Wichmann Dörte, Grether Sarah, Fundel Jana, Schweizer Ulrich, Wedi Edris, Walter Benjamin, Königsrainer Alfred, Duckworth-Mothes Benedikt
Working Group for Experimental Endoscopy, Development and Training, University Hospital of Tübingen, Waldhörnlestrasse 22, 72072 Tübingen, Germany.
Interdisciplinary Endoscopic Unit, University Hospital of Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, Germany.
J Clin Med. 2023 Apr 30;12(9):3230. doi: 10.3390/jcm12093230.
For endoscopists, knowledge of the available hemotherapeutic devices and materials as well as competence in using them is a life-saving expertise in the treatment of patients with acute gastrointestinal bleeding. These competences can be acquired in training on live animals, animal organs, or simulators. We present an animal tissue-free training model of the upper gastrointestinal tract for bleeding therapy.
An artificial, animal tissue-free mucosa and submucosa with the opportunity of injection and clipping therapy were created first. Patches with this artificial mucosa and submucosa were placed into silicone and latex organs with human-like anatomy. Esophageal bleeding situations were imitated as variceal bleeding and bleeding of a reflux esophagitis in latex organs. Finally, a modular training model with human anatomy and replaceable bleeding sources was created. Evaluation of the novel model for gastroscopic training was performed in a multicentric setting with endoscopic beginners and experts.
Evaluation was carried out by 38 physicians with different levels of education in endoscopy. Evaluation of the model was made with grades from one (excellent) to six (bad): suitability for endoscopic training was 1.4, relevance of the endoscopic training was 1.6, and grading for haptic and optic impression of the model was 1.7.
The creation of a gastroscopic model for the training of hemostatic techniques without animal tissues was possible and multiple endoscopic bleeding skills could be trained in it. Evaluation showed good results for this new training option, which could be used in every endoscopic unit or other places without hygienic doubts.
对于内镜医师而言,了解可用的血液治疗设备和材料以及使用这些设备的能力是治疗急性胃肠道出血患者的一项救命技能。这些能力可以在对活体动物、动物器官或模拟器的培训中获得。我们提出了一种用于出血治疗的上消化道无动物组织训练模型。
首先创建了一种可进行注射和钳夹治疗的人工无动物组织黏膜和黏膜下层。将带有这种人工黏膜和黏膜下层的贴片放置到具有类人解剖结构的硅胶和乳胶器官中。在乳胶器官中模拟食管静脉曲张出血和反流性食管炎出血等食管出血情况。最后,创建了一个具有人体解剖结构和可更换出血源的模块化训练模型。在多中心环境中,由内镜初学者和专家对这种新型胃镜训练模型进行评估。
38名接受过不同程度内镜培训的医生进行了评估。对该模型的评估采用从1分(优秀)到6分(差)的评分:内镜训练适用性评分为1.4分,内镜训练相关性评分为1.6分,模型的触觉和视觉印象评分为1.7分。
创建一种无需动物组织即可训练止血技术的胃镜模型是可行的,并且可以在其中训练多种内镜出血技能。评估结果表明这种新的训练方法效果良好,可在每个内镜科室或其他不存在卫生疑虑的场所使用。