{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T18:52:32Z","timestamp":1793904752985,"version":"4.8.0"},"reference-count":19,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Deutsche Gesellschaft f\u00c3\u00bcr Chirurgie","award":["10.13039\/501100010197"],"award-info":[{"award-number":["10.13039\/501100010197"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The acquisition of surgical skills in highly specialized pediatric surgical procedures\u00a0\u2013\u00a0particularly the management of rare congenital anomalies\u00a0\u2013\u00a0poses significant educational challenges. Traditional training models relying on apprenticeship and intraoperative exposure are often insufficient due to the rarity and complexity of such conditions. Simulation-based training offers a structured, reproducible, and risk-free environment to practice and refine surgical techniques. This scoping review examines the current landscape of simulation in pediatric surgery, focusing on anorectal malformations (ARM), esophageal atresia (EA), Hirschsprung\u2019s disease (HD) and congenital diaphragmatic hernia (CDH). A dual search strategy was applied: a systematic literature search via PubMed and a structured online search via Google for commercially available simulation models. A range of models was identified across the four index conditions, including low-fidelity, high-fidelity, hybrid, and animal tissue-based simulators. EA and CDH showed the highest diversity in simulation tools, supporting both open and minimally invasive approaches. Several of the models we identified have demonstrated face, content and construct validity, but systematic data on learning outcomes and user satisfaction remain scarce. While low-fidelity models are useful for basic skill acquisition, high-fidelity and hybrid simulations more closely replicate the operative environment and enhance decision-making and technical proficiency. However, access to high-fidelity simulators remains limited due to cost and resource constraints. By identifying current limitations and opportunities of simulation training, this scoping review provides insights into how the sustainable training of the next generation of pediatric surgeons can be mastered.<\/jats:p>","DOI":"10.1515\/iss-2025-0015","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T23:32:20Z","timestamp":1762299140000},"page":"203-210","source":"Crossref","is-referenced-by-count":3,"title":["The role of simulation in mastering highly specialized pediatric surgery: current trends and future perspectives"],"prefix":"10.1515","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8191-8777","authenticated-orcid":false,"given":"Louisa","family":"Schuffert","sequence":"first","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Kinderchirurgie , Universit\u00e4tsmedizin Mainz , Mainz , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3442-4851","authenticated-orcid":false,"given":"Sabine","family":"Drossard","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Allgemein-, Viszeral-, Transplantations-, Gef\u00e4\u00df- und Kinderchirurge , Universit\u00e4tsklinikum W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"2025122314030565116_j_iss-2025-0015_ref_001","unstructured":"UEMS. EUPSA. European training requirements for pediatric surgery; 2020. [cited 2025 Aug 18]; Available from: https:\/\/www.eupsa.info\/eupsa\/wp-content\/uploads\/2020\/10\/ETR_Paediatric-Surgery_10_2020.pdf."},{"key":"2025122314030565116_j_iss-2025-0015_ref_002","doi-asserted-by":"crossref","unstructured":"Pacilli, M, Clarke, SA. Simulation-based education for paediatric surgeons: does it really improve technical skills? Semin Pediatr Surg 2020;29. https:\/\/doi.org\/10.1016\/j.sempedsurg.2020.150905.","DOI":"10.1016\/j.sempedsurg.2020.150905"},{"key":"2025122314030565116_j_iss-2025-0015_ref_003","doi-asserted-by":"crossref","unstructured":"Patel, EA, Ayd\u0131n, A, Desai, A, Dasgupta, P, Ahmed, K. Current status of simulation-based training in pediatric surgery: a systematic review. J\u00a0Pediatr Surg 2019;54:1884\u201393. https:\/\/doi.org\/10.1016\/j.jpedsurg.2018.11.019.","DOI":"10.1016\/j.jpedsurg.2018.11.019"},{"key":"2025122314030565116_j_iss-2025-0015_ref_004","doi-asserted-by":"crossref","unstructured":"Joosten, M, de Blaauw, I, Botden, SM. Validated simulation models in pediatric surgery: a review. J\u00a0Pediatr Surg 2022;57:876\u201386. https:\/\/doi.org\/10.1016\/j.jpedsurg.2022.06.015.","DOI":"10.1016\/j.jpedsurg.2022.06.015"},{"key":"2025122314030565116_j_iss-2025-0015_ref_005","doi-asserted-by":"crossref","unstructured":"Youn, JK, Ko, D, Yang, HB, Kim, HY. A 3D printed esophageal atresia\u2013tracheoesophageal fistula thorascopy simulator for young surgeons. Sci Rep 2024;14. https:\/\/doi.org\/10.1038\/s41598-024-62154-4.","DOI":"10.1038\/s41598-024-62154-4"},{"key":"2025122314030565116_j_iss-2025-0015_ref_006","doi-asserted-by":"crossref","unstructured":"Joosten, M, B\u00f6kkerink, GMJ, Sutcliffe, J, Levitt, MA, Diefenbach, K, Reck, CA, et al.. Validation of a newly developed competency assessment tool for the posterior sagittal anorectoplasty. Eur J Pediatr Surg 2022;32:399\u2013407. https:\/\/doi.org\/10.1055\/s-0041-1736387.","DOI":"10.1055\/s-0041-1736387"},{"key":"2025122314030565116_j_iss-2025-0015_ref_007","unstructured":"Bokkerink, G, van Ling, J, de Blaauw, I, Botden, S. Training of the steps of a posterior sagittal anorectoplasty is feasible on a low budget model (Poster Presentation). In: . 20th Annual Congress of the European Paediatric Surgeons\u2019 Association, Belgrade. Belgrade, Serbia: 20th Annual Congress of the European Paediatric Surgeons\u2019 Association; 2019."},{"key":"2025122314030565116_j_iss-2025-0015_ref_008","doi-asserted-by":"crossref","unstructured":"Jhala, T, Rentea, RM, Aichner, J, Szavay, P. Surgical simulation of posterior sagittal anorectoplasty for rectovestibular fistula: low-cost high-fidelity animal-tissue model. 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