Impact of video-assisted informed consent on decision conflict and consultation time in gastric cancer surgery

doi:10.4240/wjgs.123251

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Publication Name

World Journal of Gastrointestinal Surgery

ISSN

1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Randomized Controlled Trial

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Sep 27, 2026; 18(9): 123251
Published online Sep 27, 2026. doi: 10.4240/wjgs.123251

Impact of video-assisted informed consent on decision conflict and consultation time in gastric cancer surgery

Kazumitsu Suzuki, Susumu Shibasaki, Yusuke Watanabe, Kazuhiro Kawabata, Masaya Nakauchi, Tsuyoshi Tanaka, Kazuki Inaba, Ichiro Uyama, Koichi Suda

Kazumitsu Suzuki, Susumu Shibasaki, Tsuyoshi Tanaka, Koichi Suda, Department of Surgery, Fujita Health University, Toyoake 470-1192, Aichi, Japan

Yusuke Watanabe, Masaya Nakauchi, Kazuki Inaba, Ichiro Uyama, Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, Toyoake 470-1192, Aichi, Japan

Yusuke Watanabe, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo 060-8638, Hokkaido, Japan

Kazuhiro Kawabata, Contrea Inc., Tokyo 160-0023, Japan

Author contributions: Suzuki K, Shibasaki S, Kawabata K, Uyama I, and Suda K contributed to study design; Suzuki K, Nakauchi M and Tanaka T contributed to data collection; Suzuki K, Shibasaki S, Watanabe Y, Nakauchi M, Tanaka T, Inaba K, and Suda K contributed to statistical analysis and interpretation of results; Suzuki K, Shibasaki S, Watanabe Y, and Suda K contributed to drafting of the manuscript; Shibasaki S, Watanabe Y, Kawabata K, Uyama I, and Suda K contributed to critical revision of the manuscript for important intellectual content. All authors read and approved the ﬁnal manuscript and all authors are accountable for all aspects of the work in ensuring that questions related to its accuracy or integrity are appropriately investigated and resolved.

AI contribution statement: The authors acknowledge the use of Gemini strictly for language polishing during the revision of the main text following peer review. No portion of the original manuscript was AI-generated. Furthermore, the AI tool did not participate in the study design, data analysis, or the interpretation of the results. Additionally, no images or figures in this manuscript were generated using AI tools. The authors take full responsibility for the content and integrity of the final manuscript.

Institutional review board statement: The study was reviewed and approved by the Fujita Health University Institutional Review Board (approval No. HM25-138).

Clinical trial registration statement: This study was registered in the UMIN Clinical Trials Registry (registration No. UMIN000056846).

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: Kazuhiro Kawabata, CEO of Contrea Inc., holds stock in the company, which provided the MediOS software used in the study.

CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.

Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at <yusuke.watanabe@fujita-hu.ac.jp> upon reasonable request.

Corresponding author: Yusuke Watanabe, MD, PhD, Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Aichi, Japan. yusuke.watanabe@fujita-hu.ac.jp

Received: May 13, 2026
Revised: June 24, 2026
Accepted: July 2, 2026
Published online: September 27, 2026
Processing time: 125 Days and 23.4 Hours

Abstract

BACKGROUND

Gastric cancer (GC) surgery requires comprehensive informed consent (IC), but conventional in-person IC is time-consuming and cognitively demanding. We hypothesized that pre-consultation video IC (PVIC) aids would reduce decisional conflict and consultation time.

AIM

To evaluate whether supplementing in-person IC with video aids reduces decisional conflict and IC duration, and to determine the optimal timing for video viewing.

METHODS

In this single-center, randomized controlled trial, 60 patients undergoing gastrectomy for GC were assigned to either the PVIC group or the standard IC (SIC) group (video viewing after consultation). The primary endpoint was the decisional conflict scale (DCS) score. Secondary endpoints included the duration of in-person IC and the proportion of patients experiencing high decisional conflict (DCS ≥ 37.5). Data were analyzed using the t-test, χ² test, and Mann-Whitney U test.

RESULTS

Although the PVIC group showed lower DCS scores than the SIC group, the difference did not reach statistical significance (P = 0.056). However, the prevalence of high decisional conflict was significantly lower in the PVIC group (0% vs 20%; P = 0.024). Furthermore, the duration of in-person IC was significantly shorter in the PVIC group compared to the SIC group (mean difference: 13.5 minutes; P < 0.001).

CONCLUSION

PVIC aids significantly reduce IC duration and eliminate high decisional conflict. This approach enhances the efficiency and quality of patient education in GC surgery.

Keywords: Decision support techniques; Gastric cancer; Stomach neoplasms; Informed consent; Patient satisfaction; Physician-patient relations

Core Tip: Integrating video-assisted informed consent into clinical practice can enhance consultation efficiency and support shared decision-making in major gastrointestinal surgeries. Video aids were beneficial regardless of timing, but pre-consultation viewing was more effective in reducing decision uncertainty. Pre-consultation video aids may better prevent high decisional conflict compared to video viewing after consultation. Video aids for surgical informed consent reduced the duration of in-person consultations by approximately 40%.