Novel simulator of endoscopic hemostasis with actual endoscope and devices

Kanno, Takeshi; Arata, Yutaro; Hatayama, Yutaka; Koike, Tomoyuki; Masamune, Atsushi

doi:10.1016/j.vgie.2022.10.004

Cited by 4 publications

(3 citation statements)

References 6 publications

(5 reference statements)

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“…After providing informed consent, trainees completed questionnaires before and after training, which assessed their confidence in performing hemostatic procedures and the effectiveness of the training (Supplemental Figures 1 and 2). We created a mechanical simulator for endoscopic hemostasis (Medical Rising STAR -Ulcer type) [14]. Briefly, the ulcer model made of an elastomer resembling human mucosal elasticity could reproduce spurting bleeding from selected artificial vessels, and ulcers could be installed anywhere in the stomach lumen, which was designed based on human data (Video 1, Figure 2).…”

Section: Endoscopic Hemostasis Training Program and Evaluation Of Its...mentioning

confidence: 99%

“…2). We created a mechanical simulator for endoscopic hemostasis (Medical Rising STAR -Ulcer type) [14]. Briefly, the ulcer model made of an elastomer resembling human mucosal elasticity could reproduce spurting bleeding from selected artificial vessels, and ulcers could be installed anywhere in the stomach lumen, which was designed based on human data (▶ Video 1, ▶ Fig.…”

Section: Endoscopic Hemostasis Training Program and Evaluation Of Its...mentioning

confidence: 99%

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Interactive training with a novel simulation model for upper gastrointestinal endoscopic hemostasis improves trainee technique and confidence

Kanno,

Arata,

Greenwald

et al. 2024

Endosc Int Open

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Background and study aims: Endoscopic hemostasis is a life-saving procedure for gastrointestinal bleeding; however, its training is often performed on real patients and during urgent situations that put patients at risk. Reports of simulation-based training models for endoscopic hemostasis are scarce. Herein, we developed a novel simulator called “Medical Rising STAR-Ulcer type” to practice endoscopic hemostasis with hemoclips and coagulation graspers. This study aimed to evaluate the reproducibility of the clinical difficulty of this model and the effectiveness of simulation-based training for clipping hemostasis. Patients and methods: This was a prospective educational study. Fifty gastroenterology resident doctors from Japan and Canada were recruited to participate in a simulation-based training program. The primary outcome was the success rate of clipping hemostasis. We measured differences in trainees’ subjective assessment scores and evaluated the co-occurrence network based on comments after training. Results: The hemostasis success rate of the trainees significantly increased after instruction (64% vs. 86%, p<0.05). The success rate for ulcers in the upper body of the stomach (59%), a high-difficulty site, was significantly lower than that for ulcers in the antrum, even after feedback and instruction. Trainees’ self-perceived proficiency and confidence significantly improved after simulation-based training (p<0.05). Co-occurrence network analysis showed that trainees valued a structured learning approach, acknowledged the simulator’s limitations, and recognized the need for continuous skill refinement. Conclusions: Our study demonstrates the potential of our simulation-based training model as a valuable tool for improving technical skills and confidence in trainees learning to perform endoscopic hemostasis.

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Section: Endoscopic Hemostasis Training Program and Evaluation Of Its...mentioning

confidence: 99%

Section: Endoscopic Hemostasis Training Program and Evaluation Of Its...mentioning

confidence: 99%

Interactive training with a novel simulation model for upper gastrointestinal endoscopic hemostasis improves trainee technique and confidence

Kanno,

Arata,

Greenwald

et al. 2024

Endosc Int Open

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“…In particular, the manipulation of the side-viewing duodenoscope in ERCP differs significantly from the techniques used in upper or lower gastrointestinal endoscopy, underscoring the need for specific training. Based on our experience in establishing a bleeding ulcer model using artificial vessels for endoscopic hemostasis [ 23 ], we developed a novel simulator model for learning comprehensive ERCP/EST procedures, mainly targeting learners with limited ERCP experience. This educational simulator model provides an immersive learning experience, systematically teaching endoscopic manipulation and fundamental procedural flow when using various devices.…”

Section: Introductionmentioning

confidence: 99%

A Novel Dry Simulator Model for Learning Comprehensive Endoscopic Retrograde Cholangiopancreatography/Endoscopic Sphincterotomy Procedures while Minimizing Adverse Bleeding Events (with Video)

Hatayama,

Kanno,

Takikawa

et al. 2024

Digestion

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) are essential skills for endoscopic cholangio-pancreatic procedures. However, these procedures have a high incidence of adverse events, and most training is currently patient-based. Herein, we aimed to develop an ERCP/EST simulator model to address the need for safer training alternatives, especially for learners with limited ERCP experience. Methods: The model was designed to facilitate the use of actual endoscopic devices, supporting learning objectives that align with the components of the validated Bethesda ERCP Skill Assessment Tool (BESAT). BESAT focuses on skills such as papillary alignment and maintenance of duodenoscope position, gentle and efficient cannulation, controlled sphincterotomy in the correct trajectory, and guidewire manipulation. Thirty gastroenterology trainees used the simulator between May 2022 and March 2023, and their satisfaction was assessed using a visual analog scale (VAS) and pre- and post-training questionnaires. Results: The novel simulator model comprises a disposable duodenal papillary portion, suitable for incision with an electrosurgical knife, alongside washable upper gastrointestinal tract and bile duct portions, designed for repeated use. The duodenal papillary portion enabled reproduction of a realistic endoscope position and the adverse bleeding events due to improper incisions. The bile duct portion allowed for the reproduction of fluoroscopic-like images, enabling learners to practice guidewire guidance and insert other devices. After training, the median VAS score reflecting the expectation for model learning significantly increased from 69.5 (interquartile range [IQR]:55.5–76.5) to 85.5 (IQR: 78.0–92.0) (P<0.01). All participants expressed their desire for repeated simulator training sessions. Conclusions: This innovative simulator serves as a practical educational tool, particularly beneficial for novices in ERCP. It facilitates hands-on practice with actual devices, enhancing procedural fluency and understanding of precise incisions to minimize the risk of bleeding complications during EST.

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Simulation-based training of endoscopic hemostasis for Japanese pediatric endoscopy learners: a pilot program

Kanno,

Iwama,

Hatayama

et al. 2024

iGIE

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Novel simulator of endoscopic hemostasis with actual endoscope and devices

Cited by 4 publications

References 6 publications

Interactive training with a novel simulation model for upper gastrointestinal endoscopic hemostasis improves trainee technique and confidence

Interactive training with a novel simulation model for upper gastrointestinal endoscopic hemostasis improves trainee technique and confidence

A Novel Dry Simulator Model for Learning Comprehensive Endoscopic Retrograde Cholangiopancreatography/Endoscopic Sphincterotomy Procedures while Minimizing Adverse Bleeding Events (with Video)

Simulation-based training of endoscopic hemostasis for Japanese pediatric endoscopy learners: a pilot program

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