{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T21:30:42Z","timestamp":1786397442957,"version":"build-2736575974"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP21vk0124001"],"award-info":[{"award-number":["JP21vk0124001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1007\/s00464-026-12927-x","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T21:13:23Z","timestamp":1781558003000},"page":"6780-6788","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Machine learning-driven automated evaluation of surgical skills during laparoscopic distal gastrectomy based on blood pixel analysis"],"prefix":"10.1007","volume":"40","author":[{"given":"Shintaro","family":"Arakaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Takenaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daichi","family":"Kitaguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tateo","family":"Ogane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimimasa","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihito","family":"Kosugi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuntaro","family":"Iuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nao","family":"Baba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitsugu","family":"Yanagida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risa","family":"Takai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyoshi","family":"Takeshita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuhisa","family":"Takatsuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1101-2707","authenticated-orcid":false,"given":"Masaaki","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"12927_CR1","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1093\/jjco\/hys220","volume":"43","author":"K Nakamura","year":"2013","unstructured":"Nakamura K, Katai H, Mizusawa J, Yoshikawa T, Ando M, Terashima M, Ito S, Takagi M, Takagane A, Ninomiya M, Fukushima N, Sasako M (2013) A phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA\/IB gastric cancer (JCOG0912). Jpn J Clin Oncol 43:324\u2013327","journal-title":"Jpn J Clin Oncol"},{"key":"12927_CR2","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1007\/s10120-016-0646-9","volume":"20","author":"H Katai","year":"2017","unstructured":"Katai H, Mizusawa J, Katayama H, Takagi M, Yoshikawa T, Fukagawa T, Terashima M, Misawa K, Teshima S, Koeda K, Nunobe S, Fukushima N, Yasuda T, Asao Y, Fujiwara Y, Sasako M (2017) Short-term surgical outcomes from a phase III study of laparoscopy-assisted versus open distal gastrectomy with nodal dissection for clinical stage IA\/IB gastric cancer: Japan Clinical Oncology Group Study JCOG0912. Gastric Cancer 20:699\u2013708","journal-title":"Gastric Cancer"},{"key":"12927_CR3","doi-asserted-by":"publisher","first-page":"2734","DOI":"10.1007\/s00268-015-3160-z","volume":"39","author":"N Inaki","year":"2015","unstructured":"Inaki N, Etoh T, Ohyama T, Uchiyama K, Katada N, Koeda K, Yoshida K, Takagane A, Kojima K, Sakuramoto S, Shiraishi N, Kitano S (2015) A multi-institutional, prospective, phase II feasibility study of laparoscopy-assisted distal gastrectomy with D2 lymph node dissection for locally advanced gastric cancer (JLSSG0901). World J Surg 39:2734\u20132741","journal-title":"World J Surg"},{"key":"12927_CR4","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1001\/jamasurg.2023.0096","volume":"158","author":"T Etoh","year":"2023","unstructured":"Etoh T, Ohyama T, Sakuramoto S, Tsuji T, Lee SW, Yoshida K, Koeda K, Hiki N, Kunisaki C, Tokunaga M, Otsubo D, Takagane A, Misawa K, Kinoshita T, Cho H, Doki Y, Nunobe S, Shiraishi N, Kitano S, Japanese Laparoscopic Surgery Study Group (JLSSG) (2023) Five-year survival outcomes of laparoscopy-assisted vs open distal gastrectomy for advanced gastric cancer: the JLSSG0901 randomized clinical trial. JAMA Surg 158:445\u2013454","journal-title":"JAMA Surg"},{"key":"12927_CR5","doi-asserted-by":"publisher","first-page":"4626","DOI":"10.3748\/wjg.v22.i19.4626","volume":"22","author":"K Suda","year":"2016","unstructured":"Suda K, Nakauchi M, Inaba K, Ishida Y, Uyama I (2016) Minimally invasive surgery for upper gastrointestinal cancer: our experience and review of the literature. World J Gastroenterol 22:4626\u20134637","journal-title":"World J Gastroenterol"},{"key":"12927_CR6","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1002\/ags3.12048","volume":"2","author":"H Shinohara","year":"2017","unstructured":"Shinohara