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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(10): E1225-E1230
DOI: 10.1055/a-1197-6418
Original article

‘Four-position method’ makes beginner endoscopists aware of spatial positioning of the left hand to master upper gastrointestinal endoscopy

Ken Sugimoto
1   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
,
Satoshi Osawa
2   Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
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A standardized technique for gastroscopy: Still missing?Endosc Int Open 2020; 08(10): E1231-E1232
DOI: 10.1055/a-1216-1933

Abstract

Background and study aims We developed a novel “four-position method” for facilitating endoscopy of the upper gastrointestinal tract, and this study aimed to verify its usefulness for beginner endoscopists.

Methods Medical students (n = 121) were divided into three groups. A simulator subsequently was used to perform endoscopy. Group A was taught how to hold the endoscope and move the dial; Group B was taught the “four-position method”; and Group C, in addition to being taught the “four-position method,” was permitted to use an endoscope before introduction to the simulator. In each group, the transit time to various parts of the upper digestive tract was recorded in addition to the time to grasp a clip in the stomach with the forceps. We also surveyed the groups with respect to their impression of the difficulty level of endoscopic operation before and after instructions.

Results Transit time to the cardia was no different among the groups; however, with regard to other targets, Group C reached the sites significantly more quickly than did Groups A and B. Time to clip grasping was significantly shorter in Groups B and C than in Group A. Regarding the impression of the difficulty level, significantly more students in Groups B and C compared to Group A felt that endoscopy was easier after instructions.

Conclusion Learning the “four-position method” made it possible to achieve stable endoscopic manipulation at an early stage and improve subsequent endoscopic procedures.



Publication History

Received: 23 February 2020

Accepted: 19 May 2020

Article published online:
21 September 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Inoue M. Changing epidemiology of Helicobacter pylori in Japan. Gastric Cancer 2017; 20: 3-7
    CrossrefPubMedSearch in Google Scholar
  • 2 Nagami Y, Ominami M, Otani K. et al. Endoscopic submucosal dissection for adenocarcinomas of the esophagogastric junction. Digestion 2018; 97: 38-44
    CrossrefPubMedSearch in Google Scholar
  • 3 Leung WK, Wu MS, Kakugawa Y. et al. Asia Pacific Working Group on Gastric Cancer. Screening for gastric cancer in Asia: current evidence and practice. Lancet Oncol 2008; 9: 279-287
    CrossrefPubMedSearch in Google Scholar
  • 4 Joo NS. Esophagastroduodenoscopic training in the family physician residency program. Korean J Fam Med 2010; 31: 585-586
    CrossrefPubMedSearch in Google Scholar
  • 5 Lee KM, Choi SR, Jang BI. et al. Education and training guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy. Korean J Gastrointest Endosc 2011; 42: 207-214
    PubMedSearch in Google Scholar
  • 6 Chun JH, Yoon YS, Oh SW. et al. Current state and demand of esophagogastroduodenoscopy training in family practice residency programs. J Korean Acad Fam Med 2003; 24: 1092-1098
    PubMedSearch in Google Scholar
  • 7 Coleman WH. Gastroscopy: a primary diagnostic procedure. Prim Care 1988; 15: 1-11
    CrossrefPubMedSearch in Google Scholar
  • 8 Ponich T, Enns R, Romagnuolo J. et al. Canadian credentialing guidelines for esophagogastroduodenoscopy. Can J Gastroenterol 2008; 22: 349-354
    CrossrefPubMedSearch in Google Scholar
  • 9 Lee SH, Park YK, Cho SM. et al. Technical skills and training of upper gastrointestinal endoscopy for new beginners. World J Gastroenterol 2015; 21: 759-785
    CrossrefPubMedSearch in Google Scholar
  • 10 Fudman DI, Falchuk KR, Feuerstein JD. Complication rates of trainee- versus attending-performed upper gastrointestinal endoscopy. Ann Gastroenterol 2019; 32: 273-277
    PubMedSearch in Google Scholar
  • 11 Ferlitsch A, Schoefl R, Puespoek A. et al. Effect of virtual endoscopy simulator training on performance of upper gastrointestinal endoscopy in patients: a randomized controlled trial. Endoscopy 2010; 42: 1049-1056
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Shirai Y, Yoshida T, Shiraishi R. et al. Prospective randomized study on the use of a computer-based endoscopic simulator for training in esophagogastroduodenoscopy. J Gastroenterol Hepatol 2008; 23: 1046-1050
    CrossrefPubMedSearch in Google Scholar
  • 13 Van Sickle KR, Buck L, Willis R. et al. A multicenter, simulation-based skills training collaborative using shared GI Mentor II systems: results from the Texas Association of Surgical Skills Laboratories (TASSL) flexible endoscopy curriculum. Surg Endosc 2011; 25: 2980-2986
    CrossrefPubMedSearch in Google Scholar