Endoscopic submucosal dissection training with ex vivo human gastric remnants
- 01.01.2014
Erschienen in:
- Verfasst von
- David V. Pham
- Anand Shah
- Frank J. Borao
- Steven Gorcey
- Erschienen in
- Surgical Endoscopy | Ausgabe 1/2014
Abstract
Background
Endoscopic submucosal dissection (ESD) offers en bloc resection of early cancer or precancerous lesions, potentially saving patients from major organ resection, such as gastrectomy, colectomy, and esophagectomy. Japan now leads the world in ESD due to its high rate of gastric cancer. Western countries, with their lower gastric cancer rates, do not get as much experience with the technique. Training in ESD utilizing both in vivo and ex vivo porcine stomach has been shown to decrease rates of perforation and operative time. Both models can be prohibitively expensive or not generally available to the majority of endoscopists on a regular basis. This study describes the framework for using human gastric remnants from sleeve gastrectomy patients for ESD training.
Methods
Patients undergoing sleeve gastrectomy for morbid obesity were consented for use of their gastric specimen before surgery. The specimen was weighed and measured by the pathologist and then used for ESD training. The specimen was mounted to a 15-mm laparoscopic port and secured using a pursestring suture. ESD was then performed through this port.
Results
We were able to successfully use this model to resect multiple marked out lesions in an en bloc fashion. Training using this model has improved our dissection times from approximately 2 h to 30 min for a 2-cm simulated lesion.
Conclusions
ESD requires the endoscopist to perform a surgical dissection. Until now, development of these skills required intensive training on porcine models that are not widely available. We were able to create a method using the excised portion from sleeve gastrectomy patients, providing a more accessible and cost-effective model for ESD training and potentially other endoscopic therapeutic modalities.
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- Titel
- Endoscopic submucosal dissection training with ex vivo human gastric remnants
- Verfasst von
-
David V. Pham
Anand Shah
Frank J. Borao
Steven Gorcey
- Publikationsdatum
- 01.01.2014
- Verlag
- Springer US
- Erschienen in
-
Surgical Endoscopy / Ausgabe 1/2014
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218 - DOI
- https://doi.org/10.1007/s00464-013-3164-4
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