Video based supervision for ESD training

Aims: While porcine model training is commonly used for learning ESD, there are limited Western ESD experts to supervise training. We aimed to assess the value of a video-based remote supervision for ESD training.
Methods: Two Western endoscopists who had no prior experience of ESD performed training procedures in an ex-vivo porcine stomach. A Japanese ESD expert analyzed the training videos, scored them, and gave written feedback for improvement after each training session. Competency was defined as consistent en-bloc resection of 3cm area within 30 minutes, and without perforation.
Results: Endoscopists 1 (attending) and 2 (fellow) reached competency at 23 and 25 procedures, respectively. No difference in skill improvement between the two endoscopists was noted.
Conclusion: Animal training with expert guidance through a remote video-based system is an effective tool for learning ESD in preparation for starting human cases.