Feasibility of expert & crowd-sourced review of intraoperative video for quality improvement

This study investigates the relationship between surgical technique and the development of uretero-ileal stricture (UIS) following robotic-assisted radical cystectomy (RARC). By comparing the operative techniques of anastomoses resulting in clinically significant UIS against their contralateral counterparts in a case-control design, researchers utilized de-identified surgical videos reviewed by both high-volume surgeons and crowd workers. The evaluation aimed to determine if the surgeons' perceived risk of UIS or crowd-sourced assessments of robotic skills were linked to UIS development.

The analysis included 10 UIS cases and eight control cases, with expert surgeons failing to establish a significant association between their evaluations and UIS occurrence (OR 0.42; p=0.91). Additionally, crowd-sourced assessments did not predict UIS (p=0.62). These findings suggest that video review may not adequately reflect surgical technique in relation to UIS, possibly due to uncontrolled patient factors or limitations in the assessment methods used. Overall, this study highlights challenges in predicting UIS through existing evaluation techniques in robotic surgery.