{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T01:06:03Z","timestamp":1759799163136,"version":"build-2065373602"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100008678","name":"Universit\u00e4t Leipzig","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008678","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Accurate intraoperative detection of nerves in critical anatomic regions during oncologic resection, such as the vagal nerve, is crucial. The vagal nerve regulates many internal organs and is at risk during surgeries, potentially leading to severe complications. While different types of intraoperative neuromonitoring methods exist for functional assessment, Hyperspectral Imaging (HSI) offers a non-invasive, real-time alternative for morphologic identification. This study is, to our knowledge, the first to assess laparoscopic HSI for imaging and delineating the vagal nerve during minimally invasive surgery.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This prospective cohort study examined the vagal nerves of 19 patients undergoing Ivor Lewis esophagectomy using a laparoscopic HSI system with a 30-degree optic during the thoracic part of the procedure. Measurements on the exposed vagal nerve collected spectral data from 500 to 995\u00a0nm at each pixel. Based on these reflectance spectra, four different state-of-the-art machine learning methods for binary and multi-class tissue differentiation were evaluated. The classifiers were validated using Leave-One-Patient-Out Cross-Validation (LOOCV) and k-fold CV.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The spectra of the tissue classes azygos vein, pleura, lung, vagal nerve, and esophagus showed high similarity, with wide inter-patient variability. All tested machine learning classifiers showed similar accuracy in differentiating vagal nerve tissue. Linear Discriminant Analysis (LDA) and Support Vector Machine (SVM) outperformed Logistic Regression (LR) and Multilayer Perceptron (MLP), with LDA showing the highest F1 score (harmonic mean of precision and recall) for binary classification (0.85), and SVM excelling in multi-class classification (0.74). Reflectance spectra without further pre-processing provided the best results for tissue differentiation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The first application of HSI to detect the vagal nerve during minimally invasive surgery has shown promising classification results for the five tissue classes considered and highlighted the technical challenges for clinical use. Further clinical research is needed to explore the full potential of HSI to improve the reliability of nerve classification during surgery.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00464-025-12028-1","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T18:47:07Z","timestamp":1754938027000},"page":"6486-6495","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic hyperspectral imaging for in vivo detection of the vagal nerve in upper gastrointestinal surgery"],"prefix":"10.1007","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9342-3288","authenticated-orcid":false,"given":"Hannes","family":"K\u00f6hler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annalena","family":"Ilgen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annekatrin","family":"Pfahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigmar","family":"Stelzner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Mehdorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boris","family":"Jansen\u2011Winkeln","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Melzer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ines","family":"Gockel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusef","family":"Moulla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"12028_CR1","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1177\/0145561319875432","volume":"100","author":"H-H Chen","year":"2021","unstructured":"Chen H-H, Chen T-C, Yang T-L, Wang C-P (2021) Transcutaneous sonography for detection of the cervical vagus nerve. Ear Nose Throat J 