Thank you for your reply and your feedback. I'm not sure about the NSFW tag - however if you select age under 18 you cannot start the survey, so I hope it is ok without the NSFW tag.

The order of the images is completely randomized - so the survey is never the same for two participants. The images however follow a complex algorithm - no image pair shows up twice. The number of images - although admittedly quite high - is the absolute minimum amount to simulate every important condition/decision-combination relevant for surgery. The load time was optimized - however depending on your location and server load it might of course be a little to long (I try to further improve that). Thank you very much for your support!