Year 2020 / Volume 112 / Number 4
Review
Device-assisted enteroscopy training. A rapid review

294-298

DOI: 10.17235/reed.2020.6923/2020

Federico Soria Gálvez, Octavio López-Albors, Pilar Esteban Delgado, Enrique Pérez-Cuadrado Robles, Rafael Latorre Reviriego,

Abstract
Device-assisted enteroscopy is currently lacking a validated training model, in contrast to the other major technique used for the study of the small bowel, namely capsule endoscopy. Training should be based on defining and achieving competency for the acquisition of the knowledge and skills required to perform enteroscopy in a safe and effective manner. The need for training is clear, since the technique is considered an advanced endoscopy form that requires maneuvers that differ from the usual ones that must be learned, in addition to specific equipment. Therefore, the ideal candidates for this training include professionals with accredited experience in therapeutic digestive endoscopy. Amongst the recommendations issued regarding device-assisted enteroscopy training, the estimation of small-bowel insertion depth and the choice of the examination route, whether oral or anal, should be highlighted. Learning curve descriptions have the limitation of being explorer-dependent with no consensus on the parameter that should be selected to establish a correct learning curve in enteroscopy. The most commonly used parameter is insertion depth. The few training models that have been proposed recommend using a highly useful tool, namely simulators and to start practicing under expert guidance. Based on the variability of published data, an experienced endoscopist may perform enteroscopy in a safe and effective manner after 5 to 35 training procedures. Although reaching the expert level requires prolonged clinical practice with exposure to the various disorders of the small bowel.
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References
1. Read AJ, Rice MD, Conjeevaram HS, et al. A Deeper Look at the Small Bowel: Training Pathways in Video Capsule Endoscopy and Device-Assisted Enteroscopy. Dig Dis Sci. 2018 ;63:2210-2219. DOI: 10.1007/s10620-018-5133-1.
2. Rees CJ, Koo S, Anderson J, et al. British society of gastroenterology Endoscopy Quality Improvement Programme (EQIP): overview and progress. Frontline Gastroenterology 2019;10:148–154. DOI: 10.1136/flgastro-2018-101073.
3. Hale MF, Davison C, Panter S, et al. Practical aspects of delivering a small bowel endoscopy service in the UK. Frontline Gastroenterol 2015 ;6:132-140. DOI: 10.1136/flgastro-2015-100557.
4. Rajan E, Martinez M, Gorospe E, et al. Prospective Multicenter Study to Evaluate Capsule Endoscopy Competency using a Validated Assessment Tool. Gastrointest Endosc. 2019. pii: S0016-5107(19)32566-0. DOI: 10.1016/j.gie.2019.12.024
5. Tee HP, How SH, Kaffes AJ. Learning curve for double-balloon enteroscopy: Findings from an analysis of 282 procedures. World J Gastrointest Endosc. 2012;4:368-72. DOI: 10.4253/wjge.v4.i8.368.
6. James PD, Antonova L, Martel M, et al. Measures of trainee performance in advanced endoscopy: A systematic review. Best Pract Res Clin Gastroenterol. 2016;30:421-52. DOI: 10.1016/j.bpg.2016.05.003.
7. Pohl J, Delvaux M, Ell C, et al. European Society of Gastrointestinal Endoscopy (ESGE). Guidelines: flexible enteroscopy for diagnosis and treatment of small bowel diseases. Endoscopy 2008;40:609-618. DOI:10.1055/s-2008-1077371.
8. ASGE Training Committee 2011-2012, Rajan EA, Pais SA, et al.. Small-bowel endoscopy core curriculum. Gastrointest Endosc 2013;77:1-6. DOI: 10.1016/j.gie.2012.09.023.
9. Kim J. Training in Endoscopy: Enteroscopy. Clin Endosc. 2017;50:328-333. DOI: 10.5946/ce.2017.089.
10. Lo SK. Technical matters in double balloon enteroscopy. Gastrointest Endosc. 2007 ;66(3 Suppl):S15-8. DOI:10.1016/j.gie.2007.05.046.
11. Schafer ME, Lo SK. Navigating beyond the ligament of Treitz: an introduction to learning enteroscopy. Gastrointest Endosc. 2010 ;71:1029-32. DOI: 10.1016/j.gie.2010.02.045.
12. Feurer ME, Draganov PV. Training for advanced endoscopic procedures. Best Pract Res Clin Gastroenterol. 2016;30:397-408. DOI: 10.1016/j.bpg.2016.04.005.
13. Buscaglia JM, Okolo PI 3rd. Deep enteroscopy: training, indications, and the endoscopic technique. Gastrointest Endosc. 2011;73:1023-8. DOI: 10.1016/j.gie.2011.01.026.
14. Spada C McNamara D, Despott EJ, et al. Performance measures for small-bowel endoscopy: A European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative. United European Gastroenterol J. 2019;7:614-641. DOI: 10.1177/2050640619850365.
