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The learning curve for endoscopic submucosal dissection in an established experimental setting.
Masayuki Kato1, Mark Gromski, Yunho Jung
1Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. masakato89@gmail.com
Surgical Endoscopy
|July 19, 2012
Summary
Simulation training significantly improves endoscopic submucosal dissection (ESD) skills. Performing 30 ESD procedures on a simulator enhances safety and efficiency for endoscopists before human application.
Area of Science:
- Gastroenterology
- Surgical Simulation
- Medical Education
Background:
- Endoscopic submucosal dissection (ESD) is a standard treatment for early gastric neoplasia.
- Simulation training offers a safe environment for endoscopists to learn ESD techniques before patient procedures.
Purpose of the Study:
- To evaluate the impact of ex vivo simulation training on endoscopic submucosal dissection (ESD) performance.
- To assess improvements in safety and efficiency after a set number of simulated ESD procedures.
Main Methods:
- Prospective ex vivo study using porcine organs and the EASIE-R endoscopic simulator.
- 150 artificial lesions were created and resected by three endoscopists (two novices, one expert).
- Procedure time, specimen size, en-bloc resection, and perforation rates were recorded.
Main Results:
- All 150 lesions were successfully resected.
- Novice endoscopists achieved a 100% en-bloc resection rate and no perforations after 30 ESD cases.
- Novices showed significant reductions in procedure time and perforation rates by their last 30 cases compared to their first 30.
Conclusions:
- Completing 30 simulated endoscopic submucosal dissections (ESD) significantly enhances procedural safety and efficiency.
- Ex vivo simulation is an effective method for improving endoscopist proficiency in ESD.
