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DOI: 10.1055/s-0042-110094
Validation of a realistic, simple, and inexpensive EUS-FNA training model using isolated porcine stomach
Publikationsverlauf
submitted 02. April 2016
accepted after revision 06. Juni 2016
Publikationsdatum:
05. August 2016 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00025476/201609/lookinside/thumbnails/258_10-1055-s-0042-110094-1.jpg)
Background and study aims: Trainees are required to learn EUS-FNA using a model before working with a patient. The aim of the current study was to validate a new training model developed for EUS-FNA.
Patients and methods: Several fresh chicken tenderloins were embedded as target lesions in the submucosal layer of an isolated porcine stomach. The stomach was fixed to a plate with nails, and was placed in a tub filled with water. The primary endpoint was feasibility of the newly developed model for EUS-FNA training, evaluated as follows: 1) visualization of the target lesion with blinding for lesion location; 2) penetrability of the needle; 3) sampling rate of macroscopic specimen; and 4) ROSE capability. Secondary endpoints were its durability and utility for multiple EUS-FNA procedures during EUS-FNA training, and the ease and cost of preparing the model.
Results: Six endoscopists (1 expert, 5 trainees) attempted EUS-FNA procedures using this model. The target lesion could be identified clearly, and EUS-FNA could be performed with realistic resistance felt. In addition, rapid on-site evaluation could be easily achieved. Based on 10 needlings by each endoscopist, adequate specimens for histology could be macroscopically taken with an average 85 % success rate. Visibility and maneuverability were maintained throughout all needlings. Preparation time for this model was less than 30 minutes with a total cost of $ 22.
Conclusions: An easy-to-use and inexpensive training model with a realistic feel of needling was created. This model can potentially enable beginners to practice safe and effective EUS-FNA procedures.
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References
- 1 Henriksen FW, Hancke S. Percutaneous cystogastrostomy for chronic pancreatic pseudocyst. Br J Surg 1994; 81: 1525-1528
- 2 Erickson RA. EUS-guided FNA. Gastrointest Endosc 2004; 60: 267-279
- 3 Polkowski M, Larghi A, Weynand B et al. Learning, techniques, and complications of endoscopic ultrasound (EUS)-guided sampling in gastroenterology. European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline. Endoscopy 2012; 44: 190-206
- 4 Hikichi T, Irisawa A, Bhutani MS et al. Endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses with rapid on-site cytological evaluation by endosonographers without attendance of cytopathologists. J Gastroenterol 2009; 44: 322-328
- 5 Dumonceau JM, Polkowski M, Larghi A et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2011; 43: 897-912
- 6 Sarker SK, Albrani T, Zaman A et al. Procedural performance in gastrointestinal endoscopy: live and simulated. World J Surg 2010; 34: 1764-1770
- 7 Barthet M, Gasmi M, Boustière C et al. EUS training in a live pig model does it improve echo endoscope hands-on and trainee competence?. Endoscopy 2007; 39: 535-539
- 8 Rösch T. State-of-the-art lecture: endoscopic ultrasonography: training and competence. Endoscopy 2006; 38: 69-72
- 9 Savides TJ, Fisher AH, Gress FG et al. 1999 ASGE endoscopic ultrasound survey. Gastrointest Endosc 2000; 52: 745-750
- 10 Matsuda K, Hawes RH, Sahai AV et al. The role of simulators, models, phantoms. Where's the evidence?. Endoscopy 2006; 38: 61-64
- 11 Bhutani MS, Hoffman BJ, Hawes RH. A swine model for teaching endoscopic ultrasound (EUS) imaging and intervention under EUS guidance. Endoscopy 1998; 30: 605-609
- 12 Fritscher-Ravens A. Training model for Endoscopic Ultrasound-gided Fine-Needle Aspiration of Lymph Nodes. Gastroenterol Hepatol (N. Y.) 2013; 9: 380-382
- 13 Matsuda K, Tajiri H, Hawes RH. How shall we experience EUS and EUSFNA before the first procedure? The development of learning tools. Dig Endosc 2004; 16: 236-239
- 14 Yasuda I, Goto N, Tsurumi H et al. Endoscopic ultrasound guided fine needle aspiration biopsy for diagnosis of lymphoproliferative disorders: feasibility of immunohistological, flow cytometric, and cytogenetic assessments. Am J Gastroenterol 2012; 107: 397-404
- 15 Itoi T, Tsuchiya T, Itokawa F et al. Histological diagnosis by EUS-guided fine-needle aspiration biopsy in pancreatic solid masses without on-site cytopathologist: a single-center experience. Dig Endosc 2011; 23: 34-38