Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Usefulness of a new polyvinyl alcohol hydrogel (PVA-H)-based simulator for endoscopic submucosal dissection training: a pilot study

  • Dong Seok Lee (Department of Gastroenterology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Gin Hyug Lee (Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sang Gyun Kim (Department of Gastroenterology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kook Lae Lee (Department of Gastroenterology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine) ;
  • Ji Won Kim (Department of Gastroenterology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine) ;
  • Ji Bong Jeong (Department of Gastroenterology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine) ;
  • Yong Jin Jung (Department of Gastroenterology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine) ;
  • Hyoun Woo Kang (Department of Gastroenterology, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine)
  • Received : 2022.06.05
  • Accepted : 2023.01.03
  • Published : 2023.09.30
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Abstract

Background/Aims: We developed a new endoscopic submucosal dissection (ESD) simulator and evaluated its efficacy and realism for use training endoscopists. Methods: An ESD simulator was constructed using polyvinyl alcohol hydrogel sheets and compared to a previous ESD simulator. Between March 1, 2020, and December 30, 2021, eight expert endoscopists from three different centers analyzed the procedure-related factors of the simulator. Five trainees performed gastric ESD exercises under the guidance of these experts. Results: Although the two ESD simulators provided overall favorable outcomes in terms of ESD-related factors, the new simulator had several benefits, including better marking of the target lesion's limits (p<0.001) and overall handling (p<0.001). Trainees tested the usefulness of the new ESD simulator. The complete resection rate improved after 3 ESD training sessions (9 procedures), and the perforation rate decreased after 4 sessions (12 procedures). Conclusions: We have developed a new ESD simulator that can help beginners achieve a high level of technical experience before performing real-time ESD procedures in patients.

Keywords

Acknowledgement

We gratefully acknowledge the staff at the SMG-SNU Boramae Medical Center for their participation and for making this study possible.

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