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Diagnostic and Therapeutic Endoscopy
Volume 2011, Article ID 847831, 8 pages
http://dx.doi.org/10.1155/2011/847831
Research Article

Learning Curve in a Western Training Center of the Circumferential En Bloc Esophageal Endoscopic Submucosal Dissection in an In Vivo Animal Model

1Gastroenterology Department, World Gastroenterology Organisation Training Center, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga No. 15, Colonia Seccion XVI, Delegacion Tlalpan, 14000 Mexico City, DF, Mexico
2Surgery and Experimental Surgery Department, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga No. 15, Colonia Seccion XVI, Delegacion Tlalpan, 14000 Mexico City, DF, Mexico
3Shinmidori Hospital Yokohama, Yokohama 226-0025, Japan
4Pathology Department, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga No. 15, Colonia Seccion XVI, Delegacion Tlalpan, 14000 Mexico City, DF, Mexico
5Experimental Surgery Department, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
6Animal Lab and Experimental Research Department, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Vasco de Quiroga No. 15, Colonia Seccion XVI, Delegacion Tlalpan, 14000 Mexico City, DF, Mexico

Received 26 May 2011; Revised 30 June 2011; Accepted 2 July 2011

Academic Editor: Shai Friedland

Copyright © 2011 Miguel A. Tanimoto et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. Evaluate the feasibility to overcome the learning curve in a western training center of the en bloc circumferential esophageal (ECE-) ESD in an in vivo animal model. Methods. ECE-ESD was performed on ten canine models under general anesthesia on artificial lesions at the esophagus marked with coagulation points. After the ESD each canine model was euthanized and surgical resection of the esophagus and stomach was carried out according to “the Principles of Humane Experimental Technique, Russel and Burch.” The specimen was fixed with needles on cork submerged in formalin with the esophagus and stomach then delivered to the pathology department to be analyzed. Results. ECE-ESD was completed without complications in the last 3/10 animal models. Mean duration for the procedures was 1 9 2 ± 3 5 minutes (range 140–235 minutes). All the procedures were done at the animal lab surgery room with cardio pulmonary monitoring and artificial ventilation by staff surgery members and a staff member of the Gastroenterology department trained during 1999–2001 at the Fujigaoka hospital of the Showa U. in Yokohama, Japan, length (range 15–18 mm) and 5 1 ± 6 . 9 9 width (range 40–60 mm). Conclusion. ECE-ESD training is feasible in canine models for postgraduate endoscopy fellows.