Thou shalt not trust online videos for inguinal hernia repair techniques
- PDF / 697,536 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 92 Downloads / 136 Views
and Other Interventional Techniques
2020 SAGES ORAL
Thou shalt not trust online videos for inguinal hernia repair techniques Desmond Huynh1 · Negin Fadaee2 · Hakan Gök3 · Andrew Wright4 · Shirin Towfigh2 Received: 22 June 2020 / Accepted: 16 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Videos are used by surgeons when learning new techniques; however, online videos are often not vetted. Our aim is to review online videos of laparoscopic inguinal hernia repairs based on a benchmark for critical view of the myopectineal orifice (MPO) and safe inguinal hernia repair as defined by Daes and Felix and commonly referred to as “the 9 Commandments.” Methods and materials YouTubeⓇ was queried for “laparoscopic inguinal hernia repair.” The top 50 videos were ranked based on number of views. Those endorsed and/or vetted by surgical societies were excluded (n = 4). Three expert hernia surgeons scored the videos based on adherence to the 9 Commandments. Results The 50 videos originated from 11 countries. They had 72,825 mean views and a mean runtime of 14 min. Videos obeyed a median of 77.8% of commandments shown. Eight videos (16%) obeyed all 9 (100%) commandments. Three videos (6%) failed to obey any commandments. Operations employed TEP (18, 36%), TAPP (28, 56%), and rTAPP (4, 8%) approach. Stratification by approach showed significant variance in commandments obeyed (Kurskal–Wallis, p = 0.016) with significant difference between TEP and rTAPP scores (p = 0.008) and no significant difference between TEP and TAPP or rTAPP and TAPP scores. Twenty-three videos (46%) displayed unsafe techniques including: threatened critical structures (16, 32%), rough tissue handling (15, 30%), and dangerous placement of fixation (9, 18%). Conclusion Online surgical videos on YouTube are not reliable in demonstrating best practices for minimally invasive inguinal hernia repairs. In our study, only 16% of the most viewed videos followed all 9 Commandments for critical view of the MPO. Many showed suboptimal repairs with significant safety concerns. While a significant number of online videos are a free and readily available resource for surgeons around the world, we recommend caution in relying on non-vetted videos as a form of surgical education. Keywords Inguinal hernia · Education · Technology · Robotic · Minimally invasive · Video The internet is filled with opportunities and resources for surgical education, including e-texts, discussion groups, educational applications, and videos [1, 2]. Surgical videos are provided online as educational tools by a variety * Shirin Towfigh [email protected] 1
Department of Surgery, Cedars-Sinai Health System, Los Angeles, CA, USA
2
Beverly Hills Hernia Center, 450 N Roxbury Drive #224, Beverly Hills, CA 90210, USA
3
Hernia Istanbul®, Hernia Surgery Center, Istanbul, Turkey
4
University of Washington Medical Center, Seattle, WA, USA
of dedicated sources, including such as online educational platforms (e.
Data Loading...
