For patients undergoing gastric cancer surgery, informed consent (IC) can involve extensive information about surgical methods, complications, risks, benefits, and life after treatment. Conventional face-to-face explanations can be difficult to absorb in one sitting and require substantial time from both patients and surgeons. Decisional conflict, the uncertainty people may feel when making a treatment choice, adds to this challenge.
A research team led by Senior Assistant Professor Kazumitsu Suzuki and Professor Susumu Shibasaki from the Department of Surgery, Fujita Health University, Japan, along with their colleagues Associate Professor Yusuke Watanabe, Professor Ichiro Uyama, and Professor Koichi Suda from the same institute, addressed this challenge. In cooperation with Contrea Inc., the team evaluated whether standardized video aids could help patients better understand the relevant information before their surgical consultation. Sixty patients scheduled for gastrectomy were randomly assigned either to watch video IC aids before their face-to-face consultation (PVIC group) or to receive the face-to-face consultation first and watch the videos afterward (standard IC group). The study was published online on September 27, 2026, in Volume 18, Issue 9, of the World Journal of Gastrointestinal Surgery.
"Rather than replacing the doctor's explanation, the video was designed to help patients understand essential information before meeting their doctor," said Dr. Suzuki. "We wanted patients to understand the surgery at their own pace so the consultation could focus more on their questions and concerns, supporting shared decision-making."
The videos were delivered through a web-based platform in short segments totaling about 30 minutes. They used animations, illustrations, and subtitles to explain topics such as surgical procedures, complications, postoperative recovery, and reconstruction methods. Surgeons selected appropriate modules for each patient's planned operation, allowing the material to be tailored while maintaining a standardized explanation.
The results showed improved consultation efficiency. Face-to-face IC discussions lasted an average of 22.4 minutes in the PVIC group, compared with 35.9 minutes in the standard IC group, a reduction of about 40%.
The primary outcome, the overall decisional conflict score, tended to be lower in the PVIC group after the consultation, although the difference did not reach statistical significance. The mean score was 13.5 in the PVIC group and 20.5 in the standard group, with P = 0.056. In both groups, decisional conflict decreased after patients received the video and physician explanation. However, no patients in the pre-consultation video group had high decisional conflict after the consultation, compared with 20% in the standard group, a statistically significant difference. These findings suggest that timing may matter: having an opportunity to understand the information through multimedia before the face-to-face discussion may help prevent high levels of uncertainty.
"Patients can watch the videos at home, revisit difficult parts, and share the information with family members before their appointment," said Dr. Suzuki. "This could help shift the consultation from simply delivering information toward a more meaningful dialogue between patients and healthcare professionals."
The researchers emphasize that the videos are not intended to replace conversations with doctors. Because videos provide one-way information, they cannot respond to personal concerns or questions. Instead, the approach could give patients a clearer baseline understanding and allow consultation time to be used for individualized discussion. In the future, digital tools, potentially including AI, could provide more personalized information and identify patients' questions and priorities before appointments.
Overall, this randomized trial suggests that pre-consultation video aids may improve the efficiency of IC for gastric cancer surgery and help prevent high decisional conflict. Further larger-scale evaluations could provide more robust evidence of these effects.
