This systematic review assesses the effectiveness of objective technical skills assessment tools for laparoscopic cholecystectomy, highlighting gaps in validation.

• Manual assessment tools have the most validity evidence but inconsistent reliability and no clear outcome correlations.
• Kinematic tools provide motion data but lack robust validation.
• AI-based systems show promise for real-time use, specifically for critical view of safety detection, but lack external validation and evidence of clinical impact.

Surgeons should be aware that while these tools exist, none are yet validated as a gold standard for performance assessment.