Educational quality of YouTube videos demonstrating minimally invasive thymectomy: a comparative analysis of VATS and RATS approaches

Online video platforms have become an increasingly important component of surgical education, allowing trainees and practising surgeons to review operative techniques outside traditional training environments. Among these platforms, YouTube is widely used to access minimally invasive surgical procedures. However, unlike peer-reviewed scientific publications, the educational quality and reliability of YouTube content are not standardised. This study aimed to compare the educational and informational quality of YouTube videos demonstrating video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracic surgery (RATS) thymectomy. A cross-sectional comparative study was conducted using YouTube videos identified through a systematic search performed on February 6, 2026. Videos demonstrating VATS or RATS thymectomy were screened according to predefined inclusion and exclusion criteria. In total, 60 videos were included in the analysis (30 VATS and 30 RATS). For each video, characteristics such as duration, view count, like count, comment count, upload year, and uploader type were recorded. Videos were also evaluated for the presence of narration, step-by-step explanations, and discussion of complications or surgical pitfalls. Educational and informational quality were assessed using three validated instruments: the DISCERN tool, the JAMA benchmark criteria, and the LAP-VEGaS guidelines. Statistical analyses were performed using R software, and p < 0.05 was considered statistically significant. The median DISCERN score was 43 (26–66) for RATS videos and 41 (16–53) for VATS videos, with no statistically significant difference between the two approaches ( p = 0.167). Similarly, LAP-VEGaS scores were comparable between groups (RATS: 16 [10–18]; VATS: 17 [5–18]; p = 0.785), and JAMA scores did not differ significantly ( p = 0.657). Videos that included narration, step-by-step explanations, and discussion of complications demonstrated significantly higher DISCERN and LAP-VEGaS scores (all p < 0.001). In addition, videos uploaded by professional or academic platforms were associated with higher procedural quality scores compared with those uploaded by individual users ( p = 0.020). Engagement metrics such as view count, like count, and comment count were not associated with higher educational quality. The educational quality of YouTube videos demonstrating minimally invasive thymectomy appears to be comparable between VATS and RATS approaches. Rather than the surgical platform itself, the way the procedure is presented seems to play a more important role in determining educational value. Videos that include narration, clear step-by-step explanations, and discussion of potential complications appear to provide greater educational benefit. Encouraging the use of structured reporting frameworks such as LAP-VEGaS may help improve the reliability and educational usefulness of surgical videos shared on open platforms.