Effectiveness of a novel ex vivo training model for gastric endoscopic submucosal dissection training: a prospective observational study conducted at a single center in Japan
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Background/Aims: The efficacy of endoscopic submucosal dissection (ESD) for early-stage gastric cancer is well established. However,its acquisition is challenging owing to its complexity. In Japan, G-Master is a novel ex vivo gastric ESD training model. The effectivenessof training using G-Master is unknown. This study evaluated the efficacy of gastric ESD training using the G-Master to evaluate trainees’learning curves and performance. Methods: Four trainees completed 30 ESD training sessions using the G-Master, and procedure time, resection area, resection completion,en-bloc resection requirement, and perforation occurrence were measured. Resection speed was the primary endpoint, and learningcurves were evaluated using the cumulative sum (CUSUM) method. Results: All trainees completed the resection and en-bloc resection of the lesion without any intraoperative perforations. The learningcurves covered three phases: initial growth, plateau, and late growth. The transition from phase 1 to phase 2 required a median of 10sessions. Each trainee completed 30 training sessions in approximately 4 months. Conclusions: Gastric ESD training using the G-Master is a simple, fast, and effective method for pre-ESD training in clinical practice. It is recommended that at least 10 training sessions be conducted.
Abstract
Background/Aims: The efficacy of endoscopic submucosal dissection (ESD) for early-stage gastric cancer is well established. However,its acquisition is challenging owing to its complexity. In Japan, G-Master is a novel ex vivo gastric ESD training model. The effectivenessof training using G-Master is unknown. This study evaluated the efficacy of gastric ESD training using the G-Master to evaluate trainees’learning curves and performance. Methods: Four trainees completed 30 ESD training sessions using the G-Master, and procedure time, resection area, resection completion,en-bloc resection requirement, and perforation occurrence were measured. Resection speed was the primary endpoint, and learningcurves were evaluated using the cumulative sum (CUSUM) method. Results: All trainees completed the resection and en-bloc resection of the lesion without any intraoperative perforations. The learningcurves covered three phases: initial growth, plateau, and late growth. The transition from phase 1 to phase 2 required a median of 10sessions. Each trainee completed 30 training sessions in approximately 4 months. Conclusions: Gastric ESD training using the G-Master is a simple, fast, and effective method for pre-ESD training in clinical practice. It is recommended that at least 10 training sessions be conducted.