{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T05:09:49Z","timestamp":1781932189816,"version":"3.54.5"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Gastroesophageal reflux disease (GERD) impacts 10\u201330% of the population in the Western world. Surgical interventions including Laparoscopic Fundoplication (LF), Transoral Incisionless Fundoplication (TIF), and Magnetic Sphincter Augmentation (MSA) have proven effective in managing GERD. This meta-analysis aims to compare short- and long-term outcomes of these surgical options.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A comprehensive search of PubMed, Embase, Scopus, Cochrane, and Medline from 1980 to 2024 was conducted to identify randomized control trials or cohort designs that included adults with GERD who underwent fundoplication (Nissen, Toupet), MSA, or TIF and had preoperative and post-operative acid exposure time (AET), DeMeester score, and\/or relief score (e.g., GERD-HRQL); we considered all post-operative outcome measurements. We excluded studies with any surgical variations of the procedures, reoperations, and studies not published in English. Risk of bias was assessed using the Oxford scoring system for randomized control trials and the Newcastle\u2013Ottawa scale (NOS) for cohort designs. A total of 3912 studies were identified initially, with our review including 78 unique studies providing 166 post-operative outcome measurements. Given studies could include multiple post-operative outcome measurements, we used multilevel random-effects meta-analysis. Between-procedure comparisons were made using multilevel meta-regression.\u00a0For all outcomes, more positive values indicated greater improvement; mean differences (MD) were estimated for AET and DeMeester scores, whereas standardized mean differences (SMD) were estimated for relief scores.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 9516 patients were included with an average age of 50.8\u00a0years (SD: 6.7) with 53.7% male and an average BMI of 27.1 (SD: 2.3). The median length of follow-up across all observations was 12\u00a0months (IQR: 6\u201324\u00a0months; range: 0.25\u2013120.5\u00a0months). All procedures indicated a statistically significant mean improvement in AET, relief score, and DeMeester scores (Table\u00a01). Compared to Nissen, TIF averaged significantly less mean improvement in AET (MD: \u2212\u00a04.06, 95% CI: \u2212\u00a08.03 to \u2212\u00a00.09, <jats:italic>p<\/jats:italic>\u2009=\u2009.045) and DeMeester score (MD: \u2212\u00a020.60, 95% CI: \u2212\u00a038.33 to \u2212\u00a02.88, <jats:italic>p<\/jats:italic>\u2009=\u2009.023), whereas MSA and Toupet averaged significantly better relief scores (SMD: 0.28, 95% CI: 0.01 to 0.56, <jats:italic>p<\/jats:italic>\u2009=\u2009.044 and SMD\u2009=\u20090.17, 95% CI: 0.01 to 0.32, <jats:italic>p<\/jats:italic>\u2009=\u2009.034, respectively).\n<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Summary<\/jats:title>\n            <jats:p>This review advances understanding of the objective and subjective improvement of the traditional and recent surgical anti-reflux procedures used for symptomatic GERD. Overall, Nissen fundoplication demonstrated significantly better improvement with acid exposure and DeMeester score compared to MSA and TIF. However, symptom relief scores are significantly improved with Toupet fundoplication and MSA compared to other surgical treatment options.