ArticleSurgical endoscopy2021
Thou shalt not trust online videos for inguinal hernia repair techniques.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed.
- Quality and educational value of youtube videos on inguinal hernia surgery: a cross-sectional study.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- A comparative evaluation of laparoscopic TAPP videos on YouTube and WebSurg: surgical steps and educational value.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Surgeon volumes: preserving appropriate surgical outcomes in higher-risk patient populations undergoing abdominal wall reconstruction.Surgical endoscopy · 2023Article
- Towards automatic verification of the critical view of the myopectineal orifice with artificial intelligence.Surgical endoscopy · 2023Article
- Generation Learning Differences in Surgery: Why They Exist, Implication, and Future Directions.The Surgical clinics of North America · 2023Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVideos are used by surgeons when learning new techniques; however, online videos are often not vetted. Our aim is to review online videos of laparoscopic inguinal hernia repairs based on a benchmark for critical view of the myopectineal orifice (MPO) and safe inguinal hernia repair as defined by Daes and Felix and commonly referred to as "the 9 Commandments." METHODS AND MATERIALS: YouTube
resultsThe 50 videos originated from 11 countries. They had 72,825 mean views and a mean runtime of 14 min. Videos obeyed a median of 77.8% of commandments shown. Eight videos (16%) obeyed all 9 (100%) commandments. Three videos (6%) failed to obey any commandments. Operations employed TEP (18, 36%), TAPP (28, 56%), and rTAPP (4, 8%) approach. Stratification by approach showed significant variance in commandments obeyed (Kurskal-Wallis, p = 0.016) with significant difference between TEP and rTAPP scores (p = 0.008) and no significant difference between TEP and TAPP or rTAPP and TAPP scores. Twenty-three videos (46%) displayed unsafe techniques including: threatened critical structures (16, 32%), rough tissue handling (15, 30%), and dangerous placement of fixation (9, 18%).
conclusionOnline surgical videos on YouTube are not reliable in demonstrating best practices for minimally invasive inguinal hernia repairs. In our study, only 16% of the most viewed videos followed all 9 Commandments for critical view of the MPO. Many showed suboptimal repairs with significant safety concerns. While a significant number of online videos are a free and readily available resource for surgeons around the world, we recommend caution in relying on non-vetted videos as a form of surgical education.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.