Educational value of YouTube surgical videos of pediatric robotic-assisted laparoscopic pyeloplasty: A qualitative assessment.

PURPOSE 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 LAP-VEGaS (LAParoscopic surgery Video Educational GuidelineS). 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 1,912). 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. The United States (US) and India were the most common countries of origin. Only 6 videos contained all critical steps of the procedure. No videos contained all 16 points of the LAP-VEGaS checklist (mean 7.6), most videos neglected preoperative information and outcomes. Percentage conformity was 48% overall, (range 25%-81%). The most viewed videos were not associated with higher conformity to LAP-VEGaS guidelines. 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. There is an opportunity to improve the educational quality and value of open access videos, starting by adopting video reporting guidelines.