Validation of a realistic, simple, and inexpensive EUS-FNA training model using isolated porcine stomach

Abstract

Background and study aims: Trainees are required to learn EUS-FNA using a model before working with a patient. The aim of the current study was to validate a new training model developed for EUS-FNA. Patients and methods: Several fresh chicken tenderloins were embedded as target lesions in the submucosal layer of an isolated porcine stomach. The stomach was fixed to a plate with nails, and was placed in a tub filled with water. The primary endpoint was feasibility of the newly developed model for EUS-FNA training, evaluated as follows: 1) visualization of the target lesion with blinding for lesion location; 2) penetrability of the needle; 3) sampling rate of macroscopic specimen; and 4) ROSE capability. Secondary endpoints were its durability and utility for multiple EUS-FNA procedures during EUS-FNA training, and the ease and cost of preparing the model. Results: Six endoscopists (1 expert, 5 trainees) attempted EUS-FNA procedures using this model. The target lesion could be identified clearly, and EUS-FNA could be performed with realistic resistance felt. In addition, rapid on-site evaluation could be easily achieved. Based on 10 needlings by each endoscopist, adequate specimens for histology could be macroscopically taken with an average 85 % success rate. Visibility and maneuverability were maintained throughout all needlings. Preparation time for this model was less than 30 minutes with a total cost of $ 22. Conclusions: An easy-to-use and inexpensive training model with a realistic feel of needling was created. This model can potentially enable beginners to practice safe and effective EUS-FNA procedures.

Validation of a novel swine model for training in EUS-FNA (with videos)

“…Until today, many training models for EUS-FNA have been reported, including phantoms, computer-based simulators, ex vivo models using isolated organs from animals, and live animal models;[ 6 7 8 9 10 11 ] yet, each features substantial limitations. Phantoms are easy to use and require minimal preparation but lack realism.…”

“…Of the several models that have been developed to date for EUS training, they are mostly ersatz, inadaptable to EUS-FNA, and not amenable to repeated use. [ 6 7 8 9 10 11 ]…”

Training in ERCP and EUS in the UK anno 2017

“…The model led to increased competence in both diagnostic and therapeutic procedures 24. More recently, Fukushima Medical University has published data on a model using pig stomach and chicken tenderloin as target lesions to train endoscopists to do FNA 25. The model proved to be valuable and cheap.…”

Advances in Pediatric Diagnostic Endoscopy: A State-of-the-Art Review

“…Pediatric gastroenterologists interested in pursuing training should identify a center with experience in EUS technique and perform supervised procedures based on the above guidelines. Hands-on sessions using animal models are useful to introduce the technique and solidify skills ( 161 ). In many centers, advanced diagnostic and therapeutic procedures in pediatric patients are performed by adult gastroenterologists with advanced training.…”