Gut Liver.
2014 Nov;8(6):619-624. 10.5009/gnl13327.
The Feasibility of Using Simulated Targets in the Stomachs of Live Pigs for Full Endoscopic Submucosal Dissection Training
- Affiliations
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- 1Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan. mingjen.ch@msa.hinet.net
- 2Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan.
- 3Clinical Skills Training Center, Department of Medical Education, Mackay Memorial Hospital, Taipei, Taiwan.
- 4Department of Medicine, Mackay Medical College, New Taipei, Taiwan.
- KMID: 2070078
- DOI: http://doi.org/10.5009/gnl13327
Abstract
- BACKGROUND/AIMS
In endoscopic submucosal dissection (ESD) training, only a flat target lesion can usually be simulated in the normal mucosa. This study aimed to evaluate the feasibility of simulated targets in the stomachs of live pigs for complete training.
METHODS
Six trained endoscopists with hands-on experience with ex vivo, isolated pig stomachs were enrolled in this pilot study. An endoscopic banding device was used to create a polyp that was snared, leaving an ulcerated lesion. This simulated target model was used to perform ESD in pigs. The en bloc resection rate, procedure time, complications, quality of resection, and participants' opinions on the simulated targets were compared with the conventional model.
RESULTS
En bloc resections were achieved in all six simulated targets and six conventional models. The mean size of the resected specimens was 32.2 mm (range, 20 to 39 mm) in the simulated target group and 23.5 mm (range, 11 to 40 mm) in the conventional group. The target model had a high quality of resection and had a high satisfaction rate for margin identification and correct peripheral marking.
CONCLUSIONS
Good identification of the lesion and ease of periphery marking in the target model may improve resection quality.
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