100:155\u2013159. https:\/\/doi.org\/10.1177\/0145561319875432","journal-title":"Ear Nose Throat J"},{"key":"12028_CR2","doi-asserted-by":"publisher","first-page":"273","DOI":"10.5137\/1019-5149.JTN.9964-13.1","volume":"25","author":"M Cakir","year":"2015","unstructured":"Cakir M, Atalay C, Cakir Z, Emet M, Aydin MD, Aydin N, Onder A, Calik M (2015) The role of vagal nerve root injury on respiration disturbances in subarachnoid hemorrhage. Turk Neurosurg 25:273\u2013278. https:\/\/doi.org\/10.5137\/1019-5149.JTN.9964-13.1","journal-title":"Turk Neurosurg"},{"key":"12028_CR3","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1111\/obr.12467","volume":"18","author":"AP van Beek","year":"2017","unstructured":"van Beek AP, Emous M, Laville M, Tack J (2017) Dumping syndrome after esophageal, gastric or bariatric surgery: pathophysiology, diagnosis, and management. Obes Rev 18:68\u201385. https:\/\/doi.org\/10.1111\/obr.12467","journal-title":"Obes Rev"},{"key":"12028_CR4","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1038\/ajg.2016.42","volume":"111","author":"S van Rijn","year":"2016","unstructured":"van Rijn S, Rinsma NF, van Herwaarden-Lindeboom MYA, Ringers J, Gooszen HG, van Rijn PJJ, Veenendaal RA, Conchillo JM, Bouvy ND, Masclee AAM (2016) Effect of vagus nerve integrity on short and long-term efficacy of antireflux surgery. Am J Gastroenterol 111:508\u2013515. https:\/\/doi.org\/10.1038\/ajg.2016.42","journal-title":"Am J Gastroenterol"},{"key":"12028_CR5","doi-asserted-by":"publisher","first-page":"44","DOI":"10.3389\/fpsyt.2018.00044","volume":"9","author":"S Breit","year":"2018","unstructured":"Breit S, Kupferberg A, Rogler G, Hasler G (2018) Vagus nerve as modulator of the brain-gut axis in psychiatric and inflammatory disorders. Front Psychiatry 9:44. https:\/\/doi.org\/10.3389\/fpsyt.2018.00044","journal-title":"Front Psychiatry"},{"key":"12028_CR6","doi-asserted-by":"publisher","first-page":"1590","DOI":"10.1023\/a:1015831505810","volume":"47","author":"A Ukleja","year":"2002","unstructured":"Ukleja A, Woodward TA, Achem SR (2002) Vagus nerve injury with severe diarrhea after laparoscopic antireflux surgery. Dig Dis Sci 47:1590\u20131593. https:\/\/doi.org\/10.1023\/a:1015831505810","journal-title":"Dig Dis Sci"},{"key":"12028_CR7","doi-asserted-by":"publisher","first-page":"17165","DOI":"10.1038\/srep17165","volume":"5","author":"T Minamikawa","year":"2015","unstructured":"Minamikawa T, Harada Y, Takamatsu T (2015) Ex vivo peripheral nerve detection of rats by spontaneous Raman spectroscopy. Sci Rep 5:17165. https:\/\/doi.org\/10.1038\/srep17165","journal-title":"Sci Rep"},{"key":"12028_CR8","doi-asserted-by":"publisher","first-page":"3921","DOI":"10.21037\/tcr-21-587","volume":"10","author":"S Sato","year":"2021","unstructured":"Sato S, Kagoshima H, Shiozawa M, Nukada S, Iguchi K, Mikayama Y, Oshima T, Numata M, Tamagawa H, Rino Y, Masuda M, Tanaka K (2021) Automated non-invasive identification of pelvic autonomic nerves with a handheld Raman spectrometer and potential application to nerve-sparing colorectal surgery: a preliminary study in surgical specimens. Transl Cancer Res TCR 10:3921\u20133929. https:\/\/doi.org\/10.21037\/tcr-21-587","journal-title":"Transl Cancer Res TCR"},{"key":"12028_CR9","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1002\/lsm.22264","volume":"46","author":"RM Schols","year":"2014","unstructured":"Schols RM, ter Laan M, Stassen LPS, Bouvy ND, Amelink A, Wieringa FP, Alic L (2014) Differentiation between nerve and adipose tissue using wide-band (350\u20131,830 nm) in vivo diffuse reflectance spectroscopy. Lasers Surg Med 46:538\u2013545. https:\/\/doi.org\/10.1002\/lsm.22264","journal-title":"Lasers Surg Med"},{"key":"12028_CR10","doi-asserted-by":"publisher","first-page":"253","DOI":"10.1002\/lsm.22755","volume":"50","author":"GC Langhout","year":"2018","unstructured":"Langhout GC, Bydlon TM, van der Voort M, M\u00fcller M, Kortsmit J, Lucassen G, Balthasar AJR, van Geffen G-J, Steinfeldt T, Sterenborg HJCM, Hendriks BHW, Ruers TJM (2018) Nerve detection using optical spectroscopy, an evaluation in four different models: in human and