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[Comment] Is this laparoscopic technique study the perfect surgical trial?

Novel surgical interventions can encompass new techniques and new technologies, both of which involve complex changes in already complicated patient pathways. In 2009, the Innovation, Development, Exploration, Assessment, Long-term study (IDEAL) collaboration introduced a framework1 that aimed to standardise the introduction of such innovations. This framework describes the optimum design for studies from small observational studies of first-in-human procedures, to early phase randomised controlled trials (RCTs) to assess safety, and late phase multicentre RCTs for efficacy.