Educational Value of YouTube Surgical Videos of Pediatric Robot-Assisted Laparoscopic Pyeloplasty: A Qualitative Assessment

Introduction: Surgeons and residents report using videos to prepare for procedures, with a preference for open access resources, specifically YouTube. The educational quality of online videos is uncertain. Videos are uploaded without quality assessment, and ranked by popularity. This study aims to better characterize the available pediatric robotic pyeloplasty videos on YouTube, and assess for conformity to LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS). Methods: The most viewed videos of "pediatric robotic pyeloplasty" on YouTube were reviewed for baseline characteristics, educational content, inclusion of critical domains of the procedure (positioning, ports, exposure, ureteral mobilization, renal pelvis dissection, hitch stitch, spatulation, and anastomosis), and conformity to LAP-VEGaS. Results: Once ranked by views, 23 videos met inclusion criteria. Views per video ranged from 40 to 15,664 (mean of 1912). The two oldest videos were uploaded in 2009, and had the highest number of views. Audio and written educational content accompanied videos, 22% and 48% of the time, respectively. United States and India were the most common countries of origin. Only six videos contained all critical steps of the procedure. No videos contained all 16 points of the LAP-VEGaS essential checklist (mean 7.6), and most videos neglected preoperative information and outcomes. Percentage conformity was 48% overall (range for each video was 25%-81%). The most viewed videos were not associated with higher conformity to LAP-VEGaS. Conclusions: Despite studies demonstrating preferences for YouTube videos as an educational tool, and pyeloplasty being the most commonly performed pediatric robotic procedure, there are currently few high value educational videos available on YouTube. Videos often lack important procedure domains, and demonstrate low conformity to LAP-VEGaS guidelines. This demonstrates an opportunity to improve the educational quality and value of open access videos, starting by adopting established video reporting guidelines.