Introduction: Simulators facilitate the acquisition of technical skills for endoscopy. Here,
we describe the development, introduction, and first evaluation of a novel generation
of mechanical endoscopic retrograde cholangiopancreatography (ERCP) simulation
models with simulated fluoroscopy, the X-Vision ERCP Training System.
Methods: A custom-made modular ERCP simulation system was built with the use of universally
obtainable materials and tools. The trainee controls ERCP activities on two screens:
the aspect of the papilla and duodenum is shown on the conventional endoscopy
monitor, and the trainee’s actions in the equivalents of the pancreaticobiliary
ducts are shown on the viewing screen of the model. Thereby, the latter screen
serves as a substitute for fluoroscopy. Currently, four different models are
available, allowing simulation of selective cannulation of the pancreatic or bile
duct, intubation of differently arranged papillae, stent placement, and sphincterotomy
of a biopapilla. The X-Vision ERCP Training System was first used during an ERCP
course attended by 26 endoscopists. Trainees were supervised by an ERCP expert
and an experienced ERCP nurse at each training model. The training system was
evaluated by the participants and experts using a specific questionnaire.
Results: During the course there were no technical problems related to the X-Vision ERCP
Training System. After sphincterotomy the organic papillae could easily be exchanged
within less than 15 seconds. Overall, the X-Vision ERCP Training System achieved
favorable results in all categories assessed.
Conclusion: The new X-Vision ERCP Training System is simple and effective. A first evaluation
in the context of an ERCP course showed impressive results.
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E. Frimberger, MD
Technical University of Munich
Klinikum rechts der Isar
2nd Medical Department
Ismaninger Str. 22
81675 München
Germany
Fax: +49-89-41404871
eMail: eckart.frimberger@lrz.tum.de
