The Learning Curve for Advanced Endoscopy for Colorectal Lesions: A Surgeon's Experience at a High-Volume Center

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Endoscopic Procedures

Background:

• Advanced endoscopy enables complete removal of large colorectal polyps.
• Proficiency in advanced endoscopy is not widespread, and the learning curve is not well-defined.
• This study aimed to define the learning curve for colorectal advanced endoscopy.

Discussion:

• The study analyzed 182 advanced endoscopy procedures performed by a high-volume colorectal surgeon.
• Key metrics included complication rates, polyp recurrence, and polyp removal rate (mm/h).
• A removal rate of 30 mm/h was achieved after 100 cases, with stable complication and recurrence rates.

Key Insights:

• A minimum of 100 cases are needed to achieve proficiency in advanced colorectal endoscopy.
• Proficiency is characterized by low complication and recurrence rates, and a high polyp removal rate (30 mm/h).
• The study highlights the importance of case volume in mastering advanced endoscopic techniques.

Outlook:

• Further research with multi-surgeon and multi-center studies is warranted to validate these findings.
• Standardizing training protocols for advanced endoscopy can accelerate the learning curve.
• Improved proficiency can lead to better patient outcomes and wider adoption of minimally invasive techniques.