KEEPING UP WITH THE TIMES: USE OF ADJUVANT TECHNOLOGY BY IRISH GASTROENTOLOGY TRAINEES

Aims:

Use of accessory devices and additional techniques in upper and lower endoscopy is always evolving. Incorporating this equipment into routine practice requires initiative often depending on the budget of the unit and the endoscopy department itself.

The aim was to establish the availability and use of specialised equipment and accessory devices readily available to trainees in Ireland.

Methods:

A survey was distributed to gastroenterology trainees working in Ireland over a four week period. Use of foot pump, scope guide, CO2, simeticone, endocuff, cap, NBI, and chromo-endoscopy was explored in addition to patient repositioning.

Results:

There were 31 respondents; 29 were included for analysis. Responses were identified from 10 hospital sites. Only 48% of trainees have a formal training list and 52% have been scoping for 4 years or more. Typically 39% of trainees use a foot pump and 38% use a scope guide for colonoscopy. Lack of availability (82%, 47% respectively) was frequently cited among non-users. Only 38% typically use CO2 during colonoscopies while just 10% use simeticone. 78% reported CO2 wasn't always available to them, whereas trainees don't find simeticone useful (35%). To aid polyp detection 68% typically reposition the patient. Trainees that don't report they don't find repositioning useful (56%). Almost two thirds of trainees typically use NBI. Those who don't report lack of confidence (33%). Only 18% typically use a cap for polypectomy. Among non-users, 35% haven't been taught how to use it. Only 11% typically use endocuff. Among non-users, 36% said it wasn't readily available to them. Only 26% typically use chromo-endoscopy (methylene blue/acetic acid).

Conclusions:

Many newer accessory devices and technology are not utilised among trainees mainly due to lack of availability or training. Addressing these issues may improve quality of endoscopy training in Ireland.