Subscribe to RSS

DOI: 10.1055/s-0045-1805054
A Simulation Study to Investigate the Usefulness of a Novel Stricture Model for Training Esophageal Metallic Stent Placement
Authors
Funding None declared.

Abstract
Background and Aims The training in esophageal self-expanding metallic stent (SEMS) placement for postgraduates needs an efficient and effective simulation model. The aim of the study was to evaluate the usefulness of a novel stricture model for training in esophageal SEMS placement.
Methods The study was a pre-test and post-test design without any control group. Three advanced flexible endoscopic courses were conducted from 2022 to 2024. The training sessions involved 20 final-year postgraduate fellows in each session from different centers. The stenting module consisted of a non-tissue esophageal model with deployment of esophageal SEMS. The trainees received a pre-test, followed by an hour of didactic lecture, mentored hands-on sessions on SEMS deployment on the model using stepwise stenting module, and ended by post-test. Assessments included verbal feedbacks and knowledge-based test scores.
Results Sixty final-year postgraduate fellows with varying endoscopic experiences participated in the training programs. All the participants had completed more than 100 therapeutic procedures. Three fellows had deployed esophageal SEMS earlier. All the trainees and the instructor had rated the model as excellent or good with stiffer haptics than real tissue. The mean (%) pre-test scores of 17 (29%) improved significantly to 57 (95%) in the mean post-test (%) questionnaire (p < 0.05). There was significant improvement in test questionnaire after the training modules.
Conclusion The simulation model using the novel esophageal model for SEMS deployment is effective with good performance evaluation and can be used to train SEMS deployment procedures.
Publication History
Article published online:
17 March 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Balekuduru AB, Dutta AK, Subbaraj SB. Endoscopy on a human cadaver: a feasibility study as a training tool. J Dig Endosc 2018; 9 (03) 103-108
- 2 Khan R, Scaffidi MA, Grover SC, Gimpaya N, Walsh CM. Simulation in endoscopy: practical educational strategies to improve learning. World J Gastrointest Endosc 2019; 11 (03) 209-218
- 3 Balekuduru AB, Appaji AC. Therapeutic endoscopic procedures on a human cadaver—a pilot feasibility study. J Dig Endosc 2021; 12 (01) 36-42
- 4 Goenka MK, Reddy DN, Kochhar R, Sharma P. Endoscopy training: Indian perspective. J Dig Endosc 2014; 5: 135-138
- 5 Wong HJ, Attaar M, Campbell M. et al. A modular simulation curriculum to teach endoscopic stenting to practicing surgeons: an “Into the fire” approach. Surg Endosc 2022; 36 (09) 6859-6867
- 6 Silva R, Stenting E, How I. Do It: Próteses esofágicas: uma abordagem pessoal. GE Port J Gastroenterol 2023; 30 (Suppl. 01) 35-44
- 7 Ebigbo A, Karstensen JG, Aabakken L. et al. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Cascade Guideline. Endosc Int Open 2019; 7 (06) E833-E836
- 8 Balekuduru AB, Sahu MK. A simulation study to investigate the usefulness of a novel stricture tool for training wire guided balloon dilation. J Dig Endosc 2022; 13: 141-146
- 9 Balekuduru AB, Kumar Sahu M, Agrahara Sreenivasa KK, Manur Gururajachar J, Reddyvari K, Bonthala Subbaraj S. Efficacy and safety of endoscopic self-expanding metallic stent for esophageal malignancy: a two-institute experience. J Dig Endosc 2019; 10: 101-106
- 10 Maulahela H, Annisa NG, Konstantin T, Syam AF, Soetikno R. Simulation-based mastery learning in gastrointestinal endoscopy training. World J Gastrointest Endosc 2022; 14 (09) 512-523
- 11 Hashimoto DA, Petrusa E, Phitayakorn R, Valle C, Casey B, Gee D. A proficiency-based virtual reality endoscopy curriculum improves performance on the fundamentals of endoscopic surgery examination. Surg Endosc 2018; 32 (03) 1397-1404
- 12 Feuille C, Sewell JL. Senior trainee as endoscopy teacher: impact on trainee learning and attending experience. Frontline Gastroenterol 2023; 15 (01) 14-20
- 13 Stoeckel D, Pelton A, Duerig T. Self-expanding nitinol stents: material and design considerations. Eur Radiol 2004; 14 (02) 292-301
- 14 Martins BC, Retes FA, Medrado BF. et al. Endoscopic management and prevention of migrated esophageal stents. World J Gastrointest Endosc 2014; 6 (02) 49-54
- 15 Shim CS. Esophageal stent for cervical esophagus and esophagogastric junction. Clin Endosc 2012; 45 (03) 235-239
- 16 Yang G, Wang S, Yin M. et al. Stent-in-stent technique under fluoroscopy for removal of embedded esophageal stent: a retrospective case series. Quant Imaging Med Surg 2022; 12 (07) 3813-3820