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HOME > Clin Endosc > Volume 58(5); 2025 > Article
Review Digital platforms, virtual reality, and augmented reality in gastrointestinal endoscopy training
Wilfredo Paganiorcid, Tavia Buysseorcid, Kulwinder S. Duaorcid
Clinical Endoscopy 2025;58(5):653-661.
DOI: https://doi.org/10.5946/ce.2024.354
Published online: May 23, 2025

Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI, USA

Correspondence: Kulwinder S. Dua Division of Gastroenterology and Hepatology, Medical College of Wisconsin, 9200, West Wisconsin Avenue, Milwaukee, WI 53226, USA E-mail: kdua@mcw.edu
Part of this article was presented at the Endo2024 Conference in Seoul, South Korea in July 2024.
• Received: December 30, 2024   • Revised: February 25, 2025   • Accepted: February 26, 2025

© 2025 Korean Society of Gastrointestinal Endoscopy

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Remote training in procedural tasks has experienced robust growth in recent years, spurred by the coronavirus disease 2019 pandemic to meet the need for basic and continued skills development, including in gastrointestinal endoscopy. Remote endoscopy training offers learners the opportunity for skill acquisition, real-time feedback, and access to experts from around the world, and gives mentors the ability to educate trainees without the need to travel themselves. Remote training can be cost-effective but requires reliable technology and continuous assessment to ensure training quality. Ethical and legal issues related to patient safety may also exist. Training using virtual or augmented reality, on the other hand, does not involve patients and, hence, has no patient safety, legal, or ethical issues. Multiple endoscopic scenarios, from basic to advanced, can be practiced multiple times with immediate feedback on performance. These innovations are expected to not only increase individual endoscopy skills but also expand access to specialized care in remote areas, either in the same country or in underserved regions of the world. This review describes various techniques in remote endoscopy training with associated advantages and drawbacks and analyzes research outcomes on the effectiveness of remote endoscopy training.
  • Keywords: Augmented reality; Computer simulation; Endoscopy, gastrointestinal; Virtual reality
Current technology has enabled the sharing of information in real-time worldwide, fostering rapid advancements in medical knowledge and practice. The use of high-speed internet, video streaming, and interactive platforms allows physicians to collaborate, learn, and consult across the globe without geographical constraints. The dramatic impact of the coronavirus disease 2019 pandemic on medical training and practice led to further reliance on remote learning to protect the safety of healthcare providers.1 Remote training and telementoring/teleproctoring have emerged as ways to help trainees develop complex procedural skills in various specialties without the need to travel. These tools allow expert supervision and real-time feedback for trainees in procedural fields such as gastrointestinal (GI) endoscopy and surgery.2 This review describes remote procedural training methods with a focus on GI endoscopy and draws comparisons from other procedural disciplines to examine the benefits, challenges, and future directions for remote medical training. It also reviews the impact of virtual reality (VR) and augmented reality (AR), which are beginning to enhance GI endoscopy training.
Traditional endoscopy mentoring is one-on-one supervision education in which the mentor is in the same room and can assist or take over the endoscope, as needed. Telementoring is synchronous, or real-time, interaction using information and communication technology to teach or train medical procedural skills at distant locations.3 Teleproctoring involves verbal guidance via live feed and is the same as telementoring.3 Telestration is the enhancement of interactions by allowing an expert to indicate or draw on a live feed video during a procedure while teleproctoring.3 These modalities can be used to remotely train individuals in basic endoscopy procedures, upskill individuals with prior endoscopy training, or update experienced individuals on new techniques or equipment. Telementoring requires a two-way audiovisual connection where the mentor can hear and see (room and monitor views) and the mentee, room and monitors can see and hear the mentor. Figure 1 depicts an experienced endoscopist in New York telementoring a gastroenterologist in Kenya in performing polypectomy.4 A secure broadband internet connection, preferably 5G to limit latency, is required, along with audiovisual software. The typical cost of this basic setup ranges from 3,500 to 5,000 United States dollars (USD). Using spherical or multiple cameras, more sophisticated setups and software allow for the visualization of the entire room by wearing special eye goggles and turning the head as one would do if physically present in the room, or by using the arrows of the keyboard. This system is especially useful in a reverse manner, where the mentee can be remotely teleported into the room of the expert endoscopist to observe the procedures being performed.
The utility of telementoring was first reported and evaluated for surgical techniques such as laparoscopy but has now also been adopted into the field of GI endoscopy for both basic and advanced procedures including endoscopic retrograde cholangiopancreatography (ERCP), GI stenting, endoscopic submucosal dissection (ESD), and endoscopic sleeve gastroplasty (ESG).5-7 In Hong Kong, international faculty telementored gastroenterologists and GI surgeons on ESD techniques using live anesthetized pigs.8 Most mentees had no prior experience with ESD. The telementors guided them through successful procedures, with the additional ability to draw and annotate images seen on the endoscopic video feed (telestration). Teleproctoring has also been used to enhance training in bariatric endoscopy by utilizing specialized techniques, such as endoscopic full-thickness suturing. After initially providing in-person training, expert endoscopists from Brazil telementored trainees in Ecuador using a web conferencing platform along with procedural room webcams and endoscopy video outputs in performing ESG procedures.5 The endoscopic procedure and suturing times decreased over the assessment period, suggesting increased efficiency and skill improvement.
