Endoshare: A Source Available Solution to De-Identify and Manage Surgical Videos
This addresses privacy and standardization issues for clinicians and researchers in surgical video management, though it is incremental as it builds on existing software development practices.
The paper tackles the problem of heterogeneous formats and privacy concerns in sharing surgical videos by developing Endoshare, a source-available application for merging, standardizing, and de-identifying endoscopic videos, which achieved high usability scores (e.g., 4.38/5) and strong recommendations (9.20/10) from surgeons in testing.
Video-based assessment and surgical data science can advance surgical training, research, and quality improvement. However, widespread use remains limited by heterogeneous recording formats and privacy concerns associated with video sharing. We present Endoshare, a source-available, cross-platform application for merging, standardizing, and de-identifying endoscopic videos in minimally invasive surgery. Development followed the software development life cycle with iterative, user-centered feedback. During the analysis phase, an internal survey of clinicians and computer scientists based on ten usability heuristics identified key requirements that guided a privacy-by-design architecture. In the testing phase, an external clinician survey combined the same heuristics with Technology Acceptance Model constructs to assess usability and adoption, complemented by benchmarking across different hardware configurations. Four clinicians and four computer scientists initially tested the prototype, reporting high usability (4.68 +/- 0.40/5 and 4.03 +/- 0.51/5), with the lowest score (4.00 +/- 0.93/5) relating to label clarity. After refinement, the testing phase surveyed ten surgeons who reported high perceived usefulness (5.07 +/- 1.75/7), ease of use (5.15 +/- 1.71/7), heuristic usability (4.38 +/- 0.48/5), and strong recommendation (9.20 +/- 0.79/10). Processing time varied with processing mode, video duration (both p <= 0.001), and machine computational power (p = 0.041). Endoshare provides a transparent, user-friendly pipeline for standardized, privacy-preserving surgical video management. Compliance certification and broader interoperability validation are needed to establish it as a deployable alternative to proprietary systems. The software is available at https://camma-public.github.io/Endoshare/