Learning of flexible endoscopy, particularly endoscopic vacuum therapy (EVT)

Grund, K. E.; Schweizer, Ulrich; Zipfel, A.; Duckworth-Mothes, Benedikt

doi:10.1007/s00104-021-01497-4

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…The development and manufacturing of a human-like model for the training of hemostatic skills in flexible endoscopy was the topic of two doctoral theses at the University Hospital of Tübingen. Models for training of the flexible endoscopy known as "Tübingen models" were used as a basis [8], upon which two organ models with exchangeable bleeding pathologies have been built. For these models, 3D data of the stomach and esophagus of patients were used, which were printed as a mold.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of a New Animal Tissue-Free Bleeding Model for Training of Endoscopic Hemostasis

Wichmann

Grether²,

Fundel

et al. 2023

JCM

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Background: For endoscopists, knowledge of the available hemotherapeutic devices and materials as well as competence in using them is a life-saving expertise in the treatment of patients with acute gastrointestinal bleeding. These competences can be acquired in training on live animals, animal organs, or simulators. We present an animal tissue-free training model of the upper gastrointestinal tract for bleeding therapy. Methods: An artificial, animal tissue-free mucosa and submucosa with the opportunity of injection and clipping therapy were created first. Patches with this artificial mucosa and submucosa were placed into silicone and latex organs with human-like anatomy. Esophageal bleeding situations were imitated as variceal bleeding and bleeding of a reflux esophagitis in latex organs. Finally, a modular training model with human anatomy and replaceable bleeding sources was created. Evaluation of the novel model for gastroscopic training was performed in a multicentric setting with endoscopic beginners and experts. Results: Evaluation was carried out by 38 physicians with different levels of education in endoscopy. Evaluation of the model was made with grades from one (excellent) to six (bad): suitability for endoscopic training was 1.4, relevance of the endoscopic training was 1.6, and grading for haptic and optic impression of the model was 1.7. Conclusions: The creation of a gastroscopic model for the training of hemostatic techniques without animal tissues was possible and multiple endoscopic bleeding skills could be trained in it. Evaluation showed good results for this new training option, which could be used in every endoscopic unit or other places without hygienic doubts.

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Section: Methodsmentioning

confidence: 99%

Evaluation of a New Animal Tissue-Free Bleeding Model for Training of Endoscopic Hemostasis

Wichmann

Grether²,

Fundel

et al. 2023

JCM

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“…However, it is well understood that in order to achieve high rates of success, a high level of competence in interventional flexible endoscopy is mandatory. This is why the long-proven training system for flexible endoscopy at Tuebingen University has already been modified to include a two-stage process of special training for EVT [129].…”

Section: Endoscopic Vacuum Therapy (Evt)mentioning

confidence: 99%

Endoscopic Salvage of Gastrointestinal Anastomosis Leaks—Past, Present, and Future—A Narrated Review

Menni,

Stavrou,

Tzikos

et al. 2023

Gastrointestinal Disorders

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Background: Anastomotic leakage, which is defined as a defect in the integrity of a surgical join between two hollow viscera leading to communication between the intraluminal and extraluminal compartments, continues to be of high incidence and one of the most feared complications following gastrointestinal surgery, with a significant potential for a fatal outcome. Surgical options for management are limited and carry a high risk of morbidity and mortality; thus, surgeons are urged to look for alternative options which are minimally invasive, repeatable, non-operative, and do not require general anesthesia. Methods: A narrative review of the international literature took place, including PubMed, Scopus, and Google Scholar, utilizing specific search terms such as “Digestive Surgery AND Anastomotic Leakage OR leak OR dehiscence”. Results: In the present review, we try to describe and analyze the pros and cons of the various endoscopic techniques: from the very first (and still available), fibrin gluing, to endoclip and over-the-scope clip positioning, stent insertion, and the latest suturing and endoluminal vacuum devices. Finally, alongside efforts to improve the existing techniques, we consider stem cell application as well as non-endoscopic, and even endoscopic, attempts at intraluminal microbiome modification, which should ultimately intervene pre-emptively, rather than therapeutically, to prevent leaks. Conclusions: In the last three decades, this search for an ideal device for closure, which must be safe, easy to deploy, inexpensive, robust, effect rapid and stable closure of even large defects, and have a low complication rate, has led to the proposal and application of a number of different endoscopic devices and techniques. However, to date, there is no consensus as to the best. The literature contains reports of only small studies and no randomized trials, failing to take into account both the heterogeneity of leaks and their different anatomical sites.

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Learning of flexible endoscopy, particularly endoscopic vacuum therapy (EVT)

Cited by 2 publications

References 12 publications

Evaluation of a New Animal Tissue-Free Bleeding Model for Training of Endoscopic Hemostasis

Evaluation of a New Animal Tissue-Free Bleeding Model for Training of Endoscopic Hemostasis

Endoscopic Salvage of Gastrointestinal Anastomosis Leaks—Past, Present, and Future—A Narrated Review

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