Telementoring has also been used to bring endoscopy to remote or low-resource underserved regions of the world. For example, telementoring technology allowed a low-volume center in Sweden to receive guided support during ERCP cases from a distant high-volume center with experienced endoscopists in an effort to expand high-quality care to more rural areas. Telemedicine reduced the need for percutaneous transhepatic cholangiography and repeat ERCP.7 Using a similar approach, one of our experienced endoscopists in Wisconsin, United States of America (USA), was telementored in performing ESD by an expert from Houston, USA, using a system that allowed enhanced interaction in which the mentor could remotely turn the camera and mark and draw on the mentee’s video screen during the live feed while teleproctoring. In Kyabirwa, Uganda, an endoscopy-naïve surgeon was initially given hands-on, in-person training for 1 week and then telementored from the USA on 139 diagnostic and therapeutic procedures using a system that allowed the mentor to simultaneously visualize the trainer’s hand and endoscope view and provided real-time feedback.9 The surgeon then independently performed 167 colonoscopies and 425 upper endoscopies, including therapeutic interventions such as polypectomies, stricture dilations, variceal banding, and placement of esophageal stents. All procedures were completed successfully with no adverse events.9
Benefits of remote endoscopy training
Before remote training is initiated, mentors must provide in-person hands-on training to the mentee. This may require a visit to the mentee’s center, during which the mentor can also become familiar with the local procedure room setup and meet the nurses and technicians working alongside the mentee. Knowledge of available support services, such as anesthesia, surgery, interventional radiology, and pathology, is also essential. Subsequent training could then be provided remotely.
Remote procedural training offers several advantages that extend beyond traditional educational models in medicine, enabling a more efficient, accessible, and sustainable approach to skills development in endoscopy training. One of the most significant advantages of remote procedural training is the ability to reduce the need for travel. By eliminating the need for trainers and trainees to travel long distances for hands-on education, remote training reduces travel-related downtime and minimizes disruptions to clinical practice. This not only saves valuable time but also helps the environment by decreasing the carbon footprint associated with frequent air or road travel. By relying on digital communication technologies, trainees can engage with expert instructors while remaining in their clinical settings, allowing them to balance professional responsibilities with skill development more effectively. Moreover, the trainee can converse with nurses and technicians in the local language as needed. Training in their own clinical setting may also offset the regulatory needs of licensing and malpractice coverage for the mentor for training in overseas centers, although this legal and ethical consideration must be clarified with the authorities at both the mentor’s and mentee’s institutions.
Remote training technologies also enable one to tap into experts from across the globe. For example, one can select an expert mentor in ERCP from one country and an expert in endoscopic ultrasound (EUS) from another country. Experts can conduct several sessions as needed because they are not restricted by geographical barriers or the logistics of on-site training, including the safety risks of travelling to politically unstable regions. The ability to receive real-time feedback fosters a more interactive and responsive learning environment, allowing trainees to adapt techniques and correct errors under direct supervision. This is particularly valuable in complex fields such as endoscopy, where precision and rapid adjustments are critical for successful outcomes.
Comparative outcomes of remote versus in-person training
Research across multiple procedure-based specialties has provided evidence that remote training can achieve outcomes similar to traditional in-person teaching. Most studies evaluating the effectiveness of telementoring have focused on surgical procedures, do not involve trainees who have not completed their formal teaching courses, or are limited by small case numbers. Hence, they cannot directly address the question of whether remote training can produce proficient endoscopists.9,10 A meta-analysis of 453 telementored surgical operations found no difference in adverse event rates between in-person and remotely proctored cases and demonstrated similar operating times.11 Another systematic review of studies involving telementoring for surgical procedures, including 22 studies with telementoring between institutions in different countries, found that most studies comparing in-person and telementored cases found no difference in outcomes; however, a minority of studies suggested prolonged operative times.12 A study involving 55 trainees using a remote laparoscopic skills learning platform that delivered remote feedback from expert laparoscopy trainers found significant improvement in laparoscopic skills and shorter task completion times when compared to initial evaluation results and no difference when compared to a control group receiving on-site feedback, suggesting that remote teaching of complex procedural skills may be as effective as in-person feedback.13 There have been several successful reports of training in basic to advanced GI endoscopy procedures using teleproctoring, although in almost all instances, initial in-person hands-on training was conducted before telementoring commenced.
Challenges of remote endoscopy training
Despite its many advantages, remote endoscopy training comes with several challenges. Ensuring patient safety is the foremost priority. Without a mentor presence in the room, the option of “taking over the endoscope” does not exist. This inability to step-in may increase the risk of adverse events or the need for repeat procedures, thereby compromising patient safety. In this setting, ensuring that procedures are performed in a center with access to support from other disciplines, such as anesthesia, surgery, or interventional radiology, is essential.
Remote training requires that the mentor not only excels in technical skills but also effectively communicates procedural steps and provides clear, real-time feedback. This dual role can be challenging in the presence of language issues, particularly when guiding complex procedures in which tactile and visual cues are critical. Trainers must establish strong communication and rapport with trainees to ensure that the feedback is well understood and implemented, a process that can be challenging to do remotely. To mitigate this, many remote training initiatives have had trainees and instructors review procedural equipment and walk through the planned procedure prior to it taking place.14