H, Kurahashi Y, Haruta S, Ishida Y, Sasako M (2017) Universalization of the operative strategy by systematic mesogastric excision for stomach cancer with that for total mesorectal excision and complete mesocolic excision colorectal counterparts. Ann Gastroenterol Surg 2:28\u201336","journal-title":"Ann Gastroenterol Surg"},{"key":"12927_CR7","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1245\/s10434-019-07700-5","volume":"27","author":"T Kumamoto","year":"2020","unstructured":"Kumamoto T, Kurahashi Y, Niwa H, Nakanishi Y, Ozawa R, Okumura K, Ishida Y, Shinohara H (2020) Laparoscopic suprapancreatic lymph node dissection using a systematic mesogastric excision concept for gastric cancer. Ann Surg Oncol 27:529\u2013531","journal-title":"Ann Surg Oncol"},{"key":"12927_CR8","doi-asserted-by":"publisher","first-page":"1434","DOI":"10.1056\/NEJMsa1300625","volume":"369","author":"JD Birkmeyer","year":"2013","unstructured":"Birkmeyer JD, Finks JF, O\u2019Reilly A, Oerline M, Carlin AM, Nunn AR, Dimick J, Banerjee M, Birkmeyer NJO, Michigan Bariatric Surgery Collaborative (2013) Surgical skill and complication rates after bariatric surgery. N Engl J Med 369:1434\u20131442","journal-title":"N Engl J Med"},{"key":"12927_CR9","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1002\/bjs5.50263","volume":"4","author":"N Ichikawa","year":"2020","unstructured":"Ichikawa N, Homma S, Funakoshi T, Ohshima T, Hirose K, Yamada K, Nakamoto H, Kazui K, Yokota R, Honma T, Maeda Y, Yoshida T, Ishikawa T, Iijima H, Aiyama T, Taketomi A (2020) Impact of technically qualified surgeons on laparoscopic colorectal resection outcomes: results of a propensity score-matching analysis. BJS Open 4:486\u2013498","journal-title":"BJS Open"},{"issue":"3","key":"12927_CR10","doi-asserted-by":"publisher","first-page":"482","DOI":"10.1097\/SLA.0000000000001862","volume":"264","author":"ME Hogg","year":"2016","unstructured":"Hogg ME, Zenati M, Novak S, Chen Y, Jun Y, Steve J, Kowalsky SJ, Bartlett DL, Zureikat AH, Zeh HJ 3rd (2016) Grading of surgeon technical performance predicts postoperative pancreatic fistula for pancreaticoduodenectomy independent of patient-related variables. Ann Surg 264(3):482\u2013491","journal-title":"Ann Surg"},{"key":"12927_CR11","first-page":"273","volume":"84","author":"JA Martin","year":"1997","unstructured":"Martin JA, Regehr G, Reznick R, MacRae H, Murnaghan J, Hutchison C, Brown M (1997) Objective structured assessment of technical skill (OSATS) for surgical residents. Br J Surg 84:273\u2013278","journal-title":"Br J Surg"},{"key":"12927_CR12","doi-asserted-by":"publisher","first-page":"960","DOI":"10.1001\/jamasurg.2020.3007","volume":"155","author":"JJ Stulberg","year":"2020","unstructured":"Stulberg JJ, Huang R, Kreutzer L, Ban K, Champagne BJ, Steele SR, Johnson JK, Holl JL, Greenberg CC, Bilimoria KY (2020) Association between surgeon technical skills and patient outcomes. JAMA Surg 155:960\u2013968","journal-title":"JAMA Surg"},{"key":"12927_CR13","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.amjsurg.2005.04.004","volume":"190","author":"MC Vassiliou","year":"2005","unstructured":"Vassiliou MC, Feldman LS, Andrew CG, Bergman S, Leffondr\u00e9 K, Stanbridge D, Fried GM (2005) A global assessment tool for evaluation of intraoperative laparoscopic skills. Am J Surg 190:107\u2013113","journal-title":"Am J Surg"},{"key":"12927_CR14","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1002\/ags3.12513","volume":"6","author":"D Kitaguchi","year":"2021","unstructured":"Kitaguchi D, Takeshita N, Hasegawa H, Ito M (2021) Artificial intelligence-based computer vision in surgery: recent advances and future perspectives. Ann Gastroenterol Surg 6:29\u201336","journal-title":"Ann Gastroenterol Surg"},{"key":"12927_CR15","doi-asserted-by":"publisher","first-page":"86","DOI":"10.31662\/jmaj.2024-0175","volume":"8","author":"S Arakaki","year":"2025","unstructured":"Arakaki S, Takenaka S, Sasaki K, Kitaguchi D, Hasegawa H, Takeshita N, Takatsuki M, Ito M (2025) Artificial intelligence in minimally invasive surgery: current state and future challenges. JMA J 8:86\u201390","journal-title":"JMA J"},{"key":"12927_CR16","doi-asserted-by":"publisher","first-page":"e250","DOI":"10.1097\/SLA.0000000000005731","volume":"278","author":"S Sasaki","year":"2023","unstructured":"Sasaki S, Kitaguchi D, Takenaka S, Nakajima K, Sasaki K, Ogane T, Takeshita N, Gotohda N, Ito M (2023) Machine learning-based automatic evaluation of tissue handling skills in laparoscopic colorectal surgery: a retrospective experimental study. Ann Surg 278:e250\u2013e255","journal-title":"Ann Surg"},{"key":"12927_CR17","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s10120-023-01450-w","volume":"27","author":"M Komatsu","year":"2024","unstructured":"Komatsu M, Kitaguchi D, Yura M, Takeshita N, Yoshida M, Yamaguchi M, Kondo H, Kinoshita T, Ito M (2024) Automatic surgical phase recognition-based skill assessment in laparoscopic distal gastrectomy using multicenter videos. Gastric Cancer 27:187\u2013196","journal-title":"Gastric Cancer"},{"key":"12927_CR18","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.1131","volume":"158","author":"T Igaki","year":"2023","unstructured":"Igaki T, Kitaguchi D, Matsuzaki H, Nakajima K, Kojima S, Hasegawa H, Takeshita N, Kinugasa Y, Ito M (2023) Automatic surgical skill assessment system based on concordance of standardized surgical field development using artificial intelligence. JAMA Surg 158:e231131","journal-title":"JAMA Surg"},{"key":"12927_CR19","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1007\/s00464-022-09573-4","volume":"37","author":"T Igaki","year":"2023","unstructured":"Igaki T, Takenaka S, Watanabe Y, Kojima S, Nakajima K, Takabe Y, Kitaguchi D, Takeshita N, Inomata M, Kuroyanagi H, Kinugasa Y, Ito M (2023) Universal meta-competencies of operative performances: a literature review and qualitative synthesis. Surg Endosc 37:835\u2013845","journal-title":"Surg Endosc"},{"key":"12927_CR20","doi-asserted-by":"publisher","first-page":"6089","DOI":"10.1007\/s00464-020-08102-5","volume":"35","author":"S Shibasaki","year":"2021","unstructured":"Shibasaki S, Suda K, Nakauchi M, Nakamura K, Tanaka T, Kikuchi K, Inaba K, Uyama I (2021) Impact of the endoscopic surgical skill qualification system on the safety of laparoscopic gastrectomy for gastric cancer. Surg Endosc 35:6089\u20136100","journal-title":"Surg Endosc"},{"key":"12927_CR21","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1038\/bmt.2012.244","volume":"48","author":"Y Kanda","year":"2013","unstructured":"Kanda Y (2013) Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics. Bone Marrow Transplant 48:452\u2013458","journal-title":"Bone Marrow Transplant"},{"key":"12927_CR22","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1007\/s11760-018-1369-7","volume":"13","author":"T Okamoto","year":"2019","unstructured":"Okamoto T, Ohnishi T, Kawahira H, Dergachyava O, Jannin P, Haneishi H (2019) Real-time identification of blood regions for hemostasis support in laparoscopic surgery. SIViP 13:405\u2013412","journal-title":"SIViP"},{"key":"12927_CR23","doi-asserted-by":"publisher","first-page":"546","DOI":"10.21037\/atm-22-1914","volume":"10","author":"S Hua","year":"2022","unstructured":"Hua S, Gao J, Wang Z, Yeerkenbieke P, Li J, Wang J, He G, Jiang J, Lu Y, Yu Q, Han X, Liao Q, Wu W (2022) Automatic bleeding detection in laparoscopic surgery based on a faster region-based convolutional neural network. Ann Transl Med 10:546","journal-title":"Ann Transl Med"},{"key":"12927_CR24","doi-asserted-by":"publisher","first-page":"1492","DOI":"10.1007\/s00464-019-07365-x","volume":"34","author":"B Tang","year":"2020","unstructured":"Tang B, Cuschieri A (2020) Objective assessment of surgical operative performance by observational clinical human reliability analysis (OCHRA): a systematic review. Surg Endosc 34:1492\u20131508","journal-title":"Surg Endosc"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-12927-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-026-12927-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-12927-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T21:11:41Z","timestamp":1786396301000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-026-12927-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["12927"],"URL":"https:\/\/doi.org\/10.1007\/s00464-026-12927-x","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]},"assertion":[{"value":"1 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Shintaro Arakaki, Shin Takenaka, Daichi Kitaguchi, Tateo Ogane, Kimimasa Sasaki, Norihito Kosugi, Xue Zhao, Shuntaro Iuchi, Nao Baba, Yoshitsugu Yanagida, Risa Takai, Nobuyoshi Takeshita, Mitsuhisa Takatsuki, and Masaaki Ito have no conflict of interest or financial ties to disclose.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}}]}}