Effectiveness of Ex-Vivo Porcine Simulator On Endoscopic Ultrasound-Guided Cystogastrostomy Using Lumen-Apposing Metal Stent (LAMS) Training

Aims Endoscopic ultrasound (EUS) guided cystogastrostomy is a well-established endoscopic technique. However, it is an advanced technique with a steep learning curve. This necessitates an ex-vivo simulator that would allow endoscopists to be adequately trained. This is a preliminary study done to assess the efficacy of a new simulator in providing training for the EUS-guided cystogastrostomy using lumen-apposing metal stents (LAMS) specifically, the Hot AXIOS™ system

Methods The simulator was created by ROEYA training center using native porcine tissue to create fluid collection. Colon sections that were sutured on one side were used to create a pouch that was sutured to the anterior gastric wall. The simulator was designed and tested in advance while the hydrogel was added on site about 5-15 minutes prior to training.

The task was to successfully deploy the Hot AXIOS to drain the created cyst. The simulator was evaluated prospectively in 5 training sessions involving 19 international experts. After using the simulator, the experts were sent a questionnaire to assess their experience. The primary end point was overall satisfaction with the training.

Results Five questions were dedicated to the trained experts. All trained experts had more than 500 EUS procedures of experience prior to the training session.

The simulator was found realistic in EUS cystogastrostomy training in 89.4 % (n = 17), visualization of the target lesion was successful in 100 % (n = 19), anatomical accuracy was achieved in 78.9 (n = 15) and the simulator was found difficult to use in 5.2 % (n = 1). Finally, the simulator was found effective in the expert’s clinical practice in 73.6 % (n = 14).

Conclusions This simulator helped the doctors with this technique in all parameters assessed. This preliminary study suggests that the aforementioned simulator can be used in training of EUS-guided cystogastrostomy using LAMS.

Citation: Roshdy N, Taleb A, Ibrahim M eP192 EFFECTIVENESS OF EX-VIVO PORCINE SIMULATOR ON ENDOSCOPIC ULTRASOUND-GUIDED CYSTOGASTROSTOMY USING LUMEN-APPOSING METAL STENT (LAMS) TRAINING. Endoscopy 2021; 53: S159.

Publication History

Article published online:
19 March 2021