Stable high-quality internet connectivity is also critical for successful remote training. Any interruptions in the video or audio can disrupt the procedure, delay feedback, or compromise patient safety. To mitigate these risks, a wired connection with backup has been suggested. In addition, sufficient bandwidth with minimal latency is required to maintain communication without significant lag time.15 However, the cost of such infrastructure and the responsibility to maintain it can be significant barriers to remote procedural training in low-resource settings. The cost of the telementoring equipment setup can range from 4,000 to up to 75,000 USD.4,12,14
In addition to safety concerns, maintaining patient privacy and protecting patient data are critical. Any breach of patient information during remote sessions can have serious ethical and legal consequences, making the use of secure encrypted platforms essential. Remote procedural training also presents other unique medicolegal challenges. Informed consent must include clear explanations of the nature of remote training, potential risks, and maintenance of patient safety. There are legal ambiguities regarding the responsibility for adverse outcomes during training sessions. It must be established whether the remote trainer or on-site trainee bears the ultimate responsibility for complications. Similarly, the legality of remote mentoring in centers where the mentor may not have a license to practice and/or malpractice insurance coverage must be addressed and clarified. Mentors may also need to clarify this from their own institution.
Effective evaluation tools are necessary to assess trainee proficiency, particularly for advanced endoscopic procedures. While remote instructors can observe and provide feedback, standardized tools to measure skill acquisition and competency are essential to ensure that trainees achieve safe and independent practice skills. As most remote training is done in an individual mentor-mentee relationship and not through any accreditation board, providing a certificate of training with accreditation may not be possible. This must be addressed by the mentee’s local institution.
VR is a simulated experience similar to or completely different from the real world that creates an immersive and interactive environment. The user is teleported to an artificial world by wearing a VR headset.16 AR is an experience in which the real world is augmented with computer-generated three-dimensional (3D) objects that overlay the physical world.16 Mixed reality (MR) includes a combination of virtual and real components. This differs from AR in that the superimposed objects are solid and can be touched and manipulated.16
The integration of VR and AR into training programs has revolutionized the way in which medical professionals acquire and refine their skills. In GI endoscopy, these technologies can provide realistic learning experiences of varying complexities that improve skill acquisition and procedural safety without the risks and ethical issues associated with learning procedural skills by practicing on patients.2,16-19
VR, AR, and MR technologies offer an immersive, 3D experience for trainees to practice diagnostic and therapeutic procedures. Immersed in realistic views, one can repeatedly practice skills using multiple scenarios, including complex and rare scenarios, without risk to the self or the patient.20 For example, Figure 2 depicts an experienced endoscopist using VR to enhance his skills in placing lumen-apposing stents to drain the gallbladder using a platform designed by Boston Scientific Inc. Immediate feedback is provided, leading to improvements in technique and confidence. The presence of multiple users facilitates interactive, collaborative, and enjoyable experiences. Compared to training on live animals or cadavers, VR and AR systems are portable, cheaper and several systems are available for training in endoscopy (Tables 1, 2).21 Unlike training on patients, there are no ethical or legal issues.
In one study, medical residents were trained in colonoscopy and upper endoscopy using AR/VR, and their results were compared with baseline performance. Global assessment of gastrointestinal endoscopy scores significantly improved, including parameters such as time to reach the cecum, percentage of mucosa examined, and patient discomfort time.17,22-24 In another series of studies, the skills of two groups of trainees were compared: those with and those without prior VR training.25,26 Higher objective competencies were achieved by those who had prior VR training with faster times to reach the cecum. This difference was most apparent in the initial 40 cases.27 No differences were observed between the groups after 60 endoscopic examinations.27 This observation may have implications for new trainees joining GI fellowship programs. Procedure times may be shorter and other competency scores may be better in those with prior VR training than in those without, particularly in the first 2 months.
Studies have reported that fellows trained using VR systems experienced a 17.8% improvement in procedural completion rates compared with those trained using traditional on-patient training methods, with features such as real-time feedback and procedural benchmarks enhancing the learning experience.28,29 AR and MR tools add another dimension by integrating digital content into the physical world, with studies showing an improvement in procedural accuracy and reduction in the time needed for complex tasks by 15%.30 Hybrid systems, which combine biological materials with VR interfaces, offer realistic practice for therapeutic techniques, such as hemostasis, leading to a reported 40% improvement in skills among trainees.31 VR-trained trainees showed a 25% improvement in procedural accuracy and a 16% reduction in patient discomfort during procedures.32 Others have also validated the impact of these technologies. Ferlitsch et al.33 reported that VR-based training reduced procedural errors by 30% and improved success rates by 20% in upper GI endoscopies. Similarly, Singh et al.34 found that simulation-based methods improved procedural outcomes by an average of 25% across various medical disciplines. The virtual bariatric endoscopic (ViBE) software developed by Erden et al.35 was specifically designed for the education and training of endoscopic bariatric therapies. It demonstrated a 50% improvement in trainees’ ability to perform bariatric procedures compared to conventional methods, highlighting its potential for advancing specialized techniques. Mechanical and ex vivo models remain valuable for basic skills training, although ethical and logistical challenges such as tissue replacement limit their use.29