swine, in-vivo, and post mortem. Lasers Surg Med 50:253\u2013261. https:\/\/doi.org\/10.1002\/lsm.22755","journal-title":"Lasers Surg Med"},{"key":"12028_CR11","doi-asserted-by":"publisher","first-page":"357","DOI":"10.3390\/life13020357","volume":"13","author":"E de Vries","year":"2023","unstructured":"de Vries E, Alic L, Schols RM, Emanuel KS, Wieringa FP, Bouvy ND, Tuijthof GJM (2023) Near-Infrared spectral similarity between ex vivo porcine and in vivo human tissue. Life 13:357. https:\/\/doi.org\/10.3390\/life13020357","journal-title":"Life"},{"key":"12028_CR12","doi-asserted-by":"publisher","first-page":"2839","DOI":"10.1364\/BOE.488761","volume":"14","author":"EJ Haugen","year":"2023","unstructured":"Haugen EJ, Throckmorton GA, Walter AB, Mahadevan-Jansen A, Baba JS (2023) Measurement of rat and human tissue optical properties for improving the optical detection and visualization of peripheral nerves. Biomed Opt Express 14:2839. https:\/\/doi.org\/10.1364\/BOE.488761","journal-title":"Biomed Opt Express"},{"key":"12028_CR13","doi-asserted-by":"publisher","first-page":"7599","DOI":"10.1038\/s41598-023-34054-6","volume":"13","author":"GA Throckmorton","year":"2023","unstructured":"Throckmorton GA, Haugen E, Thomas G, Willmon P, Baba JS, Sol\u00f3rzano CC, Mahadevan-Jansen A (2023) Label-free intraoperative nerve detection and visualization using ratiometric diffuse reflectance spectroscopy. Sci Rep 13:7599. https:\/\/doi.org\/10.1038\/s41598-023-34054-6","journal-title":"Sci Rep"},{"key":"12028_CR14","doi-asserted-by":"publisher","first-page":"4122","DOI":"10.1364\/BOE.8.004122","volume":"8","author":"KWTK Chin","year":"2017","unstructured":"Chin KWTK, Engelsman AF, Chin PTK, Meijer SL, Strackee SD, Oostra RJ, van Gulik TM (2017) Evaluation of collimated polarized light imaging for real-time intraoperative selective nerve identification in the human hand. Biomed Opt Express 8:4122\u20134134. https:\/\/doi.org\/10.1364\/BOE.8.004122","journal-title":"Biomed Opt Express"},{"key":"12028_CR15","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1364\/BOE.9.001097","volume":"9","author":"J Cha","year":"2018","unstructured":"Cha J, Broch A, Mudge S, Kim K, Namgoong J-M, Oh E, Kim P (2018) Real-time, label-free, intraoperative visualization of peripheral nerves and micro-vasculatures using multimodal optical imaging techniques. Biomed Opt Express 9:1097. https:\/\/doi.org\/10.1364\/BOE.9.001097","journal-title":"Biomed Opt Express"},{"key":"12028_CR16","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.1002\/lsm.23422","volume":"53","author":"B Ning","year":"2021","unstructured":"Ning B, Kim WW, Katz I, Park CH, Sandler AD, Cha J (2021) Improved nerve visualization in head and neck surgery using mueller polarimetric imaging: preclinical feasibility study in a swine model. Lasers Surg Med 53:1427\u20131434. https:\/\/doi.org\/10.1002\/lsm.23422","journal-title":"Lasers Surg Med"},{"key":"12028_CR17","doi-asserted-by":"publisher","first-page":"4079","DOI":"10.1007\/s00464-021-08729-y","volume":"36","author":"F Dip","year":"2022","unstructured":"Dip F, Rosenthal D, Socolovsky M, Falco J, De la Fuente M, White KP, Rosenthal RJ (2022) Nerve autofluorescence under near-ultraviolet light: cutting-edge technology for intra-operative neural tissue visualization in 17 patients. Surg Endosc 36:4079\u20134089. https:\/\/doi.org\/10.1007\/s00464-021-08729-y","journal-title":"Surg Endosc"},{"key":"12028_CR18","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1097\/SLA.0000000000003130","volume":"270","author":"EM Walsh","year":"2019","unstructured":"Walsh EM, Cole D, Udayakumar N, Kain JJ (2019) Fluorescence imaging of nerves during surgery. Ann Surg 270:8","journal-title":"Ann Surg"},{"key":"12028_CR19","doi-asserted-by":"publisher","first-page":"2000036","DOI":"10.1002\/sstr.202000036","volume":"1","author":"Y Chen","year":"2020","unstructured":"Chen Y, Zhang H, Lei Z, Zhang F (2020) Recent advances in intraoperative nerve bioimaging: fluorescence-guided surgery for nerve preservation. Small Struct 1:2000036. https:\/\/doi.org\/10.1002\/sstr.202000036","journal-title":"Small