Robotic surgery for Crohn's disease: educational value and quality of online video resources

To qualitatively assess surgical technique in robotic ileocecal resection (ICR) for Crohn's disease (CD) and evaluate the educational quality of procedural videos.

A systematic search was conducted across surgical video platforms (YouTube, Medtube, AIS Channel, WebSurg) using the terms "Robotic ileocecal resection" and "Robotic Crohn's disease." Inclusion criteria were (1) robotic ICR for CD; (2) uploaded between 2005 and 2025; (3) produced by medical professionals; (4) English language. Collected data including surgical indication, port placement, extraction site, anastomotic technique, and extent of mesenteric excision. Video content quality and training value was assessed with the Global Evaluative Assessment of Robotic Skills (GEARS) and LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) video assessment tool. A LAP-VEGaS score of ≥ 11 was defined as the educational pass mark.

Twenty-eight videos were included. Surgical indication was reported in 17 videos (60.7%): stricture (n = 7, 41.2%), fistula (n = 9, 52.9%), both (n = 1, 5.9%). Port positioning and extraction site were shown in 13 (46.4%) and 14 (50.0%) videos, respectively. Mesenteric excision was described in 19 videos (67.9%): extended (n = 5, 26.3%), limited (n = 10, 52.6%) and neither extended nor limited (n = 4, 21.1%). Anastomoses included Kono-S (n = 7, 29.2%), side-to-side (n = 16, 66.7%), side-to-end (n = 1, 4.1%). All the demonstrated anastomoses were performed intracorporeally. LAP-VEGaS scores ranged from 2 to 17 (median = 11), with only 57.14% receiving a score of 11 or higher, whilst GEARS showed novice (n = 7, 25.0%), intermediate (n = 15, 53.6%), expert (n = 6, 21.4%). Video quality was good in 7.1%, moderate in 64.3% and poor in 28.6%. Educational value for surgeons in training was ranked as good in 7.1%, moderate in 25.0% and poor in 67.9%.

Videos of robotic ICR for Crohn's disease can support surgical education, although currently only half meet minimum quality standards. Greater standardisation and adherence to validated frameworks are required to optimise their educational value.