Together, VR and AR can standardize training frameworks, address gaps in traditional teaching methods, and support the consistent mastery of advanced techniques, such as ERCP and EUS.29,31,32,36 These technologies can improve patient safety and efficiency in live scenarios. As both VR and AR technologies continue to evolve, they may play an integral role in equipping endoscopists with the skills necessary to navigate the complexities of modern clinical practice.21 The American Council for Graduate Medical Education supports the incorporation of simulation training into the curriculum of GI fellowship programs.37
VR and AR technologies can also be integrated with remote teaching. The combination of VR and AR with teleproctoring has expanded the reach of endoscopy training, making it accessible to underserved regions and rural areas. Studies demonstrate that remote VR training improves trainee proficiency with a 35% increase in the accurate execution of endoscopic tasks under virtual mentorship.29,38 These technologies create collaborative digital environments that bridge geographical and resource gaps, making them particularly important for trainees who may otherwise lack access to diverse clinical cases or advanced mentorship.
Challenges and limitations of VR and AR
The adoption of VR and AR in endoscopy training faces several challenges. VR sickness, including nausea, dizziness, and eyestrain, can occur. Reduced interaction with other people can lead to loss of social skills, empathy, and emotional connections.16 Financial constraints remain a significant barrier with costs ranging from 60,000 to 100,000 USD, which may limit access for resource-limited institutions.29 Curriculum integration is another hurdle, as resistance to change and the lack of standardized competency guidelines complicate its adoption. Clear benchmarks for skill assessment are essential for streamlined implementation.39,40 Additionally, skills acquired through virtual training may deteriorate without regular reinforcement, necessitating longitudinal studies to evaluate skill retention and design effective programs that maintain proficiency.39,41 Addressing these challenges is essential for the widespread adoption of VR and AR in endoscopic education.
Future directions
Looking ahead, the roles of VR and AR in GI endoscopy will be shaped by ongoing research, innovation, and progressive policy changes designed to integrate these tools into mainstream education. Long-term studies are essential for assessing the clinical impact of these technologies, with metrics for skill retention, patient safety, and procedural efficiency guiding curriculum improvements.27,33 Advances in artificial intelligence are anticipated to further enhance VR and AR platforms by personalizing training methods and objectives based on individual performance metrics. Portable VR and AR devices are expected to make these technologies more affordable and accessible, thereby reducing the barriers for resource-limited programs.29,38 Furthermore, the establishment of standardized competency benchmarks by endoscopy societies will integrate VR and AR into certification processes, ensuring uniform training quality and facilitating broader adoption.40 Similar to how airline pilots maintain skills, including practicing responses to emergencies, using simulators, VR and AR technologies can be incorporated into ongoing skill assessment protocols. Such efforts will promote these technologies as essential components of procedural learning in GI endoscopy.
Remote endoscopy training has been used to help trainees develop both foundational and advanced procedural skills, while bridging geographical and resource gaps. By leveraging teleproctoring, VR, and AR, remote training has expanded the access to expert mentorship and high-quality education in diverse healthcare settings, including rural and underserved regions. The integration of VR and AR into remote training offers immersive, standardized, and risk-free platforms for skill acquisition, helping to overcome traditional barriers to endoscopy education for patients. However, the widespread adoption of these technologies, including telementoring, requires overcoming critical barriers such as patient safety concerns, medicolegal complexities, and the high costs associated with advanced simulation technologies. Establishing clear competency benchmarks and ensuring broader access to these resources are necessary to create a standardized, sustainable, and impactful educational framework. In the future, the combination of remote learning and immersive technologies will present immense opportunities to advance procedural education. Continued innovations in artificial intelligence, enhanced connectivity, and portable simulation tools will make training more accessible and tailored to individual needs. As innovations continue to evolve, their impact on medical training and patient care is expected to increase, making them integral components of future endoscopy education.
Fig. 1.
Telementoring/teleproctoring a mentee performing polypectomy. After providing in-person, hands-on training to an endoscopist in Kenya, Dr. Jerome Waye from the USA is telementoring/teleproctoring an endoscopist in performing a colon polypectomy. The software setup includes two-way simultaneous (synchronous) transmission using internet broadband (preferably 5G to reduce lag time or the files have to be compressed if 3G), bluetooth audio microphone (mentor and mentee), and videos; mentor: room view, mentee: room view and monitor view where one can switch between endoscopy view fluoroscopy view, endoscopic ultrasound (EUS) view, or picture-in-picture view based on what procedure is being performed. Adapted from Waye et al. VideoGIE 2021;6:439–442, according to the Creative Commons license.4
ce-2024-354f1.jpg
Fig. 2.
Learning to perform an advanced endoscopic procedure using virtual reality. An experienced endoscopist using virtual reality to enhance his skills in placing a lumen-apposing stent to drain the gallbladder using a platform designed by Boston Scientific Inc. This procedure can be practiced several times using a headset and handheld device. As shown, these devices are portable and can easily be carried in a briefcase.
ce-2024-354f2.jpg
Table 1.
Some currently available virtual, augmented, and mixed reality endoscopy training systems
Endoscopy training system Type of procedural training available
Virtual Gastro Tutor (ViGaTu) Screening colonoscopy
Endo VR Upper and lower endoscopy
EndoSim ESD, ERCP, EUS, endoscopic suturing, ESG, TORE
GI Mentor ERCP, EUS, ESD
EndoVision Upper and lower endoscopy, dilation, stenting, ERCP, EUS, EMR

