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CC BY 4.0 · Endosc Int Open 2025; 13: a26215244
DOI: 10.1055/a-2621-5244
Original article

Does development of submucosal dissection models influence quality of training? Comparison of existing models

Clara Yzet
1   Gastroenterology, Hopital Edouard Herriot, Lyon, France (Ringgold ID: RIN36609)
2   Gastroenterology, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France (Ringgold ID: RIN36673)
,
Jérémie Jacques
3   Service d'Hépato-gastro-entérologie, CHU Dupuytren Limoges, Limoges, France
,
Pierre Lafeuille 
4   Gastroenterology, Groupement Hospitalier Edouard Herriot, Lyon, France (Ringgold ID: RIN36609)
,
Jérémie Albouys
5   Hepato-gastro-entérologie, Hopital Dupuytren, Limoges, France (Ringgold ID: RIN37925)
,
Jean-Baptiste Chevaux
6   Department of Gastroenterology, Nancy Regional University Hospital Center, Nancy, France (Ringgold ID: RIN26920)
,
Emmanuel Coron
7   Gastroenterology Unit, Nantes University, Nantes, France (Ringgold ID: RIN27045)
,
Stanislas Chaussade
8   Gastroenterology, Cochin Hospital, Paris, France
,
Sarah Leblanc
9   Gastroenterology, Jean Mermoz Private Hospital, Lyon, France (Ringgold ID: RIN89686)
,
Vincent Lepilliez
10   Gastroenterology, Hôpital Privé Jean Mermoz, Lyon, France (Ringgold ID: RIN89686)
,
Thimothee Wallenhorst
11   Department of Endoscopy and Gastroenterology, University Hospital Centre Rennes, Rennes, France (Ringgold ID: RIN36684)
,
Thierry Ponchon
12   Hepatogastroenterology, Edouard Herriot, LYON, France
,
Jérôme Rivory
13   Gastroenterology, Edouard Herriot Hospital, Lyon, France
,
Romain Legros
14   Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
,
Michel Lefranc
15   Neurologic Surgery, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France (Ringgold ID: RIN36673)
,
Marion Schaefer 
16   Hepato-gastroenterology, Centre Hospitalier Universitaire de Nancy, Vandoeuvre les Nancy, France (Ringgold ID: RIN26920)
,
Mathieu Pioche
13   Gastroenterology, Edouard Herriot Hospital, Lyon, France
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Abstract

Background and study aims

Use of endoscopic submucosal dissection (ESD) is growing, but access to it remains limited. The aim of this study was to compare the performance of various existing models and the progress made by students on them.

Methods

Four training models (bovine colon (ex-vivo), ex vivo porcine model, live porcine model, and an artificial model (Endogel)) were evaluated during a 1-week training course. Each participant was evaluated at the beginning (D1) and at the end of the training (D5). Learners performed a standardized ESD of 2 cm on the four models in a randomized order. Experts evaluated the ability of participants to perform ESD using the objective structured assessment of technical skill score (OSATS).

Results

Sixteen students were involved, the average age was 35.6 years (+/- 4.6) and they practiced endoscopy for 10 years (+/-5.3). The OSATS significantly increased in each model during the week, with mean scores increasing from 8.6 to 23.3, from 10.7 to 12.9, from 8.8 to 21.3 and from 8.2 to 12.5 for the bovine colon, ex vivo porcine model, live porcine model, and Endogel models, respectively.

Conclusions

Ex-vivo models are good models for learning ESD skills. The bovine colon model seems to be the most discriminating. Synthetic models should be reserved for novices.

Keywords

Endoscopy Lower GI Tract - Endoscopic resection (polypectomy, ESD, EMRc, ...) - Quality and logistical aspects - Training

Supplementary Material



Publikationsverlauf

Eingereicht: 09. Juli 2024

Angenommen nach Revision: 24. Februar 2025

Accepted Manuscript online:
26. Mai 2025

Artikel online veröffentlicht:
17. Juni 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/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Clara Yzet, Jérémie Jacques, Pierre Lafeuille, Jérémie Albouys, Jean-Baptiste Chevaux, Emmanuel Coron, Stanislas Chaussade, Sarah Leblanc, Vincent Lepilliez, Thimothee Wallenhorst, Thierry Ponchon, Jérôme Rivory, Romain Legros, Michel Lefranc, Marion Schaefer, Mathieu Pioche. Does development of submucosal dissection models influence quality of training? Comparison of existing models. Endosc Int Open 2025; 13: a26215244.
DOI: 10.1055/a-2621-5244
 

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