Unsupervised Training Proves Effective for Esophago-Gastric Endoscopic Submucosal Dissection

Experienced endoscopists seeking competence in endoscopic submucosal dissection (ESD) faced a challenging learning curve. This study introduced an unsupervised training model. Endoscopists initially observed 30 ESD cases and performed 15 unsupervised ex-vivo ESDs. Afterward, they tackled five human distal gastric ESDs and 55 unselected esophago-gastric cases. Results were promising, with a 93.0% en-bloc resection rate, 80.7% R0 resection rate, and an average operative time of 14.0 minutes per centimeter. Unsupervised training appears to successfully guide experienced endoscopists toward ESD competence.