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00464-025-11856-5","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T20:13:14Z","timestamp":1748549594000},"page":"4496-4504","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Fundoplication significantly improves objective and subjective reflux outcomes\u2014a meta-analysis"],"prefix":"10.1007","volume":"39","author":[{"given":"Yanick","family":"Tad\u00e9","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Newman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan W.","family":"Walters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8500-8081","authenticated-orcid":false,"given":"Kalyana C.","family":"Nandipati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"issue":"10","key":"11856_CR1","doi-asserted-by":"publisher","first-page":"3754","DOI":"10.1007\/s00464-013-2961-0","volume":"27","author":"MR Wendling","year":"2013","unstructured":"Wendling MR, Melvin WS, Perry KA (2013) Impact of transoral incisionless fundoplication (TIF) on subjective and objective GERD indices: a systematic review of the published literature. Surg Endosc 27(10):3754\u20133761. https:\/\/doi.org\/10.1007\/s00464-013-2961-0","journal-title":"Surg Endosc"},{"issue":"30","key":"11856_CR2","doi-asserted-by":"publisher","first-page":"e4366","DOI":"10.1097\/MD.0000000000004366.PMID:27472725;PMCID:PMC5265862","volume":"95","author":"E Asti","year":"2016","unstructured":"Asti E, Bonitta G, Lovece A, Lazzari V, Bonavina L (2016) Longitudinal comparison of quality of life in patients undergoing laparoscopic Toupet fundoplication versus magnetic sphincter augmentation: observational cohort study with propensity score analysis. Medicine (Baltimore) 95(30):e4366. https:\/\/doi.org\/10.1097\/MD.0000000000004366.PMID:27472725;PMCID:PMC5265862","journal-title":"Medicine (Baltimore)"},{"issue":"5","key":"11856_CR3","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1097\/SLA.0b013e3181fd879b","volume":"252","author":"L Bonavina","year":"2010","unstructured":"Bonavina L, DeMeester T, Fockens P, Dunn D, Saino G, Bona D, Lipham J, Bemelman W, Ganz RA (2010) Laparoscopic sphincter augmentation device eliminates reflux symptoms and normalizes esophageal acid exposure: one- and 2-year results of a feasibility trial. Ann Surg 252(5):857\u2013862. https:\/\/doi.org\/10.1097\/SLA.0b013e3181fd879b","journal-title":"Ann Surg"},{"issue":"3","key":"11856_CR4","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1007\/s00464-019-06921-9","volume":"34","author":"B Turner","year":"2020","unstructured":"Turner B, Helm M, Hetzel E, Schumm M, Gould JC (2020) The relationship between gastroesophageal junction integrity and symptomatic fundoplication outcomes. Surg Endosc 34(3):1387\u20131392. https:\/\/doi.org\/10.1007\/s00464-019-06921-9","journal-title":"Surg Endosc"},{"key":"11856_CR5","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.jss.2018.09.036","volume":"235","author":"KV Walle","year":"2019","unstructured":"Walle KV, Funk LM, Xu Y, Davies KD, Greenberg J, Shada A, Lidor A (2019) Persistent dysphagia rate after antireflux surgery is similar for nissen fundoplication and partial fundoplication. J Surg Res 235:52\u201357. https:\/\/doi.org\/10.1016\/j.jss.2018.09.036","journal-title":"J Surg Res"},{"issue":"2","key":"11856_CR6","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1097\/SLE.0000000000001139","volume":"33","author":"MA Salman","year":"2023","unstructured":"Salman MA, Salman A, Shaaban HE, Alasmar M, Tourky M, Elhaj MGF, Khalid S, Gebril M, Alrahawy M, Elsherbiney M, Assal MM, Osman MHA, Mohammed AA, Elewa A (2023) Nissen versus toupet fundoplication for gastro-oesophageal reflux disease, short and long-term outcomes. A systematic review and meta-analysis. Surg Laparosc Endosc Percutan Tech 33(2):171\u2013183. https:\/\/doi.org\/10.1097\/SLE.0000000000001139","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"issue":"5","key":"11856_CR7","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/j.cgh.2015.05.028","volume":"14","author":"RA Ganz","year":"2016","unstructured":"Ganz RA, Edmundowicz SA, Taiganides PA, Lipham JC, Smith CD, DeVault KR, Horgan S, Jacobsen G, Luketich JD, Smith CC, Schlack-Haerer SC, Kothari SN, Dunst CM, Watson TJ, Peters J, Oelschlager BK, Perry KA, Melvin S, Bemelman WA, Smout AJ, Dunn D (2016) Long-term outcomes of patients receiving a magnetic sphincter augmentation device for gastroesophageal reflux. Clin Gastroenterol Hepatol 