Are YouTube Videos a Reliable Training Method for Safe Laparoscopic Cholecystectomy? A Simulated Decision-Making Exercise to Assess the Critical View of Safety

Are YouTube Videos Sufficient for Educational Purposes for Robotic Right Hemicolectomy Learning and Has Complete Mesocolic Excision Changed That?

BACKGROUND/AIMS

The aim of this study is to evaluate the efficiency for educational purposes by evaluating the videos published on YouTube channel, which is an open source video sharing platform, for robotic right hemicolectomy procedure.

MATERIALS AND METHODS

We searched YouTube website to choose video clips that included information about robotic right hemicolec- tomy for right colon cancer. All videos were analyzed according to the criteria like quality of videos, quality of teaching, and modified Laparoscopic Surgery Video Educational Guidelines.

RESULTS

There were 16 complete mesocolic excision and 56 noncomplete mesocolic excision videos in the study. According to the Likert scale, calculated complete mesocolic excision scores were analyzed better than the noncomplete mesocolic excision group and this difference was statistically significant (P < .0001). The teaching quality scores of complete mesocolic excision videos were higher than noncomplete mesocolic excision group and this result was statistically significant (P = .02). The videos were scored according to the modified Laparoscopic Surgery Video Educational Guideline, and the score difference was statistically significant between complete mesocolic excision and noncomplete mesocolic excision videos (P < .001). The video power index was higher (mean 5.52 ± 15.56 vs. mean 1.66 ± 3.41) in the complete mesocolic excision group, but there was no statistically significant difference between the 2 groups (P = .086).

CONCLUSIONS

Most of the robotic right hemicolectomy videos on the YouTube platform are insufficient in terms of educational capaci- ties. Complete mesocolic excision-containing videos are slightly superior in this respect to noncomplete mesocolic excision videos, as considering a new technique can make video presenters more attentive. In our opinion, if the images presented to the video platforms are to be used for educational purposes, they must undergo a certain evaluation and screening process.

Confronting new challenges: Faculty perceptions of gaps in current laparoscopic curricula in a changing training landscape

Background

Opportunities for residents to develop laparoscopic skills have decreased with the rise in robotic operations and the development of complex, subspecialized laparoscopic operations. Given the changing training landscape, this study aimed to identify laparoscopic surgeons' perceptions of gaps in current laparoscopic skills in general surgery, obstetrics-gynecology, and urology residency programs.

Methods

Laparoscopic surgeons who operate with residents participated in semi-structured interviews. Questions addressed expectations for resident proficiency, deficits in laparoscopic surgical skills, and barriers to learning and teaching. Two authors independently coded de-identified transcripts followed by a conventional content analysis.

Results

Fourteen faculty members from thirteen subspecialties participated. Faculty identified three main areas to improve laparoscopic training across specialties: foundational knowledge, technical skills, and cognitive skills. They also recognized an overarching opportunity to address faculty development.

Conclusions

This qualitative study highlighted key deficiencies in laparoscopic training that have emerged in the current, changing era of minimally invasive surgery.

Key message

This qualitative study identified laparoscopic educators' perceptions of deficiencies in laparoscopic training. Findings emphasized the importance of incorporating high quality educational practices to optimize training in the current changing landscape of laparoscopic surgery.

Critical View of Safety in Laparoscopic Cholecystectomy: A Systematic Review of Current Evidence and Future Perspectives

BACKGROUND

The Critical View of Safety (CVS) has been increasingly recognised as the standard method for identification of the cystic structures, to prevent vasculobiliary injuries during laparoscopic cholecystectomy, however, its adoption has been anything but universal. A significant proportion of surgeons has a poor understanding of the three requirements. To bridge this gap between theory and practice, we aimed to summarise the available evidence on CVS, emphasising on current debates and future perspectives.

METHOD

We systematically reviewed the literature (1995-2021), to identify studies reporting on the CVS. Eligible articles were classified according to methodology and key idea. A quantitative analysis was performed to evaluate effectiveness of the CVS in preventing bile duct injury (BDI).

RESULTS

150 relevant articles were identified, focusing on six main points, (1) safety and effectiveness, (2) intraoperative documentation, (3) complementary imaging techniques, (4) bail-out alternatives, (5) adoption among surgeons, and (6) education and training. The quantitative analysis included 11 studies, with 10,938 cases. Overall, the CVS was achieved in 92.5%. Conversion rate was 4.8%. CVS-related BDI was 0.09% (0.05% technical errors and 0.04% misidentification errors).

CONCLUSION

Routine application of the CVS reduces BDI, but does not eliminate them altogether. Besides operative notes, the CVS should be documented by an imaging modality of sufficient quality. When the CVS cannot be safely established, the threshold for bail-out alternatives or complementary imaging should be low. Adoption by the surgical community worldwide shows great variability and focus should be placed on training through structured educational modules.