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Endoscopy 2020; 52(08): 669-686
DOI: 10.1055/a-1185-1289
Position Statement

Curriculum for small-bowel capsule endoscopy and device-assisted enteroscopy training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Reena Sidhu
 1   Academic Department of Gastroenterology and Hepatology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
,
Stefania Chetcuti Zammit
 1   Academic Department of Gastroenterology and Hepatology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
,
Peter Baltes
 2   Clinic for Internal Medicine, Bethesda Krankenhaus Bergedorf, Hamburg, Germany
,
Cristina Carretero
 3   Gastroenterology Department, University of Navarra Clinic, Pamplona, Spain
,
Edward J. Despott
 4   Royal Free Unit for Endoscopy, The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health Hampstead Campus, London, UK
,
Alberto Murino
 4   Royal Free Unit for Endoscopy, The Royal Free Hospital and University College London (UCL) Institute for Liver and Digestive Health Hampstead Campus, London, UK
,
Xavier Dray
 5   Endoscopy Unit, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris and Sorbonne Université, Paris, France
,
David S. Sanders
 1   Academic Department of Gastroenterology and Hepatology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
,
Martin Keuchel
 2   Clinic for Internal Medicine, Bethesda Krankenhaus Bergedorf, Hamburg, Germany
,
Evelien Dekker
 6   Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands
,
James E. East
 7   Translational Gastroenterology Unit, Nuffield Department of Medicine, Experimental Medicine Division, John Radcliffe Hospital, University of Oxford, Oxford, UK
 8   Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
,
Gavin Johnson
 9   University College London Hospitals, London, UK
,
Pedro Pimentel-Nunes
10   Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal
11   Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
12   Surgery and Physiology Department, Faculty of Medicine, University of Porto, Porto, Portugal
,
Marianna Arvanitakis
13   Department of Gastroenterology, Hepato-pancreatology and Digestive Oncology Erasme University Hospital, Brussels, Belgium
,
Thierry Ponchon
14   Gastroenterology Division, Hôpital Edouard Herriot, Lyon, France
,
Mario Dinis-Ribeiro
10   Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal
11   Center for Research in Health Technologies and Information Systems (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal
,
Raf Bisschops
15   Department of Gastroenterology and Hepatology, Catholic University of Leuven (KUL), TARGID, University Hospitals Leuven, Leuven, Belgium
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Correction: Curriculum for small-bowel capsule endoscopy and device-assisted enteroscopy training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position StatementEndoscopy 2020; 52(08): C9-C9
DOI: 10.1055/a-1204-5396

Main Recommendations

The European Society of Gastrointestinal Endoscopy (ESGE) has recognized the need to formalize training in small-bowel endoscopy across European centers. The following criteria and framework for training in small-bowel capsule endoscopy (SBCE) and device-assisted enteroscopy (DAE), which aim to provide uniform and high quality training to ensure that small-bowel endoscopists are competent to operate independently, are based on the current literature and experience of experts in the field. Three main areas are covered: skills required prior to commencing training in small-bowel endoscopy; structured training for trainees to become independent endoscopists; and ways of ensuring competence is achieved.

1 Centers providing training in SBCE should perform a minimum of 75 – 100 SBCEs/year.

2 Experience in bidirectional endoscopies is desirable for structured training in SBCE.

3 SBCE courses should consist of at least 50 % hands-on training and cover information on technology, indications and contraindications for SBCE, pathologies that can be encountered on SBCE, and standard terminology that should be used during reporting of SBCE. An SBCE course should be completed prior to achieving competence in SBCE reporting.

4 Competence in SBCE can be assessed by considering a minimum of 30 SBCEs. Direct Observation of Procedural Skills, short SBCE videos, and multiple-choice questions can be useful to assess improvement in the skills of trainees.

5 Centers offering training in DAE should aim to carry out at least 75 DAEs/year, should have direct links with an SBCE service, and should allow regular discussion of cases at a radiology small-bowel MDT. Training centers with lower numbers are encouraged to offer training by “buddying-up” with other centers, or using mentoring systems.

6 DAE trainees must be independent in bidirectional endoscopies and have experience in level 1 polypectomy prior to commencement of training. They should also be competent in reviewing SBCEs.

7 Training in DAE should be structured with a minimum of 75 procedures, including 35 retrograde DAEs, with therapeutic procedures undertaken in at least 50 % of the DAEs performed. Training should cover the indications, contraindications, complications including prevention, and technicalities of the DAE procedure; formal evaluation should follow. DAE trainees must acquire skills to independently manage and advise on small-bowel pathology following DAE procedures.

8 It is highly recommended that international societies develop online modules and courses on DAE, which are currently lacking across Europe.



Publication History

Article published online:
17 June 2020

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