14(5):671\u2013677. https:\/\/doi.org\/10.1016\/j.cgh.2015.05.028","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"3","key":"11856_CR8","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1136\/gutjnl-2020-321395","volume":"70","author":"BD Rogers","year":"2021","unstructured":"Rogers BD, Valdovinos LR, Crowell MD, Bell R, Vela MF, Gyawali CP (2021) Number of reflux episodes on pH-impedance monitoring associates with improved symptom outcome and treatment satisfaction in gastro-oesophageal reflux disease (GERD) patients with regurgitation. Gut 70(3):450\u2013455. https:\/\/doi.org\/10.1136\/gutjnl-2020-321395","journal-title":"Gut"},{"issue":"6","key":"11856_CR9","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1007\/s00464-002-9158-2","volume":"17","author":"T Kamolz","year":"2003","unstructured":"Kamolz T, Granderath F, Pointner R (2003) Laparoscopic antireflux surgery: disease-related quality of life assessment before and after surgery in GERD patients with and without Barrett\u2019s esophagus. Surg Endosc 17(6):880\u2013885. https:\/\/doi.org\/10.1007\/s00464-002-9158-2","journal-title":"Surg Endosc"},{"issue":"9","key":"11856_CR10","doi-asserted-by":"publisher","first-page":"6851","DOI":"10.1007\/s00464-022-09015-1","volume":"36","author":"SM O\u2019Neill","year":"2022","unstructured":"O\u2019Neill SM, Jalilvand AD, Colvin JS, Haisley KR, Perry KA (2022) S148: long-term patient-reported outcomes of laparoscopic magnetic sphincter augmentation versus Nissen fundoplication: a 5-year follow-up study. Surg Endosc 36(9):6851\u20136858. https:\/\/doi.org\/10.1007\/s00464-022-09015-1","journal-title":"Surg Endosc"},{"issue":"37","key":"11856_CR11","doi-asserted-by":"publisher","first-page":"e8085","DOI":"10.1097\/MD.0000000000008085","volume":"96","author":"X Du","year":"2017","unstructured":"Du X, Wu JM, Hu ZW, Wang F, Wang ZG, Zhang C, Yan C, Chen MP (2017) Laparoscopic Nissen (total) versus anterior 180\u00b0 fundoplication for gastro-esophageal reflux disease: a meta-analysis and systematic review. Medicine (Baltimore) 96(37):e8085. https:\/\/doi.org\/10.1097\/MD.0000000000008085","journal-title":"Medicine (Baltimore)"},{"issue":"1","key":"11856_CR12","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.jamcollsurg.2015.02.025","volume":"221","author":"JL Reynolds","year":"2015","unstructured":"Reynolds JL, Zehetner J, Wu P, Shah S, Bildzukewicz N, Lipham JC (2015) Laparoscopic magnetic sphincter augmentation vs laparoscopic nissen fundoplication: a matched-pair analysis of 100 patients. J Am Coll Surg 221(1):123\u2013128. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2015.02.025","journal-title":"J Am Coll Surg"},{"issue":"9","key":"11856_CR13","doi-asserted-by":"publisher","first-page":"1318","DOI":"10.1002\/bjs.7174","volume":"97","author":"JA Broeders","year":"2010","unstructured":"Broeders JA, Mauritz FA, Ahmed Ali U, Draaisma WA, Ruurda JP, Gooszen HG, Smout AJ, Broeders IA, Hazebroek EJ (2010) Systematic review and meta-analysis of laparoscopic Nissen (posterior total) versus Toupet (posterior partial) fundoplication for gastro-oesophageal reflux disease. Br J Surg 97(9):1318\u20131330. https:\/\/doi.org\/10.1002\/bjs.7174","journal-title":"Br J Surg"},{"issue":"10","key":"11856_CR14","doi-asserted-by":"publisher","first-page":"2949","DOI":"10.1007\/s00464-014-3557-z","volume":"28","author":"RC Bell","year":"2014","unstructured":"Bell RC, Fox MA, Barnes WE, Mavrelis PG, Sewell RW, Carter BJ, Ihde GM, Trad KS, Dargis D, Hoddinott KM, Freeman KD, Gunsberger T, Hausmann MG, Gill BD, Wilson E (2014) Univariate and multivariate analyses of preoperative factors influencing symptomatic outcomes of transoral fundoplication. Surg Endosc 28(10):2949\u20132958. https:\/\/doi.org\/10.1007\/s00464-014-3557-z","journal-title":"Surg Endosc"},{"issue":"6","key":"11856_CR15","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1055\/a-1124-3187","volume":"52","author":"PA Testoni","year":"2020","unstructured":"Testoni PA, Testoni S, Mazzoleni G, Pantaleo G, Cilona MB, Distefano G, Fanti L, Antonelli