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Endoscopic Procedures III: Video Capsule Endoscopy01:28

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Capsule endoscopy, or wireless or video capsule endoscopy, is a diagnostic procedure for examining the entire gastrointestinal tract. Patients swallow a capsule about the size of a vitamin tablet. The capsule is equipped with a transmitter, a battery, an LED light source, and a color video camera to capture images throughout the gastrointestinal tract. This procedure is particularly useful for diagnosing conditions such as Crohn's disease, ulcerative colitis, tumors, polyps, ulcers,...
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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
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The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
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This lesson explores three gastrointestinal imaging techniques: radionuclide testing, colonic transit studies, and virtual colonoscopy.
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Navigating the learning landscape: Comprehensive training in third space endoscopy - training, techniques, and

D Roser1, S Nagl1, A Ebigbo1

  • 1University Hospital Augsburg, Department for Gastroenterology, Augsburg, Germany.

Best Practice & Research. Clinical Gastroenterology
|August 29, 2024
PubMed
Summary
This summary is machine-generated.

Training for third space endoscopy (TSE), like peroral endoscopic myotomy (POEM), needs standardized protocols. A step-up approach using simulators and preclinical models, followed by supervised cases, is recommended for proficiency.

Keywords:
ESDEndoscopic trainingPOEMSTERSimulationTechnical proficiencyThird space endoscopy

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Area of Science:

  • Gastroenterology and Endoscopy
  • Surgical Education

Background:

  • Third space endoscopy (TSE) encompasses advanced endoscopic procedures such as endoscopic submucosal dissection (ESD), peroral endoscopic myotomy (POEM), and submucosal tunneling endoscopic resections (STER).
  • Despite increasing adoption, standardized training curricula and evidence-based protocols for TSE are notably absent.
  • This gap necessitates a structured approach to developing the required technical proficiency and cognitive skills for endoscopists.

Purpose of the Study:

  • To review and propose effective training methodologies for third space endoscopy (TSE).
  • To identify essential cognitive skills and technical proficiencies for performing TSE procedures, with a focus on POEM.
  • To outline practical recommendations for a comprehensive TSE training program.

Main Methods:

  • Literature review focusing on training methods, simulators, preclinical models, and clinical experience for TSE.
  • Analysis of existing evidence regarding procedural numbers for skill acquisition and the role of mentorship.
  • Synthesis of recommendations for theoretical knowledge and technical skill development.

Main Results:

  • A step-up training approach is recommended, beginning with ex-vivo models and simulators (mechanical and virtual reality).
  • Preclinical training using ex-vivo and live animal models is crucial for preparing trainees.
  • Approximately 20-40 supervised cases are suggested to reach an initial plateau in performance, with clinical training duration varying by prior experience.

Conclusions:

  • Existing evidence supports the use of preclinical models and specialized training programs for TSE.
  • A structured, step-up training approach is vital for ensuring safe and effective TSE procedures.
  • Mentorship programs and adverse event management training are critical components of TSE education.