Endoscopy 2024; 56(02): 131-150
DOI: 10.1055/a-2205-2613
Position Statement

Training in basic gastrointestinal endoscopic procedures: a European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement

Giulio Antonelli
 1   Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, "Sapienza" University of Rome, Italy
 2   Gastroenterology and Digestive Endoscopy Unit, Ospedale dei Castelli Hospital, Ariccia, Rome, Italy
Andrei M. Voiosu
 3   Department of Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania
 4   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
 5   Endoscopy Unit, Gastroenterology Department, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
 6   The Center for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, University of Toronto, Ontario, Canada
Tiago Cúrdia Gonçalves
 7   Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
 8   Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
Nha Le
 9   Gastroenterology Division, Internal Medicine and Hematology Department, Semmelweis University, Budapest, Hungary
10   Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Belgium
11   Department of Gastroenterology and Hepatology, Imelda General Hospital, Bonheiden, Belgium
12   Division of Gastroenterology, Medical Department II, University of Leipzig Medical Center, Leipzig, Germany
13   Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Menoufia, Egypt
Ulrike Beilenhoff
14   ESGENA Scientific Secretary, Ulm, Germany
Pietro Mascagni
15   IHU Strasbourg, Strasbourg, France
16   Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Theodor Voiosu
 3   Department of Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania
 4   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
17   Department of Gastroenterology, Hospital Clínic Barcelona, Barcelona, Spain
Mário Dinis-Ribeiro
18   Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal
19   MEDCIDS/Faculty of Medicine, University of Porto, Porto, Portugal
20   Gastroenterology Department, Attikon University Hospital, Chaidari, Greece
Marianna Arvanitakis
21   Department of Gastroenterology and Hepatology, University Hospitals Leuven, TARGID, Leuven, Belgium
21   Department of Gastroenterology and Hepatology, University Hospitals Leuven, TARGID, Leuven, Belgium
Cesare Hassan
22   Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
23   Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
Helmut Messmann
24   Department of Gastroenterology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
Ian M. Gralnek
25   Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, Israel
26   Rappaport Faculty of Medicine Technion Israel Institute of Technology, Haifa, Israel
› Author Affiliations

Main Statements

This ESGE Position Statement provides structured and evidence-based guidance on the essential requirements and processes involved in training in basic gastrointestinal (GI) endoscopic procedures. The document outlines definitions; competencies required, and means to their assessment and maintenance; the structure and requirements of training programs; patient safety and medicolegal issues.

1 ESGE and ESGENA define basic endoscopic procedures as those procedures that are commonly indicated, generally accessible, and expected to be mastered (technically and cognitively) by the end of any core training program in gastrointestinal endoscopy.

2 ESGE and ESGENA consider the following as basic endoscopic procedures: diagnostic upper and lower GI endoscopy, as well as a limited range of interventions such as: tissue acquisition via cold biopsy forceps, polypectomy for lesions ≤ 10 mm, hemostasis techniques, enteral feeding tube placement, foreign body retrieval, dilation of simple esophageal strictures, and India ink tattooing of lesion location.

3 ESGE and ESGENA recommend that training in GI endoscopy should be subject to stringent formal requirements that ensure all ESGE key performance indicators (KPIs) are met.

4 Training in basic endoscopic procedures is a complex process and includes the development and acquisition of cognitive, technical/motor, and integrative skills. Therefore, ESGE and ESGENA recommend the use of validated tools to track the development of skills and assess competence.

5 ESGE and ESGENA recommend incorporating a multimodal approach to evaluating competence in basic GI endoscopic procedures, including procedural thresholds and the measurement and documentation of established ESGE KPIs.

7 ESGE and ESGENA recommend the continuous monitoring of ESGE KPIs during GI endoscopy training to ensure the trainee’s maintenance of competence.

9 ESGE and ESGENA recommend that GI endoscopy training units fulfil the ESGE KPIs for endoscopy units and, furthermore, be capable of providing the dedicated personnel, infrastructure, and sufficient case volume required for successful training within a structured training program.

10 ESGE and ESGENA recommend that trainers in basic GI endoscopic procedures should be endoscopists with formal educational training in the teaching of endoscopy, which allows them to successfully and safely teach trainees.

Joint first authors

Supplementary material

Publication History

Article published online:
01 December 2023

© 2023. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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