M, Passaretti S (2020) Transoral incisionless fundoplication with an ultrasonic surgical endostapler for the treatment of gastroesophageal reflux disease: 12-month outcomes. Endoscopy 52(6):469\u2013473. https:\/\/doi.org\/10.1055\/a-1124-3187","journal-title":"Endoscopy"},{"issue":"10","key":"11856_CR16","doi-asserted-by":"publisher","first-page":"doad014","DOI":"10.1093\/dote\/doad014","volume":"36","author":"A Puri","year":"2023","unstructured":"Puri A, Steven S, Markar SR, Boyle N (2023) Longer-term outcomes of gastroesophageal reflux disease treated with magnetic sphincter augmentation. Dis Esophagus 36(10):doad014. https:\/\/doi.org\/10.1093\/dote\/doad014","journal-title":"Dis Esophagus"},{"issue":"1","key":"11856_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/0197-2456(95)00134-4","volume":"17","author":"AR Jadad","year":"1996","unstructured":"Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary. Control Clin Trials 17(1):1\u201312. https:\/\/doi.org\/10.1016\/0197-2456(95)00134-4","journal-title":"Control Clin Trials"},{"key":"11856_CR18","unstructured":"Wells GA, Shea B, O\u2019Connell D, Peterson J, Welch V, Losos M, Tugwell P (2024) The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. https:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. Accessed 19 Dec 2024"},{"key":"11856_CR19","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1186\/1471-2288-14-135","volume":"14","author":"X Wan","year":"2014","unstructured":"Wan X, Wang W, Liu J, Tong T (2014) Estimating the sample mean and standard deviation from the sampel size, median, range and\/or interquartile range. BMC Med Res Methods 14:135. https:\/\/doi.org\/10.1186\/1471-2288-14-135","journal-title":"BMC Med Res Methods"},{"issue":"3","key":"11856_CR20","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1016\/j.surg.2022.07.039","volume":"173","author":"H Wu","year":"2023","unstructured":"Wu H, Ungerleider S, Campbell M, Amundson JR, VanDruff V, Kuchta K, Hedberg HM, Ujiki MB (2023) Patient-reported outcomes in 645 patients after laparoscopic fundoplication up to 10 years. Surgery 173(3):710\u2013717. https:\/\/doi.org\/10.1016\/j.surg.2022.07.039","journal-title":"Surgery"},{"issue":"16","key":"11856_CR21","doi-asserted-by":"publisher","first-page":"1513","DOI":"10.1056\/NEJMoa1811424","volume":"381","author":"SJ Spechler","year":"2019","unstructured":"Spechler SJ, Hunter JG, Jones KM, Lee R, Smith BR, Mashimo H, Sanchez VM, Dunbar KB, Pham TH, Murthy UK, Kim T, Jackson CS, Wallen JM, von Rosenvinge EC, Pearl JP, Laine L, Kim AW, Kaz AM, Tatum RP, Lagoo-Deenadayalan S (2019) Randomized trial of medical versus surgical treatment for refractory heartburn. N Engl J Med 381(16):1513\u20131523. https:\/\/doi.org\/10.1056\/NEJMoa1811424","journal-title":"N Engl J Med"},{"issue":"5","key":"11856_CR22","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1053\/j.gastro.2017.12.021","volume":"154","author":"JE Richter","year":"2018","unstructured":"Richter JE, Kumar A, Lipka S, Miladinovic B, Velanovich V (2018) Efficacy of laparoscopic nissen fundoplication vs transoral incisionless fundoplication or proton pump inhibitors in patients with gastroesophageal reflux disease: a systematic review and network meta-analysis. Gastroenterology 154(5):1298-1308.e7. https:\/\/doi.org\/10.1053\/j.gastro.2017.12.021","journal-title":"Gastroenterology"},{"issue":"6","key":"11856_CR23","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1177\/15533506231165829","volume":"30","author":"G Li","year":"2023","unstructured":"Li G, Jiang N, Chendaer N, Hao Y, Zhang W, Peng C (2023) Laparoscopic nissen versus toupet fundoplication for short- and long-term treatment of gastroesophageal reflux disease: a meta-analysis and systematic review. Surg Innov 30(6):745\u2013757. https:\/\/doi.org\/10.1177\/15533506231165829","journal-title":"Surg Innov"},{"key":"11856_CR24","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1007\/s00464-011-1889-5","volume":"26","author":"OO