A quality assessment of youtube videos for the inclusion of the 10 critical steps of hiatal hernia repair and anti-reflux surgery.

Abstract

<h4>Background</h4>The "10 Critical Steps of Hiatal Hernia Repair and Anti-Reflux Surgery" provides a framework for the standardization of benign foregut operations. This study aimed to determine if currently available educational videos on YouTube adequately detail all 10 of these critical steps.<h4>Methods</h4>YouTube videos that were published between January 1, 2019 and July 1, 2024 were identified using Google search methods. Only English language videos detailing elective, benign foregut surgery in adults were included. Two reviewer pairs independently assessed the videos for both the demonstration and description of the 10 critical steps. The publication date, number of video views, and shown operative video length were also captured. Data were analyzed using Chi-squared tests.<h4>Results</h4>A total of 52 videos were identified; 39 (75%) videos met inclusion criteria. Adherence to expert-recommended steps was inconsistent. Only 3 (8%) videos described and/or demonstrated all 10 critical steps. Steps 7 (bougie placement) and 9 (crural repair/use of mesh) were most often neither described nor shown (77% and 56%, respectively) while steps 3 (dissection of crura), 6 (intra-abdominal esophageal length), and 10 (antirefllux surgery/fundoplication) were the most frequently described and shown (62%, 62%, and 69%, respectively). Step 8 (gastroesophageal junction assessment/Collis gastroplasty) was often shown without description (64%). There was a weak positive correlation between operative video length and number of steps that were both described and shown (r = 0.24) and a moderate negative correlation between operative video length and videos that omitted at least one step (r = - 0.4).<h4>Conclusion</h4>The results of our study highlight the need for more comprehensive hiatal hernia repair and anti-reflux surgery educational videos. We recommend updating currently available educational materials to be consistent with expert guidelines.