Abstract
Endoscopic submucosal dissection (ESD) requires skills that the vast majority of endoscopists
do not possess. ESD be broken down into component skills and at least three of the
necessary skill sets can be taught separately. In the United States most trainees
initially participate in half- or full-day courses that utilize ex vivo and in vivo
animal models and the great majority learn these advanced skills in the clinical setting.
We describe a comprehensive training over a well-defined period using ex vivo porcine
or bovine large bowel models. There are five components or modules that make up the
training program: (1) bowel wall injections in ex vivo tissue, (2) inanimate figure
tracing model to teach scope control, (3) ESD in plastic tube with window cutout over
which square of ex vivo tissue is placed, (4) ESD in ex vivo porcine or bovine large
bowel, and (5) mucosal wound closure. The authors are in the midst of training a group
of residents, fellows, and young attendings using this approach. This approach has
not been vetted yet; however, the preliminary results are promising.
Keywords
endoscopic mucosal resection - endoscopic submucosal dissection - surgical endoscopy
- surgical training
