Aims Endoscopic Submucosal Dissection (ESD) is a demanding procedure requiring high level
of expertise. ESD training programs incorporate procedures with live animal models.
This study aimed to assess the early learning curve for performing ESD on live porcine
models by endoscopists without any or limited previous ESD experience.
Methods In a live porcine model ESD workshop, number of resections, completeness of the resections,
en bloc resections, adverse events, tutor intervention, type of knife, ESD time and
size of resected specimens were recorded. ESD speed was calculated.
Results A total of 70 procedures were carried out by 17 trainees. The percentage of complete
resections, en bloc resections and ESD speed increased from the first to the latest
procedures (88,2% to 100%; 76,5% to 100%; 8,6 to 31,4 mm2/min, respectively). The number of procedures in which a trainee needed tutor intervention
and the number of adverse events also decreased throughout de procedures (4 to 0 and
6 to 0, respectively).
During the workshop, when participants changed to a different type of knife, ESD speed
slightly decreased (18,5 mm2/min to 17,0 mm2/min) and adverse events increased again (0 to 2).
Conclusions Through successive procedures, complete resections, en bloc resections and ESD speed
improve whereas adverse events diminish, supporting the role of the live porcine model
in the early learning phase. Changing ESD knives has a momentarily negative impact
on the learning curve.
