Endoscopy 2020; 52(S 01): S247-S248
DOI: 10.1055/s-0040-1704775
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Clinical endoscopic practice ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

A STEEP EARLY LEARNING CURVE FOR ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD) IN THE LIVE PORCINE MODEL

RK Magalhães
1   Santo António Hospital, Porto University Hospital Centre, Gastroenterology, Porto, Portugal
,
M Dinis-Ribeiro
2   Oncology Portuguese Institute of Porto, Gastroenterology, Porto, Portugal
3   Community Medicine, Information and Health Decision Sciences and Decision in Health (MEDCIDS) and CINTESIS, Faculty of Medicine of Porto, Porto, Portugal
,
MJ Bruno
4   Erasmus MC, University Medical Centre, Gastroenterology and Hepatology, Rotterdam, Netherlands
,
R Marcos-Pinto
1   Santo António Hospital, Porto University Hospital Centre, Gastroenterology, Porto, Portugal
3   Community Medicine, Information and Health Decision Sciences and Decision in Health (MEDCIDS) and CINTESIS, Faculty of Medicine of Porto, Porto, Portugal
5   Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
,
C Rolanda
6   Braga Hospital, Gastroenterology, Braga, Portugal
7   School of Medicine, University of Minho, Life and Health Sciences Research Institute (ICVS), Porto, Portugal
8   PT Government Associate Laboratory, ICVS/3B’s, Braga/Guimarães, Portugal
,
AD Koch
4   Erasmus MC, University Medical Centre, Gastroenterology and Hepatology, Rotterdam, Netherlands
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Endoscopic Submucosal Dissection (ESD) is a demanding procedure requiring high level of expertise. ESD training programs incorporate procedures with live animal models. This study aimed to assess the early learning curve for performing ESD on live porcine models by endoscopists without any or limited previous ESD experience.

Methods In a live porcine model ESD workshop, number of resections, completeness of the resections, en bloc resections, adverse events, tutor intervention, type of knife, ESD time and size of resected specimens were recorded. ESD speed was calculated.

Results A total of 70 procedures were carried out by 17 trainees. The percentage of complete resections, en bloc resections and ESD speed increased from the first to the latest procedures (88,2% to 100%; 76,5% to 100%; 8,6 to 31,4 mm2/min, respectively). The number of procedures in which a trainee needed tutor intervention and the number of adverse events also decreased throughout de procedures (4 to 0 and 6 to 0, respectively).

During the workshop, when participants changed to a different type of knife, ESD speed slightly decreased (18,5 mm2/min to 17,0 mm2/min) and adverse events increased again (0 to 2).

Conclusions Through successive procedures, complete resections, en bloc resections and ESD speed improve whereas adverse events diminish, supporting the role of the live porcine model in the early learning phase. Changing ESD knives has a momentarily negative impact on the learning curve.