Endoscopic tip-control measured by a snare tip soft coagulation training model correlates with endoscopist profile and therapeutic expertise (The HAM Study)
Debels, Lynn Sorge, Andrea Argenziano, Maria Lala, Vikash Montori, Michele Poortmans, Pieter Smeets, Sander Tornai, Tamas Van Vlierberghe, Hans Desomer, Lobke
Debels, Lynn
Sorge, Andrea
Argenziano, Maria
Lala, Vikash
Montori, Michele
Poortmans, Pieter
Smeets, Sander
Tornai, Tamas
Van Vlierberghe, Hans
Desomer, Lobke
Glos Author
Date
2025-03-03
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Journal Article
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Abstract
Objective Operator technical skill is recognised as a critical determinant of surgical outcomes. However, no equivalent recognition for quality of endoscope tip manipulation (tip-control) exists. We aimed to create an ex-vivo snare tip soft coagulation (STSC) model to objectively quantify endoscopist tip-control.
Method This prospective interventional study was conducted at Ghent University Hospital. Participants applied STSC to a training model simulating four endoscopic mucosal resection (EMR) defects on a slice of ham. Accuracy (correct/total-hits) and speed (correct-hits/s) were assessed from a video by a single-blinded rater using a web-based scoring system.
Results 22 endoscopists participated. Interventional endoscopists demonstrated significantly higher accuracy (87.0%) and speed (0.184 correct-hits/s) compared with trainees (74.5%, 0.106 correct-hits/s; both p<0.001) and non-interventional consultants (77%, 0.141 correct-hits/s; p<0.001). The tip-control of trainees and non-interventional consultants was not significantly different. Endoscopists having performed ≥1000 colonoscopies, performing SMSA-4 polypectomies or ≥50 EMRs/year showed superior tip-control. Endoscopists with >5 years of endoscopic experience did not have better tip-control (accuracy 88.0%(p=0.07), speed 0.132 hits/s (p=0.36)) when compared with those with ≤4 years of experience.
Conclusion This inexpensive ex vivo STSC simulation model effectively quantified endoscopic tip-control, correlating with endoscopist expertise and clinical profiles. The model could support the shift towards competency-based education, potentially improving patient outcomes.
Citation
Debels, L. K., Sorge, A., Argenziano, M. E., et al. (2025). Endoscopic tip-control measured by a snare tip soft coagulation training model correlates with endoscopist profile and therapeutic expertise (The HAM Study). Frontline Gastroenterology. Advance online publication. https://doi.org/10.1136/flgastro-2024-103044