Struct"},{"key":"12028_CR20","doi-asserted-by":"publisher","first-page":"e737","DOI":"10.1097\/SLA.0000000000005676","volume":"277","author":"W Kneist","year":"2023","unstructured":"Kneist W, Ghadimi M, Runkel N, Moesta T, Coerper S, Benecke C, Kauff DW, Gretschel S, Gockel I, Jansen-Winkeln B, Lang H, Gorbulev S, Ruckes C, Kronfeld K (2023) Pelvic intraoperative neuromonitoring prevents dysfunction in patients with rectal cancer: results from a multicenter, randomized, controlled clinical trial of a NEUROmonitoring system (NEUROS). Ann Surg 277:e737. https:\/\/doi.org\/10.1097\/SLA.0000000000005676","journal-title":"Ann Surg"},{"key":"12028_CR21","doi-asserted-by":"publisher","first-page":"756","DOI":"10.3390\/cancers11060756","volume":"11","author":"M Halicek","year":"2019","unstructured":"Halicek M, Fabelo H, Ortega S, Callico GM, Fei B (2019) In-vivo and ex-vivo tissue analysis through hyperspectral imaging techniques: revealing the invisible features of cancer. Cancers 11:756. https:\/\/doi.org\/10.3390\/cancers11060756","journal-title":"Cancers"},{"key":"12028_CR22","doi-asserted-by":"publisher","first-page":"3775","DOI":"10.1007\/s00464-019-06675-4","volume":"33","author":"H K\u00f6hler","year":"2019","unstructured":"K\u00f6hler H, Jansen-Winkeln B, Maktabi M, Barberio M, Takoh J, Holfert N, Moulla Y, Niebisch S, Diana M, Neumuth T, Rabe SM, Chalopin C, Melzer A, Gockel I (2019) Evaluation of hyperspectral imaging (HSI) for the measurement of ischemic conditioning effects of the gastric conduit during esophagectomy. Surg Endosc 33:3775\u20133782. https:\/\/doi.org\/10.1007\/s00464-019-06675-4","journal-title":"Surg Endosc"},{"key":"12028_CR23","doi-asserted-by":"publisher","DOI":"10.1117\/1.JBO.25.8.086004","author":"H K\u00f6hler","year":"2020","unstructured":"K\u00f6hler H, Kulcke A, Maktabi M, Moulla Y, Jansen-Winkeln B, Barberio M, Diana M, Gockel I, Neumuth T, Chalopin C (2020) Laparoscopic system for simultaneous high-resolution video and rapid hyperspectral imaging in the visible and near-infrared spectral range. J Biomed Opt. https:\/\/doi.org\/10.1117\/1.JBO.25.8.086004","journal-title":"J Biomed Opt"},{"issue":"4","key":"12028_CR24","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.1016\/j.jamcollsurg.2020.08.023","volume":"231","author":"B Jansen-Winkeln","year":"2020","unstructured":"Jansen-Winkeln B, Dvorak M, Niebisch S, Germann I, Koehler H, Chalopin C, Gockel I (2020) Determination of the ideal anastomotic position by hyperspectral imaging in colorectal resection. J Am College Surg 231(4):e9","journal-title":"J Am College Surg"},{"key":"12028_CR25","doi-asserted-by":"publisher","first-page":"e169","DOI":"10.1097\/AS9.0000000000000169","volume":"3","author":"E Sucher","year":"2022","unstructured":"Sucher E, Sucher R, Guice H, Schneeberger S, Brandacher G, Gockel I, Berg T, Seehofer D (2022) Hyperspectral evaluation of the human liver during major resection. Ann Surg Open 3:e169. https:\/\/doi.org\/10.1097\/AS9.0000000000000169","journal-title":"Ann Surg Open"},{"key":"12028_CR26","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.2121","author":"M Maktabi","year":"2020","unstructured":"Maktabi M, K\u00f6hler H, Ivanova M, Neumuth T, Rayes N, Seidemann L, Sucher R, Jansen-Winkeln B, Gockel I, Barberio M, Chalopin C (2020) Classification of hyperspectral endocrine tissue images using support vector machines. Int J Med Robotics Comput Assist Surg. https:\/\/doi.org\/10.1002\/rcs.2121","journal-title":"Int J Med Robotics Comput Assist Surg"},{"key":"12028_CR27","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.3390\/diagnostics11081508","volume":"11","author":"M Barberio","year":"2021","unstructured":"Barberio M, Collins T, Bencteux V, Nkusi R, Felli E, Viola MG, Marescaux J, Hostettler A, Diana M (2021) Deep learning analysis of in vivo hyperspectral images for automated intraoperative nerve detection. Diagnostics 11:1508. https:\/\/doi.org\/10.3390\/diagnostics11081508","journal-title":"Diagnostics"},{"key":"12028_CR28","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1117\/1.JMI.7.6.065001","volume":"7","author":"EL