Clinical Endoscopy

Original Articles

Determining the Safety and Effectiveness of Electrocautery Enhanced Scissors for Peroral Endoscopic Myotomy (with Video): Kelly E. Hathorn, Walter W. Chan, Hiroyuki Aihara, Christopher C. Thompson; Clin Endosc 2020;53(4):443-451. Published online May 22, 2020; DOI: https://doi.org/10.5946/ce.2019.214

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Background
/Aims: Peroral endoscopic myotomy (POEM) has recently come to the forefront in the management of achalasia. We aimed to analyze the efficacy and safety of the use of electrocautery enhanced scissors (EES) for POEM.
Methods
This retrospective cohort study prospectively collected the data of all adult patients (aged ≥18 years) with normal foregut anatomy who underwent POEM using EES. The patients’ baseline characteristics and procedure details (time, tunnel length, myotomy length, depth, and location) were recorded. The primary outcome was clinical success (3-month post-procedure Eckardt score of ≤3). The secondary outcomes were technical success and adverse events. A paired Student’s t-test was performed.
Results
Fifteen patients were included in this study. The technical success rate of myotomy using EES was 100%. Fellows participated in the myotomy in all cases. The clinical success rate was 93.3% (14/15). The mean pre-Eckardt score was 5.4±2.5, while the mean post-Eckardt score was 1.3±1.3, which indicated a significant improvement (p≤0.0001). The most common treatment-related adverse events were post-procedure pain (4, 26.7%) and symptomatic reflux disease (4, 26.7%).
Conclusions
In the largest series to date on the use of EES in POEM, we demonstrated that this technique has both technical and clinical efficacy as well as an excellent safety profile.

Citations

Citations to this article as recorded by

Peroral endoscopic myotomy using an endoscopic dissector: another novel device in our toolbox
Shruti Mony, Apurva Shrigiriwar, Andrew Canakis, Mouen A. Khashab
VideoGIE.2023; 8(1): 5. CrossRef
Peroral endoscopic myotomy (POEM) is more cost-effective than laparoscopic Heller myotomy in the short term for achalasia: economic evaluation from a randomized controlled trial
Tatiana Morgado Conte, Luciana Bertocco de Paiva Haddad, Igor Braga Ribeiro, Eduardo Turiani Hourneaux de Moura, Luiz Augusto Carneiro DʼAlbuquerque, Eduardo Guimarães Hourneaux de Moura
Endoscopy International Open.2020; 08(11): E1673. CrossRef

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Validation of a Novel Endoscopic Retrograde Cholangiopancreatography Cannulation Simulator: Pichamol Jirapinyo, Andrew C. Thompson, Hiroyuki Aihara, Marvin Ryou, Christopher C. Thompson; Clin Endosc 2020;53(3):346-354. Published online February 17, 2020; DOI: https://doi.org/10.5946/ce.2019.105

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) requires a unique skill set. Currently, there is no objective methodology to assess and train a professional to perform ERCP. This study aimed to develop and validate a novel ERCP simulator.
Methods
The simulator consists of papillae presenting different anatomy and positioned in varied locations. Deep cannulation of the pancreatic duct, followed by the bile duct, was performed. The time allotted was 5 minutes. The content validity indexes (CVIs) for realism, relevance, and representativeness were calculated. Correlation between ERCP experience and simulator score was determined.
Results
Twenty-three participants completed the simulation. The CVIs for realism were orientation of duodenoscope to papilla (1.00), angulation of papillotome to achieve cannulation (0.71), and haptic feedback during cannulation (0.80). The CVIs for relevance were use of elevator (1.00), wheels to achieve en face orientation (1.00), and papillotome for selective cannulation (1.00). Regarding CVI for representativeness, the results were as follows: basic cannulation (0.83), papilla locations (0.83), and papilla anatomies (0.80). The novice, intermediate, and experienced groups scored 6.7±8.7, 30.0±16.3, and 74.4±43.9, respectively (p<0.0001). There was a strong correlation between the ERCP experience level and the individual’s simulator score (Pearson value of 0.77, R2 of 0.60).
Conclusions
This simulator appears to be realistic, relevant, and representative of ERCP cannulation techniques. Additionally, it is effective at objectively assessing basic ERCP skills by differentiating scores based on clinical experience.

Citations

Citations to this article as recorded by

Morfología de la papila de Vater como factor que influye en el éxito en canulación durante el entrenamiento del Residente en Endoscopia Avanzada. Estudio clínico prospectivo
D.E. Benavides-Salgado, R.A. Jiménez-Castillo, J.E. Cuéllar-Monterrubio, J.O. Jáquez-Quintana, A. Garza-Galindo, C. Cortes-Hernández, H.J. Maldonado-Garza, D. García-Compeán, J.A. González-González
Revista de Gastroenterología de México.2024; 89(2): 237. CrossRef
Papilla of Vater morphology as an influencing factor in successful cannulation during resident training in advanced endoscopy. A prospective clinical study
D.E. Benavides-Salgado, R.A. Jiménez-Castillo, J.E. Cuéllar-Monterrubio, J.O. Jáquez-Quintana, A. Garza-Galindo, C. Cortes-Hernández, H.J. Maldonado-Garza, D. García-Compeán, J.A. González-González
Revista de Gastroenterología de México (English Edition).2024; 89(2): 237. CrossRef
Anatomical endoscopic retrograde cholangiopancreatography simulator using moulded meshed silicone: A novel simulator pilot study
Alen Maximillian Brodaric, Ngar Lok Joshua Wong, Jessica Falon, Jean Wong, Kai Cheng, Sarah Whereat, David Storey
ANZ Journal of Surgery.2023; 93(7-8): 1817. CrossRef
The use of simulators to acquire ERCP skills: a systematic review
Konstantinos Georgiou, Kiril T. Atliev, Ninos Oussi, Nikola Boyanov, Gabriel Sandblom, Lars Enochsson
Annals of Medicine & Surgery.2023; 85(6): 2924. CrossRef
There is no royal road: a shortcut for endoscopic submucosal dissection training
Seong Woo Jeon
Clinical Endoscopy.2023; 56(5): 590. CrossRef
Validity of a virtual reality endoscopic retrograde cholangiopancreatography simulator: can it distinguish experts from novices?
Konstantinos Georgiou, Nikola Boyanov, Pantelis Antonakis, Dimitrios Thanasas, Gabriel Sandblom, Lars Enochsson
Frontiers in Surgery.2023;[Epub] CrossRef
Training in endoscopic retrograde cholangio-pancreatography: a critical assessment of the broad scenario of training programs and models
Camilla Gallo, Ivo Boškoski, Maria Valeria Matteo, Beatrice Orlandini, Guido Costamagna
Expert Review of Gastroenterology & Hepatology.2021; 15(6): 675. CrossRef

6,039 View
140 Download
8 Web of Science
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