结肠内镜下粘膜下解剖远程操作培训系统的潜力

Q3 Medicine

VideoGIE Pub Date : 2025-04-06 DOI:10.1016/j.vgie.2025.03.037

Kohei Ono MD , Ken Ohata MD, PhD , Daisuke Ide MD, PhD , Akiko Ohno MD, PhD , Takashi Muramoto MD, PhD , Yosuke Tsuji MD, PhD , Hideyuki Chiba MD, PhD , Hiroaki Kato LLB

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引用次数: 0

摘要

背景和目的实践培训在内窥镜技能的获得中起着至关重要的作用；然而，由于教学本身的触觉和直接性质，它向在线格式的过渡一直被认为是具有挑战性的。自2020年起，开展结直肠内镜粘膜下解剖术（ESD）在线培训班，共举办9期，培训75人。本研究的目的是评估我们的结肠直肠ESD远程实践培训计划的有效性。方法使用50mbps的有线连接，我们将一个中心设施连接到日本的3个远程站点。一个集成手、镜、姿势和内窥镜视图的4屏幕画中画（PinP）视频进行了实时演示。每位参与者都进行了70分钟的结构化培训，包括使用Scope handling training （ST）工具包的初始计时赛和最终计时赛、内窥镜操作练习以及使用人工模型的动手ESD培训。在远程操作阶段，受训者在完成手术过程的同时，通过一个Picture-in-Picture视频系统接受专家的实时指导，该系统显示内窥镜视图和手部运动。音频或视频通信没有可检测到的延迟，实现了无缝的双向交互。结果训练前后进行的ST kit计时赛结果显示，训练后的速度有显著提高（从训练前的89.3秒提高到训练后的49.4秒）。此外，在参与者中进行的问卷调查显示，94%的人表示希望将来参加类似的远程培训课程。结论结肠ESD涉及到精细和高度复杂的技术，即使在面对面的情况下也具有挑战性。然而，我们能够在这个项目中提供高质量的教学。这种方法为偏远地区的医生提供了培训机会，减少了时间、旅行和成本的负担，并有可能成为未来一种有前途的教育工具。

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Potential for remote hands-on training system for colorectal endoscopic submucosal dissection

Background and Aims

Hands-on training plays a crucial role in the acquisition of endoscopic skills; however, its transition to an online format has been considered challenging due to the inherently tactile and direct nature of instruction. Since 2020, we have conducted an online colorectal endoscopic submucosal dissection (ESD) training course, holding 9 sessions and training a total of 75 participants. The aim of this study is to evaluate the effectiveness of our remote hands-on training program for colorectal ESD.

Methods

Using a wired 50 Mbps connection, we linked a central facility to 3 remote sites across Japan. A 4-screen Picture-in-Picture (PinP) video integrating hand, scope, posture, and endoscopic views was streamed for real-time demonstration. Each participant underwent a structured 70-minute training session consisting of an initial and final time trial using the Scope handling Training (ST) kit, endoscope handling practice, and hands-on ESD training with an artificial model. During the remote hands-on phase, trainees performed procedures while receiving real-time instruction from experts via a Picture-in-Picture video system, which displayed both the endoscopic view and hand movements. There were no detectable delays in audio or video communication, enabling seamless 2-way interaction.

Results

The results of the ST kit time trials conducted before and after the training showed a significant improvement in speed after the training (from 89.3 seconds before training to 49.4 seconds after training). Additionally, a questionnaire survey conducted among participants revealed that 94% expressed a desire to participate in similar remote training sessions in the future.

Conclusions

Colorectal ESD, which involves delicate and highly intricate techniques, is challenging to teach even in face-to-face settings. However, we were able to provide high-quality instruction in this program. This method provides training opportunities for physicians in remote areas, reducing the burden of time, travel, and costs, and has the potential to become a promising educational tool for the future.

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.