VR, virtual reality; ESD, endoscopic submucosal dissection; ERCP, endoscopic retrograde cholangiopancreatography; EUS, endoscopic ultrasound; ESG, endoscopic sleeve gastroplasty; TORE, transoral outlet reduction; GI, gastrointestinal; EMR, endoscopic mucosal resection.

Table 2.
Commercialized gastrointestinal endoscopy training systems
Name Manufacturer Class Target
EGD Simulator Koken Co., Ltd., Japan Mechanical EGD, ERCP
EMS Trainer Chamberlain Group LLC, USA Mechanical EGD, CSPY
Thompson Endoscopic Skill Trainer EndoSim LLC, USA Mechanical EGD, CSPY
Upper GI Trainer Chamberlain Group, USA Mechanical EGD
EGD Method Trainer Anymedi Inc., Korea Mechanical EGD
Erlangen Active Simulator for Interventional Endoscopy Series EndoSim LLC, USA Ex vivo EGD, CSPY, ERCP, EUS
DeLegge EndoExpert Tray DeLegge Medical, USA Ex vivo EGD, CSPY, ERCP
EndoVR CAE Healthcare, Canada VR EGD, CSPY, ERCP
GI Mentor II virtual endoscopy simulator Simbionix, USA VR EGD, CSPY, ERCP
EndoSim Surgical Science, Sweden VR EGD, CSPY, ERCP
3D Colonoscope Training Simulator NKS Kyoto Kagaku Co., Japan Mechanical CSPY
Colonoscope Training Simulator Kyoto Kagaku Co., Japan Mechanical CSPY
Colonoscopy Lower GI Endoscopy Simulator Koken Co., Ltd., Japan Mechanical CSPY, enteroscopy
Colonoscopy Trainer Chamberlain Group, USA Mechanical CSPY
EVL Simulator Glück Co., Korea Mechanical EVL
PEG Simulator Glück Co., Korea Mechanical PEG
Left-Hand Trainer Glück Co., Korea Mechanical EGD
EndoGel Training Model for ESD/POEM Sunarrow Co., Japan Mechanical ESD/POEM
ESD Training Model Koken Co., Ltd., Japan Mechanical ESD

