SIMPLE AND PRACTICAL EX-VIVO, NON-BIOLOGIC SIMULATION MODEL FOR PLACEMENT OF SELF-EXPANDING METAL STENTS

Self-expanding metal stent placement is a key therapeutic intervention in gastrointestinal endoscopy. Unfortunately, there is lack of training models for SEMS. The training is further compounded by the need to “experiment” in humans during the initial stent release experiences. Whereas the presence of an expert alleviates the burden of this approach, it still remains a suboptimal approach to train the novice therapeutic endoscopist. We have 3 developed a simple, inexpensive, practical and reproducible model to train endoscopists to insert SEMS. The aim of this model is to provide the endoscopist with the essential steps and knowledge of endoscopic stenting, thus improving the manual and cognitive dexterity needed for this procedure.

The model is based on a plastic tube measuring, which is tightly attached to a wood base. This platform can be easily transported and placed on any surface for training. A tube like sponge is inserted into the plastic tube. This sponge is cut at a specific level, where the “stricture” will be located. The sponge has two aims, one to serve as an esophagus and two to prevent scope damage while being advanced through the plastic tube. A key advantage of this model is its use with fluoroscopy. The video shows the key steps of SEMS placing, from endoscopy, to wire insertion and exchange, use of fluoroscopy and stent release. In sum, we believe that training models such as this one increase the cognitive and manual dexterity of endoscopists, and prepare them for a more precise and safer intervention in human beings.