The wonderful collaboration with Esther continues. Several years in the making, we can finally present a protocol for a study that aims to assess the impact of minimally invasive surgery (MIS) on surgeon well-being and performance: Amirthanayagam A , Zecca M , Barber S , Singh B, Moss EL Impact of minimally invasive surgery on surgeon health (ISSUE) study: protocol of a single-arm observational study conducted in the live surgery setting BMJ Open 2023; 13: e066765. doi: 10.1136/bmjopen-2022-066765 We believe that MIS has many benefits for patients, but also poses challenges for surgeons. We want to measure various aspects of surgeon well-being and performance before and after MIS procedures. We also want to explore the factors that influence surgeon well-being and performance in MIS. We hope that our study will provide insights into how to improve surgeon training, education and support for MIS.