Online Surgical Learning of Laparoscopic Pyeloplasty in Adults: Is YouTube a Reliable Source?

Ureteropelvic junction obstruction (UPJO) is a common disease of the urinary system. Laparoscopic pyeloplasty, especially robot-assisted laparoscopic pyeloplasty, has become the primary surgical method for the treatment of UPJO. As YouTube gradually becomes a platform for young doctors to learn surgical techniques, we intend to assess these surgical videos of traditional laparoscopic pyeloplasty and robot-assisted pyeloplasty on YouTube in terms of their educational quality.

Two authors searched for "laparoscopic pyeloplasty," "robot-assisted pyeloplasty," and "robotic pyeloplasty" on YouTube (https://www.youtube.com/) individually on March 16, 2023. We developed the LAP-VEGaS Video Assessment Tool/LAP-VEGaS-LP scale based on the LAP-VEGaS guidelines to quantify the quality of the videos. And we used JAMA (Journal of the American Medical Association) Benchmark Criteria to assess the reliability of the videos. SPSS 26.0 software was applied to the description of the statistics and correlation analysis.

Finally, 55 videos were included. The average length of the videos was 9.30 min (interquartile range [IQR]: 22.56 min). The mean number of subscribers was 4,745 (range: 3-28,700, IQR: 16,684). The mean number of views per like (VPI) was defined as the percentage of the like ratio, and the ratio of the views was 2.48% (IQR: 6.79). The median JAMA score of the videos was 6 (IQR: 2). The mean LAP-VEGaS-LP score was 17.72 (SD: 0.76). The video definition had a positive correlation with the number of subscribers (r = 0.410, p = 0.003), the views-to-subscribers ratio (r = 0.431, p = 0.002), and VPI (r = 0.443, p = 0.001). The LAP-VEGaS-LP score had a positive correlation with the number of subscribers (r = 0.398, p = 0.004), definition (r = 0.314, p = 0.026), views ratio (r = 0.459, p = 0.001), VPI (r = 0.496, p < 0.001), and the score of reliability (r = 6.53, p < 0.001).

The educational quality of laparoscopic pyeloplasty surgical videos is concerning. A more authoritative standard is needed to guide the uploaders and improve the educational value of the videos.