Content Assessment of Online Surgical Education Videos for Total Laparoscopic Hysterectomy (TLH)

Abstract

Study Objective This study aims to assess the content of online videos as an educational supplement for gynecology trainees for Total Laparoscopic Hysterectomy (TLH). Design We performed a cross-sectional analysis of relevant YouTube videos. The keywords “laparoscopic total hysterectomy surgical training” and “laparoscopic total hysterectomy surgical education” were used to retrieve the top 60 videos per search query. Videos without live surgical footage, audio narration, or with commercial intent were excluded. Two independent reviewers evaluated the videos using the “Objective Scale Specific for the Assessment of Technical skills for Laparoscopic Hysterectomy” (H-OSATS) to assess the inclusion of necessary steps, the “Modified Objective Structured Assessment of Technical Skills” (M-OSATS) for laparoscopy to assess surgical technique and a 3-point Likert scale to assess surgical difficulty. Setting N/A Patients or Participants N/A Interventions N/A Measurements and Main Results A total of 12 videos were analyzed: 11/12 (91.6%) videos were created by physicians without academic affiliations, and 1 was from an academic center. The mean H-OSATS and M-OSATS scores were 21.73/53 (41%) and 16.5/20 (82.5%) respectively. Inter-rater agreement was rated at 95.3% with a Cohen's kappa of 0.90. All videos included instruction on the division of uterine and utero-ovarian pedicles (100%). However, the majority of videos did not provide instruction on patient positioning (83%), abdominal entry (77%), trocar insertion (67%), division of the cervical attachments of the cardinal ligaments (62%), port removal (100%), and skin closure (100%). The mean surgical difficulty was rated as 1.6/3. Conclusion Online surgical videos likely demonstrate adequate surgical skill and technique, but do not provide comprehensive instruction on the essential steps of conducting a TLH. There is a need for the production of open-access high quality comprehensive videos for TLH instruction.