How to establish endoscopic submucosal dissection in Western countries

Area of Science:

• Gastroenterology
• Surgical Oncology
• Endoscopic Procedures

Background:

• Endoscopic submucosal dissection (ESD) is a Japanese innovation for early gastrointestinal cancer resection.
• High-level ESD necessitates precise staging using image-enhanced endoscopy (IEE) and advanced electrosurgical skills.
• Expertise in Japan spread via direct mentorship from inventors and specialists.

Purpose of the Study:

• To outline a strategy for global dissemination of Endoscopic submucosal dissection (ESD) expertise.
• To address obstacles in translocating ESD training and practice to Western countries.
• To emphasize the need for collaboration with Japanese masters for effective ESD implementation.

Main Methods:

• Highlighting the complexity of IEE and ESD for trainees.
• Identifying the need for suitable training lesions and experienced mentors.
• Proposing a phased approach for ESD adoption in Western centers.

Main Results:

• Western endoscopists must first achieve proficiency through a rigorous learning curve.
• Establishment of major ESD referral centers in Western countries is crucial.
• Trained Western experts must then mentor other endoscopists to facilitate widespread adoption.

Conclusions:

• Patient care for early GI cancer demands mastering IEE and ESD skills.
• Sustained cooperation with Japanese experts is vital for successful ESD training.
• A structured strategy is necessary to overcome barriers and spread ESD globally.