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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2021; 12(01): 036-042
DOI: 10.1055/s-0041-1728223
Original Article

Therapeutic Endoscopic Procedures on a Human Cadaver—A Pilot Feasibility Study

Avinash Bhat Balekuduru
1   Department of Gastroenterology, M. S. Ramaiah Hospitals, Bangalore, Karnataka, India
,
Ashwini C. Appaji
2   Department of Anatomy, M. S. Ramaiah Hospitals, Bangalore, Karnataka, India
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Abstract

Introduction The traditional apprentice model of teaching therapeutic endoscopic skills is inadequate due to unpredictable frequency and high stakes for patient outcome. Simulation had gained widespread acceptance for training modules. But all the procedures cannot be trained on simulator. We designed a novel human cadaver hands-on training module for practicing percutaneous endoscopic gastrostomy (PEG), endoscopic variceal band ligation (EVL), endoscopic injection (EI), snare polypectomy (SP), thermal cautery (TC), and endoscopic clip (EC) placement.

Methods A single preserved pre-coronavirus disease 2019 human cadaver was used as a training model. Twelve trainees (6 teams) used the module to acquire and practice new skills of PEG, EVL, EI, SP, and EC using standard endoscope and regular endoscopic accessories. All the trainees completed the course evaluation using a 5-point Likert scale (5= strongly agree).

Results The training resulted in a self-reported increase in equipment familiarity and all the trainees felt uniformly that they are better prepared for performing the procedures on real patients. They strongly agreed that this exhaustive hands-on exercise has more educational value than attending lectures.

Conclusion Human cadaver can be used for trainees to hone therapeutic endoscopic skills by teaching modules with predefined learning objectives.

Keywords

cautery - clipping - endoscopic training - injection - PEG - polypectomy


Publication History

Article published online:
20 April 2021

© 2021. Society of Gastrointestinal Endoscopy of India. 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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  • References

  • 1 Balekuduru AB, Dutta AK, Subbaraj SB. Endoscopy on a human cadaver: a feasibility study as a training tool. J Digest Endosc 2018; 09 (03) 103-108
    Thieme ConnectSearch in Google Scholar
  • 2 Woods KL. Simulators in training for upper gastrointestinal endoscopy. Gastroenterol Hepatol (N Y) 2019; 15 (04) 207-209
    Search in Google Scholar
  • 3 Khan R, Plahouras J, Johnston BC, Scaffidi MA, Grover SC, Walsh CM. Virtual reality simulation training for health professions trainees in gastrointestinal endoscopy. Cochrane Database Syst Rev 2018; 8: CD008237 [PMID: 30117156 DOI: 10.1002/ 14651858.CD008237.pub3]
    CrossrefPubMedSearch in Google Scholar
  • 4 Khan R, Scaffidi MA, Grover SC, Gimpaya N, Walsh CM. Simulation in endoscopy: practical educational strategies to improve learning. World J Gastrointest Endosc 2019; 11 (03) 209-218
    CrossrefPubMedSearch in Google Scholar
  • 5 Issenberg SB, McGaghie WC, Petrusa ER, Lee Gordon D, Scalese RJ. Features and uses of high-fidelity medical simulations that lead to effective learning: a BEME systematic review. Med Teach 2005; 27 (01) 10-28 [PMID: 16147767 DOI:10.1080/01421590500046924]
    CrossrefPubMedSearch in Google Scholar
  • 6 Hamstra SJ, Brydges R, Hatala R, Zendejas B, Cook DA. Reconsidering fidelity in simulation-based training. Acad Med 2014; 89 (03) 387-392 [PMID: 24448038 DOI: 10.1097/ ACM.0000000000000130]
    CrossrefPubMedSearch in Google Scholar
  • 7 Walsh CM, Cohen J, Woods KL. et al. ASGE EndoVators Summit: simulators and the future of endoscopic training. Gastrointest Endosc 2019; 90 (01) 13-26
    CrossrefPubMedSearch in Google Scholar
  • 8 Siau K, Dunckley P, Valori R. et al. Joint Advisory Group on Gastrointestinal Endoscopy (JAG). Changes in scoring of Direct Observation of Procedural Skills (DOPS) forms and the impact on competence assessment. Endoscopy 2018; 50 (08) 770-778
    Thieme ConnectPubMedSearch in Google Scholar
  • 9 Walsh K. The rules. BMJ 2005; 331 (7516) 574
    CrossrefSearch in Google Scholar
  • 10 Moulaert V, Verwijnen MG, Rikers R, Scherpbier AJJ. The effects of deliberate practice in undergraduate medical education. Med Educ 2004; 38 (10) 1044-1052
    CrossrefPubMedSearch in Google Scholar
  • 11 Gauderer MWL, Ponsky JL, Izant RJ Jr. Gastrostomy without laparotomy: a percutaneous endoscopic technique. J Pediatr Surg 1980; 15 (06) 872-875
    CrossrefPubMedSearch in Google Scholar
  • 12 Matthes K, Dunkin BJ, Jensen DM. Simulator training in endoscopic hemostasis. Tech Gastrointest Endosc 2011; 13 (03) 174-182 https://doi.org/10.1016/j.tgie.2011.07.001
    CrossrefSearch in Google Scholar
  • 13 Hochberger J, Matthes K, Maiss J, Koebnick C, Hahn EG, Cohen J. Training with the compactEASIE biologic endoscopy simulator significantly improves hemostatic technical skill of gastroenterology fellows: a randomized controlled comparison with clinical endoscopy training alone. Gastrointest Endosc 2005; 61 (02) 204-215
    CrossrefPubMedSearch in Google Scholar
  • 14 Matthes K, Cohen J, Kochman ML, Cerulli MA, Vora KC, Hochberger J. Efficacy and costs of a one-day hands-on EASIE endoscopy simulator train-the-trainer workshop. Gastrointest Endosc 2005; 62 (06) 921-927
    CrossrefPubMedSearch in Google Scholar
  • 15 Blackburn SC, Griffin SJ. Role of simulation in training the next generation of endoscopists. World J Gastrointest Endosc 2014; 6 (06) 234-239
    CrossrefPubMedSearch in Google Scholar