How many cases do instructor class pediatric surgeons need to experience to be an independent operator in performing advanced endoscopic surgery? A nationwide survey to establish an ideal curriculum for pediatric endoscopic surgery in Japan

This nationwide Japanese survey of 52 instructor-level pediatric surgeons found that autonomy in advanced endoscopic procedures is typically achieved after 2-3 cases, yet 42% felt their training was insufficient. The study highlights critical gaps in off-the-job training and provides evidence-based benchmarks for developing competency-based surgical curricula in pediatric minimally invasive surgery.