{ "abstract": "Background: The expansion of minimally invasive surgery has transformed surgical practice and training worldwide. However, operative exposure to laparoscopic and open procedures may vary across healthcare systems. Comparative international data on operative autonomy and procedural experience during surgical residency remain limited. This study aimed to compare operative exposure, autonomy, and trainee perceptions regarding open and laparoscopic surgery among surgical trainees at selected centers in France and Morocco.\n\nMethods: A multicenter cross-sectional survey was conducted among surgical trainees at academic centers in France and Morocco. Participants were stratified by postgraduate year (PGY 1–8). Self-reported operative exposure and autonomy were assessed for common general surgical procedures (appendectomy, cholecystectomy, and inguinal hernia repair) and complex colorectal procedures (colectomy and proctectomy) performed using open and laparoscopic approaches. Trainee perceptions of preparedness for minimally invasive surgery and the value of prior training in open surgery were also evaluated. Comparisons were made according to country and level of training.\n\nResults: A total of 131 trainees participated, including 67 from Morocco and 64 from France. Trainees at French centers reported significantly greater exposure to laparoscopic procedures across training levels (p < 0.001), whereas trainees at Moroccan centers reported greater exposure to open appendectomy, inguinal hernia repair, and proctectomy (p < 0.001). Operative autonomy increased with training seniority in both groups, although trainees at French centers reported greater autonomy in laparoscopic procedures. Trainees at Moroccan centers were significantly more likely to consider prior training in open surgery necessary before performing laparoscopic procedures (p < 0.01).\n\nConclusions: These findings support context-adapted curricula that preserve competence in open surgery while expanding access to structured, supervised training in minimally invasive surgery.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12909-026-10129-6.", "abstract_shown": true, "affiliations": [ "Department of Digestive, Oncologic, Endocrine, Hepatobiliary and Liver Transplant Surgery, Trousseau Hospital, University Hospital of Tours, Tours, France", "Department of Surgical Oncology, National Institute of Oncology, Mohammed V University, Rabat, Morocco", "Faculty of médecine and pharmacydepartment of surgery, University ibnou zohr, Agadir, Morocco", "Department of Digestive Surgery, Amiens University Hospital, Amiens, France", "Department of Digestive Surgery, Angers University Hospital, Angers, France", "Department of Digestive Surgical Oncology and Liver Transplantation, Besançon University Hospital, Besançon, France", "Department of General and Digestive Surgery, Brest University Hospital, Brest, France", "Department of Digestive Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France", "Department of Oncologic, Digestive and Endocrine Surgery, Nantes University Hospital, Nantes, France", "Department of Digestive Surgery, Limoges University Hospital, Limoges, France", "Department of Digestive Surgery, Nîmes University Hospital, Nîmes, France", "Department of Digestive Surgery, Aix-Marseille University, AP-HM, Timone University Hospital, Marseille, France", "Department of Digestive Surgery, Saint-Louis Hospital, Université Paris Cité, AP-HP, Paris, France", "Department of Digestive Surgery, Sorbonne Université, AP-HP, Saint-Antoine Hospital, Paris, France", "Department of Digestive and Oncologic Surgery, Georges Pompidou European Hospital, AP-HP, Université Paris Cité, Paris, France", "Department of Digestive Surgery, AP-HM, North University Hospital, Marseille, France", "Department of Digestive Surgery, Rouen University Hospital, Rouen, France", "Department of Digestive