impact of robotic surgery on patient outcomes, - Comparison of robotic surgery adoption and training in other…
Comparison of European regionwide and Japanese nationwide surveys on gynecologic robotic surgery · 2026 · DOIThe study used a retrospective review of video archives, - The sample size was limited to 40 video clips, - The study only included single-level interlaminar endoscopic lumbar…
Validation of the VIEW score: a novel intraoperative grading scale for visualization in endoscopic spine surgery · 2026 · DOIThe study was conducted in a limited number of countries - The model was tested by a limited number of surgeons and trainees - The study did not compare the SWIFTSS model to other low-cost hernia simulation…
The SWIFTSS hernia model: putting ultra-low-cost hernia simulation in everybody’s hands · 2026 · DOIExpanding mesh use internationally - Developing a sustainable strategy by enhancing local healthcare capacity - Increasing access to, and training programmes for, mesh inguinal hernia…
The SWIFTSS hernia model: putting ultra-low-cost hernia simulation in everybody’s hands · 2026 · DOIThe dataset is limited to 205 patients and specific to an ENT unit in Chile, constraining the generalizability of the findings to other specialties or larger healthcare systems - The relatively small size of the dataset raises concerns about potential impacts on model performance - Certain variables, such as Rcuid and Ccrit, showed minimal impact on q p (t), raising questions about their relevance or potential…
Quantifying the economic and operational benefits of the methodology, including potential cost savings from optimized resource utilization and improved patient outcomes - Validating the scalability and applicability of the methodology with larger and more diverse datasets - Refining feature engineering to improve the relevance and predictive power of the included variables - Exploring alternative ML techniques…
Validation of the NVAC controller in real-world surgical scenarios. Comparison with other control architectures in terms of computational complexity and performance. Investigation of the NVAC controller's ability to adapt to different types of surgical procedures.
Investigation of the long-term effects of robotic surgery on surgeons, - Study of the effects of robotic surgery on learning curves in gynaecological oncology, - Research on access to robotic training and its impact on surgical…
Robotic Surgery from a Gynaecological Oncology Perspective: A Global Gynaecological Oncology Surgical Outcomes Collaborative Led Study (GO SOAR3) · 2025 · DOI
Most-cited papers in Surgical Simulation and Training
- An estimation of the global volume of surgery: a modelling strategy based on available data · The Lancet · 2008 · 1,902 citations
- Association Between Implementation of a Medical Team Training Program and Surgical Mortality · JAMA · 2010 · 829 citations
- Development of a rating system for surgeons' non‐technical skills · Medical Education · 2006 · 505 citations
- Simulation in surgical training: educational issues and practical implications · Medical Education · 2003 · 461 citations
- A Review on Virtual Reality Skill Training Applications · Frontiers in Virtual Reality · 2021 · 424 citations
- Accuracy of a Computer-Aided Surgical Simulation Protocol for Orthognathic Surgery: A Prospective Multicenter Study · Journal of Oral and Maxillofacial Surgery · 2012 · 399 citations
- Artificial Intelligence for Intraoperative Guidance · Annals of Surgery · 2020 · 383 citations
- Autonomous robotic laparoscopic surgery for intestinal anastomosis · Science Robotics · 2022 · 365 citations
- Artificial Intelligence for Surgical Safety · Annals of Surgery · 2020 · 326 citations
- Association Between Surgeon Technical Skills and Patient Outcomes · JAMA Surgery · 2020 · 303 citations
Most recent work
- Reliability of urological telesurgery compared with local surgery: multicentre randomised controlled trial · BMJ · 2026
- Large-scale self-supervised video foundation model for intelligent surgery · npj Digital Medicine · 2026
- Artificial Intelligence in Minimally Invasive and Robotic Gastrointestinal Surgery: Major Applications and Recent Advances · Journal of Personalized Medicine · 2026
- AI‐Driven Revolution of Medical Robotics Across Surgical Innovation, Rehabilitation Intelligence, and Multimodal Healthcare Delivery · MedComm · 2026
- Artificial intelligence analysis of minimally invasive surgery data · Journal of Robotic Surgery · 2026
- Global evolution of robot-assisted spine surgery: a bibliometric and knowledge-mapping study (1997–2026) · Journal of Robotic Surgery · 2026
- AI-based computer vision as an adjunct tool for CVS documentation in laparoscopic cholecystectomy · Surgical Endoscopy · 2026
- Comparative validation of surgical phase recognition, instrument keypoint estimation, and instrument instance segmentation in endoscopy: Results of the PhaKIR 2024 challenge · Medical Image Analysis · 2026
- The Impact of a Self‐Directed, Low‐Cost Laparoscopic Simulation‐Based Training Model Among Surgical Trainees in Cameroon · World Journal of Surgery · 2026
- Decoding the surgical scene: A scoping review of scene graphs in surgery · Medical Image Analysis · 2026
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