Surgeon perceptions of essential skills and simulation for percutaneous transforaminal endoscopic discectomy training

This study sought to identify the procedural competencies deemed necessary by Chinese surgeons for performing percutaneous transforaminal endoscopic discectomy (PTED), and to assess the current landscape of its simulated training. The survey, comprising 38 items and developed by PTED experts, was distributed via five dedicated social media groups for spine surgeons and at two major orthopaedic surgery conferences, targeting surgeons with experience in PTED. A total of 154 valid responses were received from surgeons across 22 of China's 34 provincial-level administrative divisions (64.7% coverage). Cognitive skills were identified as the most critical for performing PTED. Although cadaveric specimens were the preferred training modality, younger surgeons reported limited access to them. High-fidelity physical models and virtual reality (VR) simulators were regarded as the most favorable alternatives. The reported average duration of simulated training was 22.8 ± 43.6 h. A solid anatomical foundation is critical for novice surgeons to achieve proficiency in PTED. While cadaveric training remains the ideal modality, high-fidelity physical models and VR simulators are viable and increasingly accessible alternatives for training the next generation of surgeons.