Design and Development of a Preliminary Virtual Endoluminal Surgical Simulation (VESS) for Endoscopic Submucosal Dissection (ESD) Surgery

摘要

Endoscopic Submucosal Dissection (ESD) is an endoscopic technique for en bloc resection of gastrointestinal lesions. Inadequate training platforms and lack of established training curricula have restricted its wide acceptance in the US. Thus, we aim to develop a Virtual Endoluminal Surgery Simulator (VESS) for objective ESD training and assessment.;We performed a detailed colorectal ESD task analysis and identified the critical ESD steps. We constructed a hierarchical task tree that elaborates the order of tasks in these steps. Furthermore, we generated quantitative ESD performance metrics. We measured task times and scores of 16 ESD surgeries performed by four different endoscopic surgeons. Then, we developed a preliminary VESS for lesion identification of colorectal ESD and performed a validation study at Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Annual Meeting and World Congress of Endoscopic Surgery in 2018.