15. Kashani A, Abboud G, Lo SK, et al. Double balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in Roux-en-Y gastric bypass anatomy: expert vs. Novice experience. Endosc Int Open. 2018 ;6:E885-E891. DOI: 10.1055/a-0599-6059.
16. Waschke KA, Anderson J, Valori RM, et al. ASGE principles of endoscopic training. Gastrointest Endosc. 2019;90:27-34. DOI: 10.1016/j.gie.2018.10.017.
17. Rondonotti E, Spada C, Adler S, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review. Endoscopy. 2018;50:423-446. DOI: 10.1055/a-0576-0566.
18. Chokshi RV, Hovis CE, Hollander T, et al. Prevalence of missed adenomas in patients with inadequate bowel preparation on screening colonoscopy. Gastrointest Endosc 2012; 75: 1197–1203. DOI: 10.1016/j.gie.2012.01.005.
19. May A, Nachbar L, Schneider M, et al. Push-and-pull enteroscopy using the double-balloon technique: method of assessing depth of insertion and training of the enteroscopy technique using the Erlangen Endo-Trainer. Endoscopy. 2005 ;37:66-70. DOI:10.1055/s-2004-826177.
20. López-Albors O, Soria F, Pérez Cuadrado E, et al. Validity of insertion depth measurement in double-balloon endoscopy. Endoscopy. 2012;44:1045-50. DOI: 10.1055/s-0032-1310106.
21. Mehdizadeh S, Han NJ, Cheng DW, et al. Success rate of retrograde double-balloon enteroscopy. Gastrointest Endosc. 2007 ;65:633-9. DOI: 10.1016/j.gie.2006.12.038.
22. Mehdizadeh S, Ross A, Gerson L, et al. What is the learning curve associated with double-balloon enteroscopy? Technical details and early experience in 6 U.S. tertiary care centers. Gastrointest Endosc. 2006 ;64:740-50. DOI:10.1016/j.gie.2006.05.022.
23. Gross SA, Stark ME. Initial experience with double-balloon enteroscopy at a U.S. center. Gastrointest Endosc. 2008;67:890-7. DOI: 10.1016/j.gie.2007.07.047.
24. Dutta AK, Sajith KG, Joseph AJ, et al. Learning curve, diagnostic yield and safety of single balloon enteroscopy. Trop Gastroenterol. 2012;33:179-84. DOI:10.7869/tg.2012.45.
25. Su MY, Lin WP, Chiu CT. Experience of double balloon enteroscopy. J Chin Med Assoc. 2018 ;81:225-229. DOI: 10.1016/j.jcma.2017.06.020.
26. Chen, A, Navdeep C, Levihim S et al. Su1353. Double-balloon enteroscopy at a single U.S.. tertiary center: a large 7-year experience. Gastrointestinal Endoscopy 2019; 89 (6): AB342 - AB343. DOI: https://doi.org/10.1016/j.gie.2019.03.480
27. Jeon SR, Kim JO. Deep enteroscopy: which technique will survive? Clin Endosc. 2013 ;46:480-5. DOI: 10.5946/ce.2013.46.5.480.
28. Yamamoto H, Yano T, Ohmiya N, et al. Double-balloon endoscopy is safe and effective for the diagnosis and treatment of small-bowel disorders: prospective multicenter study carried out by expert and non-expert endoscopists in Japan. Dig Endosc. 2015 ;27:331-7. DOI: 10.1111/den.12378.
29. Perez-Cuadrado E, Latorre R, Carballo F, et al. Training and new indications for double balloon endoscopy (with videos). Gastrointest Endos 2007; 66 Supp: S39-S46. DOI: https://doi.org/10.1016/j.gie.2007.02.058
30. Soria F, López-Albors O, Latorre R, et al. Entrenamiento en enteroscopia. Modelo fresco ex vivo, modelo animal, simuladores, tutorización. Programas de entrenamiento para técnica asistida por balón y espiral. En Pérez-Cuadrado E (editor). Enteroscopy. (1ª edición). Sevilla: Sulime ediciones; 2014:página inicio-página final.
31. Akerman PA, Cantero D, Bookwalter WH, et al. A new in vitro porcine model for spiral enteroscopy training. The Akerman enteroscopy trainer. Gastrointest Endosc. 2008;67:AB264. DOI: 10.1016/j.gie.2008.03.722.
32. Maiss J, Diebel H, Naegel A, et al. A novel model for training in ERCP with double-balloon enteroscopy after abdominal surgery. Endoscopy. 2007;39:1072-5. DOI:10.1055/s-2007-96702.
33. Buscaglia JM, Dunbar KB, Okolo PI 3rd, et al. The spiral enteroscopy training initiative: results of a prospective study evaluating the Discovery SB overtube device during small bowel enteroscopy (with video). Endoscopy. 2009;41:194-9. DOI: 10.1055/s-0028-1119602.
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Soria Gálvez F, López-Albors O, Esteban Delgado P, Pérez-Cuadrado Robles E, Latorre Reviriego R. Device-assisted enteroscopy training. A rapid review. 6923/2020


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Publication history

Received: 30/01/2020

Accepted: 16/02/2020

Online First: 20/03/2020

Published: 07/04/2020

Article Online First time: 50 days

Article editing time: 68 days


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