Within the framework of the endoscopy training course at Kanazawa Medical University the Hands-on training on ex-vivo pig stomachs was held under the guidance of Professor Tohru Itoh on January 21, 2011 on the base of the Endoscopy Department. It was devoted to advanced therapeutic technologies in GI endoscopy. The highlight of the hands-on training was ESD (Endoscopic Submucosal Dissection) technique.
The ESD technique introduced by Hirao et al has subsequently been modified by several investigators, allowing curative en bloc resection of broad superficial tumors with the use of special cutting knives.
A dedicated gastroscope (Olympus® EVIS LUCERA video gastroscope GIF-Q260J), electric ESD knives (IT-knife and Hook-knife Olympus®), and an Erbe electric generator were employed.
According to Professor Tohru Itoh the base ESD technique includes:
A total of 2 ESDs of “target lesions” on a healthy mucosa were performed using the following technique described. All target lesions were located in the upper body great curvature of the stomach. Resection specimens ranged from 1 to 2 cm in length (median: 1,5 cm). ESD duration ranged from 40 to 60 minutes (median: 50 minutes). ESD could be completed in all cases (technical success: 2/2 = 100%).
The base ESD technique is an extremely significant therapeutic method for the treatment of the early GI cancer. The practical experience gained by me is unique and will be used in future
professional career as an Endoscopist.
|Training model - ex-vivo harvested pig stomach|
|From right to left: Professor Tohru Itoh, Dr. Gvozdev, Dr. Kitakata|
|From right to left: Dr. Hamada, Dr. Kawaura, Professor Tohru Itoh, Dr. Gvozdev, Dr. Kitakata|