Validation of the X-Vision ERCP Training System and technical challenges during early training of sphincterotomy.

von Delius, S; Thies, P; Meining, A; Wagenpfeil, S; Burian, M; Huber, W; Weidenbach, H; Ebert, MP; Neu, B; Ludwig, L; Almeida, J; Prinz, C; Schmid, RM; Frimberger, E

doi:10.1016/j.cgh.2008.11.004

2009

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Titel:: Validation of the X-Vision ERCP Training System and technical challenges during early training of sphincterotomy.
Dokumenttyp:: Journal Article; Research Support, Non-U.S. Gov't; Validation Studies
Autor(en):: von Delius, S; Thies, P; Meining, A; Wagenpfeil, S; Burian, M; Huber, W; Weidenbach, H; Ebert, MP; Neu, B; Ludwig, L; Almeida, J; Prinz, C; Schmid, RM; Frimberger, E
Abstract:: BACKGROUND & AIMS: A new fluoroscopy-free training system for endoscopic retrograde cholangiopancreatography (ERCP) with different model subtypes recently was developed. This study aimed to establish construct validity by investigating whether the X-Vision ERCP Training System could distinguish experienced endoscopists from beginners and to reveal characteristic mistakes during sphincterotomy. METHODS: Six staff gastroenterologists that practice ERCP, 10 trainees that perform esophagogastroduodenoscopy and colonoscopy, and 12 residents without endoscopic experience each sequentially attempted 4 different models, simulating selective cannulation of the pancreatic or bile duct, intubation of differently arranged rubber papillas, stent placement, and sphincterotomy of a biopapilla. Performance parameters were recorded and participants' expectations were compared before and after training to determine whether the simulator was a credible tool for ERCP training. Staff gastroenterologists graded the realism and utility of the simulation. The quality of sphincterotomy was assessed by an expert endoscopist. RESULTS: Participants with ERCP experience had significantly shorter procedure times compared with those with intermediate (P < .001) or no endoscopic experience (P < .001). Total and single credibility scores significantly increased after simulator practice. The faculty found the X-Vision ERCP Training System to be realistic and useful for training. In the less-experienced groups, common mistakes made during sphincterotomy included inadequate positioning of the duodenoscope, traumatic intubation of the papilla, and continued cutting despite insufficient endoscopic view. CONCLUSIONS: The X-Vision ERCP Training System distinguished subjects with different levels of experience and was regarded as realistic and useful for ERCP training. Common mistakes during sphincterotomy could be assessed objectively.
Zeitschriftentitel:: Clin Gastroenterol Hepatol
Jahr:: 2009
Band / Volume:: 7
Heft / Issue:: 4
Seitenangaben Beitrag:: 389-96
Sprache:: eng
Volltext / DOI:: doi:10.1016/j.cgh.2008.11.004
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/19049832
Print-ISSN:: 1542-3565
TUM Einrichtung:: II. Medizinische Klinik und Poliklinik (Gastroenterologie); Institut für Medizinische Statistik und Epidemiologie
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