Wisotzky","year":"2020","unstructured":"Wisotzky EL, Kossack B, Uecker FC, Arens P, Hilsmann A, Eisert P (2020) Validation of two techniques for intraoperative hyperspectral human tissue determination. J Med Imaging 7:20","journal-title":"J Med Imaging"},{"key":"12028_CR29","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1016\/j.jht.2020.03.008","volume":"34","author":"MM Stonner","year":"2021","unstructured":"Stonner MM, Mackinnon SE, Kaskutas V (2021) Predictors of functional outcome after peripheral nerve injury and compression. J Hand Ther 34:369\u2013375. https:\/\/doi.org\/10.1016\/j.jht.2020.03.008","journal-title":"J Hand Ther"},{"key":"12028_CR30","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/B978-0-12-819826-1.00011-9","volume":"186","author":"MR Nuwer","year":"2022","unstructured":"Nuwer MR, Husain AM, Soto F (2022) Overview of intraoperative neuromonitoring. Handb Clin Neurol 186:3\u20139. https:\/\/doi.org\/10.1016\/B978-0-12-819826-1.00011-9","journal-title":"Handb Clin Neurol"},{"key":"12028_CR31","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1016\/j.fertnstert.2021.03.014","volume":"116","author":"K Kanno","year":"2021","unstructured":"Kanno K, Aiko K, Yanai S, Sawada M, Sakate S, Andou M (2021) Clinical use of indocyanine green during nerve-sparing surgery for deep endometriosis. Fertil Steril 116:269\u2013271. https:\/\/doi.org\/10.1016\/j.fertnstert.2021.03.014","journal-title":"Fertil Steril"},{"key":"12028_CR32","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1186\/s12967-015-0739-y","volume":"13","author":"BHW Hendriks","year":"2015","unstructured":"Hendriks BHW, Balthasar AJR, Lucassen GW, van der Voort M, Mueller M, Pully VV, Bydlon TM, Reich C, van Keersop ATMH, Kortsmit J, Langhout GC, van Geffen G-J (2015) Nerve detection with optical spectroscopy for regional anesthesia procedures. J Transl Med 13:380. https:\/\/doi.org\/10.1186\/s12967-015-0739-y","journal-title":"J Transl Med"},{"key":"12028_CR33","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1002\/lsm.22938","volume":"50","author":"AJR Balthasar","year":"2018","unstructured":"Balthasar AJR, Bydlon TM, Ippel H, van der Voort M, Hendriks BHW, Lucassen GW, van Geffen G-J, van Kleef M, van Dijk P, Lataster A (2018) Optical signature of nerve tissue-Exploratory ex vivo study comparing optical, histological, and molecular characteristics of different adipose and nerve tissues: optical signature of nerve tissue. Lasers Surg Med 50:948\u2013960. https:\/\/doi.org\/10.1002\/lsm.22938","journal-title":"Lasers Surg Med"},{"key":"12028_CR34","doi-asserted-by":"publisher","first-page":"69","DOI":"10.3390\/bioengineering11010069","volume":"11","author":"A Ilgen","year":"2024","unstructured":"Ilgen A, K\u00f6hler H, Pfahl A, Stelzner S, Mehdorn M, Jansen-Winkeln B, Gockel I, Moulla Y (2024) Intraoperative laparoscopic hyperspectral imaging during esophagectomy\u2014a pilot study evaluating esophagogastric perfusion at the anastomotic sites. Bioengineering 11:69. https:\/\/doi.org\/10.3390\/bioengineering11010069","journal-title":"Bioengineering"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-12028-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-025-12028-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-025-12028-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T20:03:45Z","timestamp":1759781025000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-025-12028-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":34,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["12028"],"URL":"https:\/\/doi.org\/10.1007\/s00464-025-12028-1","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"type":"print","value":"0930-2794"},{"type":"electronic","value":"1432-2218"}],"subject":[],"published":{"date-parts":[[2025,8,11]]},"assertion":[{"value":"2 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 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":"Hannes K\u00f6hler, Annalena Ilgen, Annekatrin Pfahl, Sigmar Stelzner, Matthias Mehdorn, Boris Jansen\u2011Winkeln, Andreas Melzer, Ines Gockel, and Yusef Moulla have no conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}