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CC BY 4.0 · Surg J (N Y) 2021; 07(04): e357-e362
DOI: 10.1055/s-0041-1740627
Original Article

Are YouTube Videos a Reliable Training Method for Safe Laparoscopic Cholecystectomy? A Simulated Decision-Making Exercise to Assess the Critical View of Safety

Dimitrios K. Manatakis 
1   2nd Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece
2   Department of Surgical Oncology, Saint Savvas Cancer Hospital, Athens, Greece
,
Emmanouil Mylonakis 
1   2nd Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece
,
Petros Anagnostopoulos 
1   2nd Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece
,
Konstantinos Lamprakakis
1   2nd Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece
,
Christos Agalianos 
3   Department of Surgery, Naval Hospital of Crete, Chania, Greece
,
Dimitrios P. Korkolis
2   Department of Surgical Oncology, Saint Savvas Cancer Hospital, Athens, Greece
,
Christos Dervenis
4   Department of Surgery, Medical School, University of Cyprus, Nicosia, Cyprus
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Abstract

Background The present study assesses the educational value of laparoscopic cholecystectomy videos on YouTube regarding the correct application of the critical view of safety (CVS), and evaluates… surgical trainees' perceptions of the CVS criteria in a simulated, operative decision-making exercise.

Methods YouTube was systematically searched for laparoscopic cholecystectomy videos, explicitly reporting a satisfactory CVS. The top 30 most popular videos, by number of views, were identified and scored on the 6-point scale by three experienced consultants. After watching a training module on CVS rationale and criteria, 10 trainees, blinded to the consultants' assessment, were instructed to view the videos, score each criterion and answer the binary question “Would you divide the cystic structures?” by “yes” or “no.”

Results An inadequate CVS was found in 30% of the included videos. No statistical association was noted between number of views, likes, or dislikes with successful CVS rates. Inter-observer agreement between consultants and trainees ranged from minimal to moderate (k = 0.07–0.60). Discrepancy between trainees' CVS scores and their simulated decision to proceed to division of the cystic structures was found in 15% of assessments, with intra-observer agreement ranging from minimal to excellent (k = 0.27–1.0). For the CVS requirements, inter-observer agreement was minimal for the dissection of the cystic plate (k = 0.26) and triangle clearance (k = 0.39) and moderate for the identification of two and only two structures (k = 0.42).

Conclusion The CVS is central to the culture of safety in laparoscopic cholecystectomy. Surgical videos are a useful training tool as simulated, operative decision-making exercises. However, public video platforms should be used judiciously, since their content is not peer-reviewed or quality-controlled.

Keywords

surgical training - laparoscopic cholecystectomy - bile duct - critical view of safety (CVS).


Publication History

Received: 22 September 2021

Accepted: 26 October 2021

Article published online:
23 December 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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