Safe and Efficient Procedures and Training System for Endoscopic Submucosal Dissection

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Endoscopic submucosal dissection (ESD) is increasingly standard in hospitals.
• ESD carries risks of perforation and hemorrhage.
• Continuous development of safer and more efficient ESD techniques is crucial.

Purpose of the Study:

• To review therapeutic procedures and training methods for improving ESD safety and efficiency.
• To describe a specific ESD training system implemented in a Japanese university hospital.

Main Methods:

• Review of existing literature on ESD therapeutic procedures and training.
• Description of a training system implemented in a newly established Digestive Endoscopy department.
• Analysis of ESD outcomes, including perforation rates, during the department's establishment phase.

Main Results:

• The implemented ESD training system contributed to a gradual increase in ESD procedures.
• Zero perforation rate was achieved for all ESD procedures, including those performed by trainees, during the department's establishment.
• The review highlights advancements in ESD safety and efficiency.

Conclusions:

• The described training system and therapeutic approaches are effective in enhancing ESD safety and efficiency.
• Successful implementation of ESD, even by trainees, is achievable with appropriate training and procedures.
• This model can inform the development of ESD programs in other institutions.