Training program using a traction device improves trainees' learning curve of colorectal endoscopic submucosal...

Area of Science:

• Gastroenterology
• Surgical Education
• Medical Device Technology

Background:

• Colorectal endoscopic submucosal dissection (ESD) demands advanced endoscopic proficiency.
• Traction devices (TDs) have emerged to enhance the safety and reliability of ESD procedures.
• Evaluating ESD training programs incorporating TDs is crucial for skill acquisition.

Purpose of the Study:

• To assess the impact of a traction device (TD) training program on colorectal endoscopic submucosal dissection (ESD) skill acquisition among trainees.
• To compare learning curves and treatment outcomes between a conventional ESD training group and a TD-assisted ESD training group.

Main Methods:

• A comparative study design was employed, analyzing data before (control group) and after (TD group) the introduction of TDs.
• Patient data from January 2014 to June 2018 were retrospectively analyzed.
• Outcomes included the number of cases to achieve proficiency, ESD self-completion rate, dissection speed, en bloc resection rate, and R0 resection rate.

Main Results:

• The TD group (202 cases) required fewer cases (10) to achieve proficiency compared to the control group (114 cases, 21 cases).
• The TD group demonstrated superior ESD self-completion rates (73.8% vs. 58.8%), faster dissection speeds (19.5 mm²/min vs. 15.9 mm²/min), and higher en bloc (100% vs. 90%) and R0 resection rates (96% vs. 83%).

Conclusions:

• Training with a traction device (TD) significantly improves colorectal endoscopic submucosal dissection (ESD) skill acquisition in trainees.
• The TD training program led to immediate improvements in ESD self-completion rates and a linear increase in dissection speed with experience.
• TD-assisted ESD training enhances the safety and reliability of ESD techniques for endoscopists in training.