Adapted from Kim et al. Clin Endosc 2023;56:1–13, according to the Creative Commons license.21

EGD, esophagogastroduodenoscopy; ERCP, endoscopic retrograde cholangiopancreatography; CSPY, colonoscopy; EUS, endoscopic ultrasound; VR, virtual reality; 3D, three-dimensional; EVL, endoscopic band ligation; PEG, percutaneous endoscopic gastrostomy; ESD, endoscopic submucosal dissection; POEM, peroral endoscopic myotomy.

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REFERENCES

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      Digital platforms, virtual reality, and augmented reality in gastrointestinal endoscopy training
      Clin Endosc. 2025;58(5):653-661.   Published online May 23, 2025
      DOI: https://doi.org/10.5946/ce.2024.354
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    Digital platforms, virtual reality, and augmented reality in gastrointestinal endoscopy training
    Image Image
    Fig. 1. Telementoring/teleproctoring a mentee performing polypectomy. After providing in-person, hands-on training to an endoscopist in Kenya, Dr. Jerome Waye from the USA is telementoring/teleproctoring an endoscopist in performing a colon polypectomy. The software setup includes two-way simultaneous (synchronous) transmission using internet broadband (preferably 5G to reduce lag time or the files have to be compressed if 3G), bluetooth audio microphone (mentor and mentee), and videos; mentor: room view, mentee: room view and monitor view where one can switch between endoscopy view fluoroscopy view, endoscopic ultrasound (EUS) view, or picture-in-picture view based on what procedure is being performed. Adapted from Waye et al. VideoGIE 2021;6:439–442, according to the Creative Commons license.4
    Fig. 2. Learning to perform an advanced endoscopic procedure using virtual reality. An experienced endoscopist using virtual reality to enhance his skills in placing a lumen-apposing stent to drain the gallbladder using a platform designed by Boston Scientific Inc. This procedure can be practiced several times using a headset and handheld device. As shown, these devices are portable and can easily be carried in a briefcase.