Surgery, Caen University Hospital, Caen, France", "Department of Digestive Surgery, Louis-Mourier Hospital, AP-HP, Colombes, France", "Service de Chirurgie Viscérale, CHU Hassan II, Fès, Morocco", "Department of Digestive and Oncologic Surgery, CHU Lille, Lille, France", "UMR 1327 ISCHEMIA, Membrane Signalling and Inflammation in Reperfusion Injuries, Université de Tours, Tours, France", "Service de Chirurgie Digestive, Oncologique, Endocrine, Hépatobiliaire et de Transplantation Hépatique, Unité de Chirurgie Colorectale Hôpital Trousseau, Avenue de La République, Chambray-lès-Tours, France" ], "article_type": "research article", "arxiv": null, "author_total": 31, "authors": [ { "affs": [ 0 ], "name": "Nicolas Michot" }, { "affs": [ 1 ], "name": "Amine Souadka" }, { "affs": [ 2 ], "name": "Mehdi Soufi" }, { "affs": [ 3 ], "name": "Charles Sabbagh" }, { "affs": [ 1 ], "name": "Oumayma Lahnaoui" }, { "affs": [ 4 ], "name": "Aurélien Venara" }, { "affs": [ 5 ], "name": "Zaher Lakkis" }, { "affs": [ 6 ], "name": "Bogdan Badic" }, { "affs": [ 1 ], "name": "Zakaria El Mouatassim" }, { "affs": [ 7 ], "name": "Johan Gagnière" }, { "affs": [ 8 ], "name": "Emilie Duchalais" }, { "affs": [ 9 ], "name": "Niki Christou" }, { "affs": [ 10 ], "name": "Bertrand Martin" }, { "affs": [ 1 ], "name": "Yassine El Bouazizi" }, { "affs": [ 11 ], "name": "Diane Mège" }, { "affs": [ 12 ], "name": "Léon Maggiori" }, { "affs": [ 1 ], "name": "Mohamed Reda El Hassouni" }, { "affs": [ 13 ], "name": "Jérémie Lefèvre" }, { "affs": [ 14 ], "name": "Gilles Manceau" }, { "affs": [ 15 ], "name": "Laura Beyer" }, { "affs": [ 16 ], "name": "Valérie Bridoux" }, { "affs": [ 17 ], "name": "Arnaud Alves" }, { "affs": [ 1 ], "name": "Amina Houmada" }, { "affs": [ 18 ], "name": "David Moskowitz" }, { "affs": [ 19 ], "name": "Tarik Souiki" }, { "affs": [ 20 ], "name": "Guillaume Piessen" }, { "affs": [ 0 ], "name": "Ephrem Salamé" }, { "affs": [ 1 ], "name": "Abdellilah Souadka" }, { "affs": [ 21 ], "name": "Urs Giger-Pabst" }, { "affs": [ 0, 21, 22 ], "name": "Mehdi Ouaissi", "orcid": "0000-0002-0906-4428" }, { "affs": [ 1 ], "name": "OncologiqueLa Société Marocaine d’Oncologie Digestive (SMOD)" } ], "bibtex": "https://research.draconitic.com/paper/ex2nnv0tdwe00.bib", "cited_by": 0, "doi": "10.1186/s12909-026-10129-6", "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13746408/", "id": "ex2nnv0tdwe00", "issns": [ "1472-6920" ], "landing_url": "https://doi.org/10.1186/s12909-026-10129-6", "language": "en", "licence": "CC-BY-NC-ND-4.0", "licence_label": "CC BY-NC-ND 4.0", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "hal", "0.sdv" ], [ "hal", "1.sdv.mhep" ], [ "hal", "2.sdv.mhep.chi" ], [ "heading", "Research" ], [ "openalex", "2746|Surgical Simulation and Training" ] ], "openalex": "W7202175566", "pdf_url": null, "pmcid": "PMC13746408", "pmid": "43000334", "published": "2026-08-11", "publisher": "BMC", "ris": "https://research.draconitic.com/paper/ex2nnv0tdwe00.ris", "sources": [ { "first_seen": "2026-11-11T12:23:45Z", "native_id": "PMC13746408", "source": "pmc", "url": "https://doi.org/10.1186/s12909-026-10129-6" }, { "first_seen": "2026-11-13T12:20:03Z", "native_id": "hal-05862165", "source": "hal", "url": "https://u-picardie.hal.science/hal-05862165v1" } ], "subjects": [ { "field": "biology", "origin": "hal:0.sdv", "subfield": "general" }, { "field": "medicine", "origin": "hal:2.sdv.mhep.chi", "subfield": "surgery" } ], "title": "Self-reported operative exposure and autonomy among surgical trainees at selected centers in France and Morocco: a multicenter survey", "title_text": "Self-reported operative exposure and autonomy among surgical trainees at selected centers in France and Morocco: a multicenter survey", "type": "peer-reviewed", "updated_at": "2026-11-13T12:22:50Z", "url": "https://research.draconitic.com/paper/ex2nnv0tdwe00", "venue": "BMC Medical Education", "versions": [] }