Simulator training in endoscopic hemostasis

Novel simulator of endoscopic hemostasis with actual endoscope and devices

Video 1Demonstration of novel simulator of endoscopic hemostasis.

Therapeutic Endoscopic Procedures on a Human Cadaver—A Pilot Feasibility Study

Introduction The traditional apprentice model of teaching therapeutic endoscopic skills is inadequate due to unpredictable frequency and high stakes for patient outcome. Simulation had gained widespread acceptance for training modules. But all the procedures cannot be trained on simulator. We designed a novel human cadaver hands-on training module for practicing percutaneous endoscopic gastrostomy (PEG), endoscopic variceal band ligation (EVL), endoscopic injection (EI), snare polypectomy (SP), thermal cautery (TC), and endoscopic clip (EC) placement.

Methods A single preserved pre-coronavirus disease 2019 human cadaver was used as a training model. Twelve trainees (6 teams) used the module to acquire and practice new skills of PEG, EVL, EI, SP, and EC using standard endoscope and regular endoscopic accessories. All the trainees completed the course evaluation using a 5-point Likert scale (5= strongly agree).

Results The training resulted in a self-reported increase in equipment familiarity and all the trainees felt uniformly that they are better prepared for performing the procedures on real patients. They strongly agreed that this exhaustive hands-on exercise has more educational value than attending lectures.

Conclusion Human cadaver can be used for trainees to hone therapeutic endoscopic skills by teaching modules with predefined learning objectives.

A Newly Designed 3-Dimensional Printer-Based Gastric Hemostasis Simulator with Two Modules for Endoscopic Trainees (with Video)

Background/Aims

We used 3-dimensional (3D) printing technology to create a new hemostasis simulator for the stomach and investigated its efficacy and realism in endoscopic hemostasis training.

Methods

A new stomach hemostasis simulator, with two hemostasis modules for hemoclipping and injection, was constructed using a 3D printer. Twenty-one endoscopists, including 11 first-year fellows (beginner group) and 10 faculty members (expert group), tested the performance of the simulator. We recorded and reviewed five training sessions and evaluated the simulator with questionnaires using a 7-point Likert scale.

Results

The mean evaluation score of the expert group was 6.3±0.5 for the hemoclipping module and 6.0±0.6 for the injection module. The expert group strongly agreed that endoscopic handling in the simulator was realistic and reasonable for hemostasis training. The mean procedure time for hemoclipping was 72.7±7.1 seconds for the beginner group and 19.7±1.2 seconds for the expert group. The mean procedure time for injection was 92.1±9.8 seconds for the beginner group and 36.3±2 seconds for the expert group. The procedure time of beginner group became shorter with repetition and was significantly lower by the fifth trial.

Conclusions

A new 3D-printed hemostasis simulator is capable of hemostasis training and can very effectively train beginners before they perform the procedure in patients with gastrointestinal bleeding.