Transanal TME Video Quality on YouTube Versus WebSurg and the Development of a Procedure-Specific TaTME StepScore: A Cross-Sectional Validation Study.

BACKGROUND

Video-based learning is a central tool in minimally invasive surgical training; however, the educational/reporting quality and reliability of online content must be evaluated using objective criteria. This study aimed to compare the educational quality of transanal total mesorectal excision (TaTME) videos published on YouTube and WebSurg and to test the validity of the TaTME-specific StepScore scale.

METHODS

A cross-sectional content analysis was performed across platforms (total n = 30; YouTube = 15, WebSurg = 15). Videos were scored using Laparoscopic Surgery Video Educational Guidelines (LAP-VEGaS) (0-18), Journal of the American Medical Association (JAMA) (0-4), modified DISCERN (mDISCERN) (5-25), and total mesorectal excision (TME) StepScore (14 steps, 0-28). Correlations were examined using Spearman's ρ with false discovery rate adjustment. Logistic regression and ROC/AUC were used to predict LAP-VEGaS ≥ 11 adequacy; the optimal threshold was determined using the Youden index.

RESULTS

Total scores and LAP-VEGaS ≥ 11 rates were similar across platforms (YouTube 66.7%; WebSurg 60.0%). StepScore showed a strong correlation with LAPVEGaS and mDISCERN and a moderate correlation with JAMA. Each +1 point increase in StepScore increased the odds of a LAP-VEGaS score ≥ 11. According to the Youden analysis, a StepScore ≥ 15 was found to be the best threshold.

CONCLUSION

Popular TaTME videos on YouTube and WebSurg appear similar in terms of educational/reporting quality. The procedure-specific StepScore is consistent with general quality measures and can predict LAP-VEGaS ≥ 11 adequacy with a practical ≥15 point target. Using StepScore for video assessment and as a step-by-step instructional checklist may contribute to improving TaTME training standards.