Training in endoscopic mucosal resection and endoscopic submucosal dissection: Face, content and expert validity of the live porcine model

Küttner-Magalhães, Ricardo; Dinis-Ribeiro, Mário; Bruno, Marco J.; Marcos-Pinto, Ricardo; Rolanda, Carla; Koch, Arjun D.

doi:10.1177/2050640617742484

Cited by 19 publications

(15 citation statements)

References 33 publications

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“…Great model for any open‐airway surgery technique.” The high ratings are congruous with feedback we have received from our surgical dissection manual for tracheostomy and open‐airway surgery in a live porcine model. Studies evaluating live porcine models for surgical training in other specialties (gastroenterology, urology) have reported similar face and content validity scores, and also concluded that realistic tactile feedback from live tissues, bleeding, and breathing movements contributed to high scores . Similar scores have also been reported in studies evaluating cadaveric animal models for surgical training in rhinology and laryngology .…”

Section: Discussionsupporting

confidence: 58%

Live porcine model for surgical training in tracheostomy and open‐airway surgery

et al. 2019

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Objectives/Hypothesis To evaluate the validity of a live porcine model for surgical training in tracheostomy and open‐airway surgery. Study Design Prospective observational study. Methods Eleven expert otolaryngologists–head and neck surgeons rated a live porcine model's realism/anatomical accuracy (face validity) and perceived effectiveness as a training tool (content validity) for tracheostomy and laryngotracheoplasty using anterior costal cartilage and thyroid ala cartilage grafts using a 53‐item post‐trial questionnaire with a five‐point Likert scale. Results Experts rated the face validity of the live porcine model a median (interquartile range [IQR]) of 4/5 (4–5) and the content validity a median (IQR) of 5/5 (4–5) for each surgical procedure. Overall, 91% strongly agreed or agreed that the simulator would increase trainee competency for tracheostomy and laryngotracheoplasty using costal cartilage graft, and 82% strongly agreed or agreed that it would increase trainee competency for laryngotracheoplasty using thyroid ala cartilage graft. Conclusions The live porcine model has high face and content validity as a training tool for tracheostomy and laryngotracheoplasty using costal cartilage and thyroid ala cartilage grafts. This training model can help surgical trainees practice these complex, low‐frequency procedures. Level of Evidence NA Laryngoscope, 130: 2063–2068, 2020

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Section: Discussionsupporting

confidence: 58%

Live porcine model for surgical training in tracheostomy and open‐airway surgery

et al. 2019

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“…There is some clinical evidence to support the positive impact of animal model training before beginning ESD in humans, but prospective comparative studies are still not available. Nevertheless, training in a live porcine model was considered very realistic by participants compared with the human setting and was highly appreciated as a learning tool [34,35]. Moreover, the outcomes of ESD, even with previous animal training albeit not in the respective human organ [33], do not encourage the proposal of comparative studies between trainees who have experienced previous animal training and those who have not.…”

Section: Trainingmentioning

confidence: 99%

Curriculum for endoscopic submucosal dissection training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

et al. 2019

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Main RecommendationThere is a need for well-organized comprehensive strategies to achieve good training in ESD. In this context, the European Society of Gastrointestinal Endoscopy (ESGE) have developed a European core curriculum for ESD practice across Europe with the aim of high quality ESD training.Advanced endoscopy diagnostic practice is advised before initiating ESD training. Proficiency in endoscopic mucosal resection (EMR) and adverse event management is recommended before starting ESD trainingESGE discourages the starting of initial ESD training in humans. Practice on animal and/or ex vivo models is useful to gain the basic ESD skills. ESGE recommends performing at least 20 ESD procedures in these models before human practice, with the goal of at least eight en bloc complete resections in the last 10 training cases, with no perforation. ESGE recommends observation of experts performing ESD in tertiary referral centers. Performance of ESD in humans should start on carefully selected lesions, ideally small ( < 30 mm), located in the antrum or in the rectum for the first 20 procedures. Beginning human practice in the colon is not recommended. ESGE recommends that at least the first 10 human ESD procedures should be done under the supervision of an ESD-proficient endoscopist.Endoscopists performing ESD should be able to correctly estimate the probability of performing a curative resection based on the characteristics of the lesion and should know the benefit/risk relationship of ESD when compared with other therapeutic alternatives. Endoscopists performing ESD should know how to interpret the histopathology findings of the ESD specimen, namely the criteria for low risk resection (“curative”), local risk resection, and high risk resection (“non-curative”), as well as their implications. ESD should be performed only in a setting where early and delayed complications can be managed adequately, namely with the possibility of admitting patients to a ward, and access to appropriate emergency surgical teams for the organ being treated with ESD.

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“…Various gastrointestinal endoscopy training simulators have been developed [14]. Live porcine models are realistic compared to the human setting and highly regarded as a learning tool for esophageal and gastric ESD [15]. In our study, only 13% of the participants in the �5 years after fellowship training group, who had been trained about 5-10 years ago, experienced a hands-on course during their training period; conversely, 50% of the participants in the second-year fellow group experienced such.…”

Section: Plos Onementioning

confidence: 99%

Current status and trend in training for endoscopic submucosal dissection: A nationwide survey in Korea

Lee¹,

Park²,

Lee³

et al. 2020

PLoS ONE

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Background Although endoscopic submucosal dissection (ESD) is widely used, the current status and trend in its training have yet to be fully evaluated. We aimed to investigate how ESD endoscopists have been trained in actual clinical practice. Methods Endoscopists aged <45 years who have completed a gastroenterology fellowship or were currently in a fellowship for �2 years were included. We conducted a nationwide survey on the ESD training experiences of these endoscopists. Results Among 79 young Korean endoscopists invited to participate in the survey, 68 (86.1%) trained in 24 major hospitals responded to the questionnaire. Twenty, 25, and 23 participants belonged to the second-year fellow, <5 years after training, and �5 years after training groups, respectively. Sixty-nine percent of the participants observed �50 ESD cases before starting ESD under supervision by an expert endoscopist. Additionally, 22% experienced �20 supervised ESDs during the training period. The proportion of the participants who underwent a hands-on course differed among the groups (�5 years after training, 13.0%; <5 years after training, 40.0%; and second-year fellow, 50.0%; P = 0.027). ESD under supervision, observation, and hands-on course were the preferred methods for learning ESD (91.1%, 80.9%, and 35.3%, respectively). Overall, 42.6% of the participants were satisfied with their training program. More experience in supervised ESD (�20 cases) was associated with an increased satisfaction (odds ratio, 6.65; 95% confidence interval, 1.62-36.31).

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Training in endoscopic mucosal resection and endoscopic submucosal dissection: Face, content and expert validity of the live porcine model

Cited by 19 publications

References 33 publications

Live porcine model for surgical training in tracheostomy and open‐airway surgery

Live porcine model for surgical training in tracheostomy and open‐airway surgery

Curriculum for endoscopic submucosal dissection training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Current status and trend in training for endoscopic submucosal dissection: A nationwide survey in Korea

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