ESD KNOW-HOW & Self Training
ESD basic technique
- chap 3: T Oyama, N Yahagi. Principles of endoscopic resection: Diagnostic and curative resection of mucosal neoplasias. pp 47-52.
3.4-3.6 ESD: basic techniques, outcome, complications and management; learning ESD. pp 53-62.
In: Atlas of Early NPL of the GIT, Berr F, Oyama T, Ponchon T, Yahagi N (eds), 2nd ed, Springer New York, 2019 - ESD Know-how: Techniques, electrosurgical settings, experimental training, material list®
Syllabus – ESD Hands-on Workshop , Berr F, Kiesslich T (unpublished; updated 2024)
ESD Training with antegrade-cut ESD knives
(Dual-J®-, Hook-J®-, Flush-BT®-knife, HYBRIDknife-flex®)
- Yahagi N. Colorectal ESD Training using Dual knife (Olympus ESD Self-Learning tool)
*** basic program on endoscope and knife manipulation for beginners, and set-up for training on ex-vivo porcine stomach. - alternative novel synthetic training model: EndoGel® Simulator Endogel® Information
Ex-vivo ESD Training
≥20 experimental ex-vivo ESD procedures (team work with knife type of your preference)
- Model see Yahagi above (porcine stomach or bovine colon) or synthetic simulator "EndoGel"
final series of 10 ex-vivo ESD (>90% en-bloc) without perforation. - Consider training with ATRACT device® for use in Clinical ESD (Video). M Pioche ESDschool
Observation of clinical ESD procedures:
≥20 expert ESDs in different anatomic GI locations:
- personal reflection of indication, strategy, risks of ESD (alternative approaches) for that lesion.
- document indication, graph of lesion, sequential ESD steps (strategy), procedure time.
Mentorship for ESD indication and ESD assistance
during ESD Hands-on Workshop or ESD Clinical Tutoring Course
- answer/demonstrate personal know-how during ESD assistance
- document as above
First Clinical ESD (n≥10) under supervision by expert ESD mentor
- diagnostic endoscopy (ESD indication & strategy) before scheduling of the patient
- fully informed consent of the patient
- ESD procedure: complete video recording & image documentation (lesion, ESD steps, AE, outcome, register for follow-up)
Lectures on:
ESD Know-how
- (2015) Toyonaga T: Principles of electrosurgery used for ESD and ESR
- (2015) Uraoka T: Three-hands-technique, skills and strategies for ESD
- (2018) Kato M: Technical skills and tricks for ESD
- (2017) Oyama T: Esophageal ESD
- (2017) Messmann H: ESD, EMR or RFA in Barrett´s esophagus
- (2017) Yahagi N: ESD in colorectum
- (2018) Toyonaga T: Lesion-specific strategies for ESD and STER in GI tract
- (2017) Ziachehabi A: Alternative approaches for en-bloc resection
- (2016) Hochberger J: Using tunelling for resection of submucosal tumors: STER / SET / EFTR
ESD Complications
- (2016) Berr F: ESD analysis for frequent errors - prevent complications
- (2017) Toyonaga T: ESD complications
- (2016) Wagner A, Berr F: Management of residual or recurrent early neoplasia
- (2016) Toyonaga T: Manage perforation: clip suture / loop trick / omental patch
- (2016) Hochberger J: OTSC for salvage of thin-walled resection beds
- (2017) Kantsevoy SV: Endoscopic suturing in ESD and EFTR
ESD Cases
Takashi Toyonaga / Kobe, JP
Pat. (82 y.o. female, ASA II) referred by Michael Anzinger / Munich
Tsuneo Oyama / Saku, Nagano, JP
Moderator: Alexander Ziachehabi / Linz, AT
Appendix - ESD Material List
- pp 45-48 in Syllabus – ESD Hands-on Berlin 2024 (For complete access: „user2024“ and „updt2024“
ESGE position statement for ESD training curriculum
(& trainee Log book and excel files for Preclinical and Clinical training register)