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Ex Vivo Bovine Model : A Diagnostic and Therapeutic Endoscopy Training Model

Jaspreet Sandhu, MD1, Carl Winkler, MD2, Xiaohong Yan, PhD2, Chandana Herath Mudiyanselage, PhD2, Vesna Cekic, RN2, Nipa Gandhi, MD2, Richard Whelan, MD2. 1Brookdale University Hospital Medical Center, 2Mount Sinai West Hospital

Introduction: Flexible endoscopy is an integral part of General and Colorectal Surgery. The American Board of Surgery (ABS) now mandates endoscopy training and successful completion of the Fundamentals of Endoscopic Surgery program. As a result simulators have become a ubiquitous tool for pre-clinical training.  While simulators are useful for learning scope insertion and maneuvering skills, they do not convey a realistic sense of bowel compliance and tissue handling.  We have developed an ex vivo bovine model to be used as an adjunct to endoscopy simulators.  Once insertion and maneuvering skills have been acquired, trainees will use this model to learn the following basic diagnostic and therapeutic endoscopy skills:  1) forceps biopsy, 2) saline lift / tattooing, and 3) polypectomy.

Method: A bovine colon obtained from a slaughterhouse is cleaned, and the proximal end is everted to expose the mucosa. Targets for biopsy and saline lift are created (branded) using a heated nail head. Polyps are made using a hemorrhoid bander. Once the lesions are created, the end is inverted and sealed using a clip.  The colon is insufflated, and the trainees proceed to biopsy 6 targets, lift 6 targets, and snare 4 polyps.  The difficulty level can be increased by placing the colon in different configurations.

Results/Conclusion: The ex vivo bovine model provides realistic visual and tactile feedback. Further, it mimics clinical endoscopy in terms of tissue handling, scope manipulation using torque and tip deflection, insufflation, lens cleaning, as well as through the channel instrumentation.  These advantages enable optimal pre-clinical training in basic diagnostic and therapeutic endoscopy after scope insertion and maneuvering skills have been acquired.  Early experience in this ongoing study indicates that proficiency with the model can be obtained in 5 sessions.  Gaining proficiency with the ex vivo bovine model allows trainees to develop more advanced skills during their subsequent clinical exposure to endoscopy.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 87039

Program Number: V118

Presentation Session: Friday Exhibit Hall Theater (Non CME)

Presentation Type: EHVideo

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