AIM: To test a strategy for endoscopic submucosal dissection (ESD) training in animal models designed to overcome the initial learning curve. METHODS: ESD was attempted in ex vivo and in vivo pig models. Thirty ESD procedures were attempted in the esophagus (n = 9) or the stomach (n = 21). The ex vivo model was used until initial competence was achieved. In the in vivo model, several ESD procedures were performed in up to 3 sessions. The following variables were analyzed: specimen size, complete and en bloc resection rate, time for circumferential incision, time for submucosal dissection, total ESD duration, and complications. RESULTS: Complete resection was achieved in 28 cases (en bloc 27); 2 could not be completed (one perforation, one technical difficulty). The mean +/- SD time for circumferential incision was 36.2 +/- 16.8 min (range: 8-87 min), and the mean +/- SD time for submucosal dissection was 45.1 +/- 35.7 min (range: 9-196 min). The mean +/- SD size of the resected specimens was 45.2 +/- 17.8 mm. The mean +/- SD total resection time was significantly increased for the gastric cases performed in the first half of the study (n = 13) than in the second half (n = 8) (98.9 +/- 62.4 min vs 61.7 +/- 17.6 min, P = 0.04), although the specimen size did not differ. CONCLUSION: Training in animal models could help endoscopists overcome the learning curve before starting ESD in humans.
AIM: To test a strategy for endoscopic submucosal dissection (ESD) training in animal models designed to overcome the initial learning curve. METHODS: ESD was attempted in ex vivo and in vivo pig models. Thirty ESD procedures were attempted in the esophagus (n = 9) or the stomach (n = 21). The ex vivo model was used until initial competence was achieved. In the in vivo model, several ESD procedures were performed in up to 3 sessions. The following variables were analyzed: specimen size, complete and en bloc resection rate, time for circumferential incision, time for submucosal dissection, total ESD duration, and complications. RESULTS: Complete resection was achieved in 28 cases (en bloc 27); 2 could not be completed (one perforation, one technical difficulty). The mean +/- SD time for circumferential incision was 36.2 +/- 16.8 min (range: 8-87 min), and the mean +/- SD time for submucosal dissection was 45.1 +/- 35.7 min (range: 9-196 min). The mean +/- SD size of the resected specimens was 45.2 +/- 17.8 mm. The mean +/- SD total resection time was significantly increased for the gastric cases performed in the first half of the study (n = 13) than in the second half (n = 8) (98.9 +/- 62.4 min vs 61.7 +/- 17.6 min, P = 0.04), although the specimen size did not differ. CONCLUSION: Training in animal models could help endoscopists overcome the learning curve before starting ESD in humans.
Authors: M Muto; S Miyamoto; A Hosokawa; T Doi; A Ohtsu; S Yoshida; Y Endo; K Hosokawa; D Saito; C-S Shim; L Gossner Journal: Endoscopy Date: 2005-02 Impact factor: 10.093
Authors: E Vázquez-Sequeiros; D Boixeda de Miquel; J R Foruny Olcina; J A González Martín; M García; D Juzgado Lucas; E Garrido; C González; A Parra Blanco; M R Arnau; A Buenadicha; V Moreira Vicente; C Martín de Argila; J M Milicua Journal: Rev Esp Enferm Dig Date: 2009-08 Impact factor: 2.086
Authors: Miguel A Tanimoto; M Lourdes Guerrero; Yoshinori Morita; Jonathan Aguirre-Valadez; Elisa Gomez; Carlos Moctezuma-Velazquez; Jose A Estradas-Trujillo; Miguel A Valdovinos; Luis F Uscanga; Rikiya Fujita Journal: World J Gastrointest Endosc Date: 2015-04-16