Colorectal Unit, Plymouth Hospitals NHS Trust, Plymouth, UK.
Department of Clinical Medicine and Surgery, School of Medicine, Federico II University, Naples, Italy.
Surg Endosc. 2017 Nov;31(11):4496-4504. doi: 10.1007/s00464-017-5504-2. Epub 2017 Apr 4.
Instructive laparoscopy videos with appropriate exposition could be ideal for initial training in laparoscopic surgery, but unfortunately there are no guidelines for annotating these videos or agreed methods to measure the educational content and the safety of the procedure presented. Aim of this study is to systematically search the World Wide Web to determine the availability of laparoscopic colorectal surgery videos and to objectively establish their potential training value.
A search for laparoscopic right hemicolectomy videos was performed on the three most used English language web search engines Google.com, Bing.com, and Yahoo.com; moreover, a survey among 25 local trainees was performed to identify additional websites for inclusion. All laparoscopic right hemicolectomy videos with an English language title were included. Videos of open surgery, single incision laparoscopic surgery, robotic, and hand-assisted surgery were excluded. The safety of the demonstrated procedure was assessed with a validated competency assessment tool specifically designed for laparoscopic colorectal surgery and data on the educational content of the video were extracted.
Thirty-one websites were identified and 182 surgical videos were included. One hundred and seventy-three videos (95%) detailed the year of publication; this demonstrated a significant increase in the number of videos published per year from 2009. Characteristics of the patient were rarely presented, only 10 videos (5.4%) reported operating time and only 6 videos (3.2%) reported 30-day morbidity; 34 videos (18.6%) underwent a peer-review process prior to publication. Formal case presentation, the presence of audio narration, the use of diagrams, and snapshots and a step-by-step approach are all characteristics of peer-reviewed videos but no significant difference was found in the safety of the procedure.
Laparoscopic videos can be a useful adjunct to operative training. There is a large and increasing amount of material available for free on the internet, but this is currently unregulated.
带有适当讲解的有教育意义的腹腔镜视频可能是腹腔镜手术初步培训的理想选择，但遗憾的是，目前没有针对这些视频进行标注的指南，也没有用于衡量所呈现的手术内容教育价值和安全性的公认方法。本研究旨在通过系统搜索万维网，确定腹腔镜结直肠手术视频的可用性，并客观地确定其潜在的培训价值。
在三个使用最广泛的英语网络搜索引擎 Google.com、Bing.com 和 Yahoo.com 上搜索腹腔镜右半结肠切除术视频；此外，对 25 名当地学员进行了一项调查，以确定其他可供纳入的网站。所有带有英文标题的腹腔镜右半结肠切除术视频均被纳入。排除开腹手术、单切口腹腔镜手术、机器人和手助腹腔镜手术的视频。使用专门为腹腔镜结直肠手术设计的经过验证的能力评估工具评估所展示手术的安全性，并提取视频的教育内容数据。
共确定了 31 个网站，纳入了 182 个手术视频。173 个视频（95%）详细说明了发布年份；这表明每年发布的视频数量显著增加，从 2009 年开始。患者的特征很少被提及，只有 10 个视频（5.4%）报告了手术时间，只有 6 个视频（3.2%）报告了 30 天发病率；34 个视频（18.6%）在发布前经过同行评审。正式的病例介绍、音频旁白、使用图表和快照以及逐步操作是同行评审视频的特点，但在手术安全性方面没有发现显著差异。
腹腔镜视频可以成为手术培训的有用辅助手段。互联网上有大量且不断增加的免费材料，但目前这些材料不受监管。