Koch","year":"2012","unstructured":"Koch OO, Kaindlstorfer A, Antoniou SA et al (2012) Laparoscopic Nissen versus Toupet fundoplication: objective and subjective results of a prospective randomized trial. Surg Endosc 26:413\u2013422. https:\/\/doi.org\/10.1007\/s00464-011-1889-5","journal-title":"Surg Endosc"},{"issue":"10","key":"11856_CR25","doi-asserted-by":"publisher","first-page":"1568","DOI":"10.1007\/s00595-021-02226-4","volume":"51","author":"K Tsuboi","year":"2021","unstructured":"Tsuboi K, Yano F, Omura N, Hoshino M, Yamamoto SR, Akimoto S, Masuda T, Sakashita Y, Ikegami T (2021) Factors affecting the treatment outcomes of laparoscopic fundoplication for erosive reflux esophagitis: findings of esophageal pathological function tests. Surg Today 51(10):1568\u20131576. https:\/\/doi.org\/10.1007\/s00595-021-02226-4","journal-title":"Surg Today"},{"key":"11856_CR26","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.ijsu.2018.02.041","volume":"52","author":"A Aiolfi","year":"2018","unstructured":"Aiolfi A, Asti E, Bernardi D, Bonitta G, Rausa E, Siboni S, Bonavina L (2018) Early results of magnetic sphincter augmentation versus fundoplication for gastroesophageal reflux disease: Systematic review and meta-analysis. Int J Surg 52:82\u201388. https:\/\/doi.org\/10.1016\/j.ijsu.2018.02.041","journal-title":"Int J Surg"},{"issue":"9","key":"11856_CR27","doi-asserted-by":"publisher","first-page":"doz031","DOI":"10.1093\/dote\/doz031","volume":"32","author":"N Guidozzi","year":"2019","unstructured":"Guidozzi N, Wiggins T, Ahmed AR, Hanna GB, Markar SR (2019) Laparoscopic magnetic sphincter augmentation versus fundoplication for gastroesophageal reflux disease: systematic review and pooled analysis. Dis Esophagus 32(9):doz031. https:\/\/doi.org\/10.1093\/dote\/doz031","journal-title":"Dis Esophagus"},{"issue":"12","key":"11856_CR28","doi-asserted-by":"publisher","first-page":"2620","DOI":"10.1007\/s00268-009-0216-y","volume":"33","author":"PE Beck","year":"2009","unstructured":"Beck PE, Watson DI, Devitt PG, Game PA, Jamieson GG (2009) Impact of gender and age on the long-term outcome of laparoscopic fundoplication. World J Surg 33(12):2620\u20132626. https:\/\/doi.org\/10.1007\/s00268-009-0216-y","journal-title":"World J Surg"},{"issue":"6","key":"11856_CR29","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1007\/s00268-013-2415-9","volume":"38","author":"A Staehelin","year":"2014","unstructured":"Staehelin A, Zingg U, Devitt PG, Esterman AJ, Smith L, Jamieson GG, Watson DI (2014) Preoperative factors predicting clinical outcome following laparoscopic fundoplication. World J Surg 38(6):1431\u20131443. https:\/\/doi.org\/10.1007\/s00268-013-2415-9","journal-title":"World J Surg"},{"issue":"7","key":"11856_CR30","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1046\/j.1445-2197.2002.02455.x","volume":"72","author":"CJ O\u2019Boyle","year":"2002","unstructured":"O\u2019Boyle CJ, Watson DI, DeBeaux AC, Jamieson GG (2002) Preoperative prediction of long-term outcome following laparoscopic fundoplication. ANZ J Surg 72(7):471\u2013475. https:\/\/doi.org\/10.1046\/j.1445-2197.2002.02455.x","journal-title":"ANZ J Surg"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-11856-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-025-11856-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-11856-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T17:38:39Z","timestamp":1751477919000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-025-11856-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,29]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["11856"],"URL":"https:\/\/doi.org\/10.1007\/s00464-025-11856-5","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,29]]},"assertion":[{"value":"25 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"YT, DN, and RW authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript. KN\u2014Proctor for Intuitive Surgical.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}