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DOI: 10.1055/a-1845-5556
Development of new gastric endoscopic submucosal dissection training model: A reproducibility evaluation study
KOTOBUKI Medical Inc
Abstract
Background and study aims Gastric endoscopic submucosal dissection (ESD) is a highly technical procedure mainly due to the distinctive shape of the stomach and diverse locations of lesions. We developed a new gastric ESD training model (G-Master) that could accurately recreate the location of the stomach and assessed the reproducibility of located lesions in the model.
Methods The model comprises a simulated mucous membrane sheet made of konjac flour and a setting frame, which can simulate 11 locations of the stomach. We assessed the reproducibility of each location in the model by assessing the procedure speed and using a questionnaire that was distributed among experts. In the questionnaire, each location was scored on a six-point scale for similarity of locations.
Results The mean score for all locations was high with > 4 points. Regarding locations, lower anterior and posterior walls had medium scores with 3 to 4 points. The procedure speed was slower in the greater curvature of the upper and middle gastric portions, where ESD is considered more difficult than the overall procedure speed.
Conclusions The new gastric ESD training model appears to be highly reproducible for each gastric location and its application for training in assuming actual gastric ESD locations.
Publication History
Received: 04 May 2022
Accepted after revision: 04 May 2022
Accepted Manuscript online:
06 May 2022
Article published online:
14 September 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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References
- 1 Isomoto H, Shikuwa S, Yamaguchi N. et al. Endoscopic submucosal dissection for early gastric cancer: a large-scale feasibility study. Gut 2009; 58: 331-336
- 2 Lian J, Chen S, Zhang Y. et al. A meta-analysis of endoscopic submucosal dissection and EMR for early gastric cancer. Gastrointest Endosc 2012; 76: 763-770
- 3 Pimentel-Nunes P, Dinis-Ribeiro M, Ponchon T. et al. Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2015; 47: 829-854
- 4 Vázquez-Sequeiros E, de Miquel DB, Olcina JR. et al. Training model for teaching endoscopic submucosal dissection of gastric tumors. Rev Esp Enferm Dig 2009; 101: 546-552
- 5 Parra-Blanco A, Arnau MR, Nicolás-Pérez D. et al. Endoscopic submucosal dissection training with pig models in a Western country. World J Gastroenterol 2010; 16: 2895-2900
- 6 Teoh AY, Chiu PW, Wong SK. et al. Difficulties and outcomes in starting endoscopic submucosal dissection. Surg Endosc 2010; 24: 1049-1054
- 7 Yano T, Hasuike N, Ono H. et al. Factors associated with technical difficulty of endoscopic submucosal dissection for early gastric cancer that met the expanded indication criteria: post hoc analysis of a multi-institutional prospective confirmatory trial (JCOG0607). Gastric Cancer 2020; 23: 168-174
- 8 Konuma H, Matsumoto K, Ueyama H. et al. Procedure time for gastric endoscopic submucosal dissection according to location, considering both mucosal circumferential incision and submucosal dissection. Gastroenterol Res Pract 2016; 2016: 9183793
- 9 Sato H, Mizuno KI, Sato Y. et al. Development and use of a non-biomaterial model for hands-on training of endoscopic procedures. Ann Transl Med 2017; 5: 182
- 10 Chen MJ, Wang HY, Chang CW. et al. A novel artificial tissue simulator for endoscopic submucosal resection training – a pilot study. BMC Gastroenterol 2016; 16: 112
- 11 Horii J, Goto O, Shimoda M. et al. Which part of a porcine stomach is suitable as an animal training model for gastric endoscopic submucosal dissection?. Endoscopy 2016; 48: 188-193
- 12 Oda I, Odagaki T, Suzuki H. et al. Learning curve for endoscopic submucosal dissection of early gastric cancer based on trainee experience. Dig Endosc 2012; 24: 129-132
- 13 Yoshida M, Kakushima N, Mori K. et al. Learning curve and clinical outcome of gastric endoscopic submucosal dissection performed by trainee operators. Surg Endosc 2017; 31: 3614-3622
- 14 Sakamoto T, Saito Y, Fukunaga S. et al. Learning curve associated with colorectal endoscopic submucosal dissection for endoscopists experienced in gastric endoscopic submucosal dissection. Dis Colon Rectum 2011; 54: 1307-1312
- 15 Hotta K, Oyama T, Shinohara T. et al. Learning curve for endoscopic submucosal dissection of large colorectal tumors. Dig Endosc 2010; 22: 302-306
- 16 Zhang X, Ly EK, Nithyanand S. et al. Learning curve for endoscopic submucosal dissection with an untutored, prevalence-based approach in the United States. Clin Gastroenterol Hepatol 2020; 18: 580-588.e581
- 17 Probst A, Golger D, Anthuber M. et al. Endoscopic submucosal dissection in large sessile lesions of the rectosigmoid: learning curve in a European center. Endoscopy 2012; 44: 660-667
- 18 Berr F, Ponchon T, Neureiter D. et al. Experimental endoscopic submucosal dissection training in a porcine model: learning experience of skilled Western endoscopists. Dig Endosc 2011; 23: 281-289
- 19 Papanikolaou IG, Haidopoulos D, Paschopoulos M. et al. Changing the way we train surgeons in the 21th century: A narrative comparative review focused on box trainers and virtual reality simulators. Eur J Obstet Gynecol Reprod Biol 2019; 235: 13-18