Orientation in upper gastrointestinal endoscopy-the only way is up

Area of Science:

• Gastroenterology
• Medical Education
• Surgical Anatomy

Background:

• Oesophagogastroduodenoscopy is the standard for upper GI tract investigation.
• Accurate anatomical orientation during endoscopy is challenging.
• Precise location reporting of pathologies is vital for treatment planning.

Purpose of the Study:

• To assess endoscopists' spatial orientation abilities within the upper GI tract.
• To compare landmark identification accuracy between experienced and novice endoscopists.

Main Methods:

• A cross-sectional descriptive study utilizing an anonymous survey.
• Assessed endoscopists' ability to correctly identify anatomical landmarks.
• Compared accuracy rates between experienced (>1000 procedures) and novice endoscopists using Pearson's chi-squared test.

Main Results:

• 44.4% correctly identified the anterior stomach; 47.3% identified the posterior second part of the duodenum.
• Experienced endoscopists showed significantly higher accuracy for anterior stomach identification (61.6% vs. 31.3%, P=0.001).
• No significant difference in posterior duodenal landmark identification between experienced and novice groups.

Conclusions:

• A majority of surveyed endoscopists demonstrated difficulty identifying key upper GI landmarks.
• While experience enhances orientation, some landmarks remain poorly recognized.
• Inaccurate landmark identification may affect patient management, particularly for posterior duodenal ulcers, necessitating a consensus on endoscopic descriptions.