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CC BY-NC-ND 4.0 · Endosc Int Open 2022; 10(05): E634-E643
DOI: 10.1055/a-1784-3978
Original article

Evaluation of an all-in-one hybrid model (EUS Magic Box) for stepwise teaching and training in multiple interventional EUS procedures

Vinay Dhir
Department of Gastroenterology, School of EUS, Institute of Digestive & Liver Care, S. L. Raheja Hospital, Mumbai, India
,
Priyanka Udawat
Department of Gastroenterology, School of EUS, Institute of Digestive & Liver Care, S. L. Raheja Hospital, Mumbai, India
,
Rahul Shah
Department of Gastroenterology, School of EUS, Institute of Digestive & Liver Care, S. L. Raheja Hospital, Mumbai, India
,
Aruna Alahari
Department of Gastroenterology, School of EUS, Institute of Digestive & Liver Care, S. L. Raheja Hospital, Mumbai, India
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Abstract

Background and study aims While multiple interventional endoscopic ultrasound (EUS)-guided procedures have evolved over the past two decades, there is no model that allows for training in all of these procedures. We aimed to develop and validate an all-in-one hybrid model for stepwise learning in multiple EUS interventions.

Methods A hybrid model was created utilizing a pig esophagus and stomach, a silicon-based duodenum and pancreato-biliary system, a pseudocyst, and biopsy targets. This model was designed to provide hands-on training in multiple interventional EUS procedures, such as EUS-guided fine-needle biopsy (EUS-FNB), biliary drainage (BD), pancreatic duct drainage (PD), pseudocyst drainage (PSD), and gastro-enterostomy (GE). Thirty-six trainees underwent training on this model over 6 days, in two batches. Lumen apposing metal stents were used for PSD and GE. Trainees were assessed for objective criteria of technical difficulties. Subjective assessment by trainees was done via a questionnaire.

Results All the trainees were able to complete the requisite steps for all the procedures under supervision. On subjective assessment, 30 trainees (83 %) graded the model as good or excellent. A total of 107 technical difficulties were noted (scope position 55, duct puncture 27, guidewire-related problems 25). Time taken to complete the requisite steps of biopsy, PSD, and GE (10.5 minutes; range 3.5 to 22) was significantly less than that for BD and PD (28 minutes; range 17 to 40) (P < 0.001).

Conclusions The hybrid model provided training for multiple EUS interventions with good acceptance by trainees. Stepwise mentoring with the possibility of performing multiple procedures in a single model with or without X-ray could prove useful in conference as well as institutional settings.



Publication History

Received: 23 September 2021

Accepted after revision: 10 November 2021

Article published online:
13 May 2022

© 2022. 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 commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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