    Fig. 1.

    Fig. 2.

    Digital platforms, virtual reality, and augmented reality in gastrointestinal endoscopy training
    Endoscopy training system Type of procedural training available
    Virtual Gastro Tutor (ViGaTu) Screening colonoscopy
    Endo VR Upper and lower endoscopy
    EndoSim ESD, ERCP, EUS, endoscopic suturing, ESG, TORE
    GI Mentor ERCP, EUS, ESD
    EndoVision Upper and lower endoscopy, dilation, stenting, ERCP, EUS, EMR
    Name Manufacturer Class Target
    EGD Simulator Koken Co., Ltd., Japan Mechanical EGD, ERCP
    EMS Trainer Chamberlain Group LLC, USA Mechanical EGD, CSPY
    Thompson Endoscopic Skill Trainer EndoSim LLC, USA Mechanical EGD, CSPY
    Upper GI Trainer Chamberlain Group, USA Mechanical EGD
    EGD Method Trainer Anymedi Inc., Korea Mechanical EGD
    Erlangen Active Simulator for Interventional Endoscopy Series EndoSim LLC, USA Ex vivo EGD, CSPY, ERCP, EUS
    DeLegge EndoExpert Tray DeLegge Medical, USA Ex vivo EGD, CSPY, ERCP
    EndoVR CAE Healthcare, Canada VR EGD, CSPY, ERCP
    GI Mentor II virtual endoscopy simulator Simbionix, USA VR EGD, CSPY, ERCP
    EndoSim Surgical Science, Sweden VR EGD, CSPY, ERCP
    3D Colonoscope Training Simulator NKS Kyoto Kagaku Co., Japan Mechanical CSPY
    Colonoscope Training Simulator Kyoto Kagaku Co., Japan Mechanical CSPY
    Colonoscopy Lower GI Endoscopy Simulator Koken Co., Ltd., Japan Mechanical CSPY, enteroscopy
    Colonoscopy Trainer Chamberlain Group, USA Mechanical CSPY
    EVL Simulator Glück Co., Korea Mechanical EVL
    PEG Simulator Glück Co., Korea Mechanical PEG
    Left-Hand Trainer Glück Co., Korea Mechanical EGD
    EndoGel Training Model for ESD/POEM Sunarrow Co., Japan Mechanical ESD/POEM
    ESD Training Model Koken Co., Ltd., Japan Mechanical ESD
    Table 1. Some currently available virtual, augmented, and mixed reality endoscopy training systems

    VR, virtual reality; ESD, endoscopic submucosal dissection; ERCP, endoscopic retrograde cholangiopancreatography; EUS, endoscopic ultrasound; ESG, endoscopic sleeve gastroplasty; TORE, transoral outlet reduction; GI, gastrointestinal; EMR, endoscopic mucosal resection.

    Table 2. Commercialized gastrointestinal endoscopy training systems

    Adapted from Kim et al. Clin Endosc 2023;56:1–13, according to the Creative Commons license.21

    EGD, esophagogastroduodenoscopy; ERCP, endoscopic retrograde cholangiopancreatography; CSPY, colonoscopy; EUS, endoscopic ultrasound; VR, virtual reality; 3D, three-dimensional; EVL, endoscopic band ligation; PEG, percutaneous endoscopic gastrostomy; ESD, endoscopic submucosal dissection; POEM, peroral endoscopic myotomy.

    Table 1.

    Table 2.

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