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Updated: May 31, 2026
A New Ex Vivo Model for the Evaluation of Endoscopic Submucosal Injection Material Performance
Published on: October 19, 2018
Simulating a target lesion for endoscopic submucosal dissection training in an ex vivo pig model
Tsang-En Wang1, Horng-Yuan Wang, Ching-Chung Lin
1Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital and Mackay Medicine Nursing and Management College, Taipei, Taiwan.
Background:
Currently, there is no training model that simulates the target lesion encountered during endoscopic submucosal dissection.
Objective:
To develop a novel method simulating a target lesion for endoscopic submucosal dissection.
Design:
Training program with the use of an ex vivo porcine stomach model.
Setting:
Clinical skills training center.
Intervention:
A pseudopolyp was created by using an esophageal variceal ligation device to simulate a protruding (0-Ip) lesion, and the pseudopolyp was transected with a snare cautery to simulate a depressed (0-IIc) lesion.
Main Outcome Measurements:
Evaluate the histological depth of the target lesions and resected specimens.
Results:
Histological findings of the simulated targets showed artificial ulcerative or polypoid lesions involving the muscularis mucosa or superficial submucosa. The resected specimen was limited to the submucosal layer, and no perforation was noted.
Limitations:
Pilot study in an ex vivo porcine stomach model.
Conclusion:
The most important advantage of the model is to simulate realistic target lesions like those encountered in clinical practice in endoscopic submucosal dissection training. It allows trainees to practice how to make proper markings, delineate adequate safety margins, and properly manage different subtypes of early gastric cancer.
