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Task Deconstruction of Colonic Endoscopic Submucosal Dissection (cESD): An Expert Consensus.

Karen J Dickinson^1,2, Brian J Dunkin^3,4, John J Nguyen-Lee^3,4

¹Houston Methodist Institute for Technology, Innovation and Education (MITIE), 6670 Bertner Ave, Houston, TX, 77030, USA. kjdickinson@houstonmethodist.org.

World Journal of Surgery

|March 6, 2020

Summary

This summary is machine-generated.

Developing a standardized colorectal endoscopic submucosal dissection (cESD) task list is crucial for training endoscopists. This evidence-based approach aims to improve patient care by increasing cESD adoption and potentially avoiding surgery.

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Area of Science:

Gastroenterology
Surgical Innovation
Medical Education

Background:

Colorectal endoscopic submucosal dissection (cESD) adoption in the US is hindered by limited training, technical challenges, and complication risks.
Over 28,000 patients annually undergo colonic resection for benign lesions, a procedure potentially manageable with cESD.
Increased cESD adoption could enable selected patients to avoid surgery, necessitating accessible training.

Framework:

A literature review identified initial cESD procedural steps.
A modified Delphi process involving clinical and educational subject-matter experts (SMEs) was employed.
The goal was to establish consensus on a comprehensive, deconstructed cESD task list for standardized teaching.

Implementation:

An initial list of eight cESD steps was generated from the literature review.
Consensus was achieved on seven steps in the first Delphi round.
Focus groups and hands-on labs refined the steps, resulting in a final ten-step deconstructed task list.

Implications:

A standardized cESD task list provides a foundation for safe and efficient training of practicing endoscopists.
This framework can guide the development of a training pathway to boost cESD procedural adoption.
Wider adoption of cESD can benefit patients currently undergoing colonic resections.