Читать книгу Successful Training in Gastrointestinal Endoscopy - Группа авторов - Страница 2
Table of Contents
Оглавление1 Cover
5 Foreword
6 Preface
9 I: The Evolution of Basic Principles and Practice 1 Training in Endoscopy Introduction Standard training in endoscopy: then and now Standards and end points of current endoscopic training Emergence of complementary teaching modalities The future of simulators in endoscopy training A peek into the future of endoscopic training to 2030 Conclusion References 2 How Endoscopy is Learned Introduction Identification of fundamental endoscopy skills Introduction of the scope Navigation Overcoming obstacles Inspection Instrumentation Simulators and task deconstruction Summary References 3 Training to Become a High‐Quality Endoscopist Preprocedure Intraprocedure Postprocedure Conclusion References 4 Training the Endoscopic Trainer Introduction Training environment Attributes of effective endoscopy trainers Framework for endoscopic training Training aids Train‐the‐trainer programs Conclusions References
10 II: Training in the Major Endoscopic Procedures 5 Esophagogastroduodenoscopy (EGD) Introduction to EGD training Requirements for EGD training EGD training Alternatives for EGD training: simulator‐based training Assessment of performance Conclusions Videos References 6 Colonoscopy Introduction Early skills Intermediate skills How to teach and assess colonoscopy skills Videos References 7 Endoscopic Ultrasound EUS requires different skill sets than standard endoscopy Learning resources for EUS The skill sets needed to learn EUS Pathways for EUS training Complementary training options Conclusion References 8 ERCP Introduction to ERCP training Prerequisite for training ERCP training Alternatives for ERCP training Assessment of performance Training and clinical outcome correlation How much volume is needed to maintain skill—retraining and new techniques The role of the assistant Conclusion Videos References 9 Capsule Endoscopy Introduction Description of the capsules The capsule endoscopy unit Preparing the patient Administering the capsule Capsule endoscopy reading in clinical settings Reading capsule endoscopy study Credentialing the capsule endoscopist: current guidelines Training the capsule endoscopist: current literature Conclusions References 10 Deep Enteroscopy Introduction Prerequisites for training in deep enteroscopy Cognitive component of deep enteroscopy Equipment for deep enteroscopy Technical aspects of enteroscopy training Advancement technique(s) Therapeutic enteroscopy maneuvers Ex vivo training models Conclusion Videos References 11 Cholangioscopy and Pancreatoscopy Introduction Technique of cholangiopancreatoscopy Trainee prerequisites Summary Videos References 12 Principles of Electrosurgery Introduction Basics of electricity as applied to electrosurgery Monopolar and bipolar circuits Safety measures in electrosurgery Tissue effects of electrosurgery in endoscopy Clinical applications of electrosurgery in endoscopy Incorporation of electrosurgical principles into endoscopy training References 13 Training in the Use of Fluoroscopy for Gastrointestinal Endoscopy Introduction Training in fluoroscopy Hardware basics Protective garments Scout films ERCP Fluoroscopy and enteral stents Enteroscopy Lumen‐apposing metal stents (LAMS) Conclusion References 14 Training in Pediatric Endoscopy Introduction Training program requirements Esophagogastroduodenoscopy and colonoscopy Patient assessment Informed consent Sedation Cognitive aspects of training in sedation Technical aspects of training in sedation Upper endoscopy Technical skills Instruments Colonoscopy Cognitive skills Technical skills Instruments Diagnostic techniques in upper endoscopy and colonoscopy Identifying pathology Therapeutic procedures in pediatric endoscopy Percutaneous endoscopic gastrostomy (PEG) Stricture dilation Management of GI bleeding The role of adult endoscopists in pediatrics Defining and assessing procedural competency Assessing competency Simulation in pediatric endoscopy Advanced procedures Endoscopic retrograde cholangiopancreatography (ERCP) Endoscopic ultrasound Wireless video capsule endoscopy References
11 III: Training in Specific Techniques 15 Contrast‐Enhanced Endoscopy Introduction Overview of contrast (image)‐enhancement techniques: chromoendoscopy and other optical techniques Chromoendoscopy FICE, BLI, BLI‐Bright, LCI, and iScan Evidence for effect of training Summary Videos References 16 Training in GI Hemostasis Introduction Prerequisite cognitive knowledge required prior to learning GI endoscopic hemostatic techniques Prerequisite technical knowledge and skills required to learn endoscopic hemostasis Required technical knowledge and skills to be proficient in endoscopic hemostasis Common knowledge and skills for all hemostatic strategies Specific hemostatic strategies Thermal Mechanical Simulators to learn and practice endoscopic hemostasis Available models of endoscopic hemostasis Teaching in endoscopic hemostasis Data supporting the role of hemostasis training on simulators Learning progress in endoscopic hemostasis Concept of integrating simulator work into standard endoscopy training Maintaining skills in endoscopic hemostasis Additional teaching aides for learning GI hemostasis Limitations of GI endoscopy for diagnosis and hemostasis of GI bleeding: teaching pearls for troubleshooting and challenges for the future Definition of minimal thresholds for determining competency in endoscopic hemostasis Requirements to maintain endoscopic hemostasis skills Ongoing challenges in learning new GI hemostasis techniques or improving skills Summary Acknowledgment Videos References 17 Luminal Dilation Techniques (Strictures, Achalasia, Anastomotic, IBD) Introduction Equipment Ancillary devices Endoscope key points to remember Fluoroscopy Mechanism of dilation Technique of dilation Goal Ancillary techniques Contraindications Some key points Achalasia Endoscopy and performance of pneumatic balloon dilation in achalasia Suggested skill set to master and potential outcome measures to assess proficiency in performing luminal dilation Suggested skill level to perform dilation Videos References 18 Management of Foreign Body Ingestion and Esophageal Food Bolus Obstruction Introduction Training in FB extraction Pre‐procedure assessment Identify devices Anticipate the endoscopy Endoscopic removal Further evaluation Conclusions Videos References 19 Endoscopic Mucosal Resection, Submucosal Dissection, and Full Thickness Resection Techniques Introduction Endoscopic mucosal resection Endoscopic submucosal dissection Post‐EMR and post‐ESD management Management of complications When to use EMR and when ESD? Training and first steps in ESD Endoscostrapic Full Thickness Resection using the Ovesco eFTRD® system Conclusions and perspectives Videos References 20 Mucosal Ablation Techniques Introduction Procedures and equipment involved in mucosal ablation Prerequisite cognitive and technical skills for trainees prior to learning mucosal ablation Setting of training Specific knowledge trainees must acquire during training to perform esophageal mucosal ablation Equipment and technical steps Opportunities and methods for training in mucosal ablation Defining competency Maintaining skill level Videos References 21 Complicated Polypectomy Patient assessment and consent Timing Endoscopy Team General principles The electrosurgical unit Carbon dioxide Snares for polypectomy The snare handle as an information center Safety in snare handling Techniques for successful removal of sessile polyps Special techniques for sessile polyps Pedunculated polyps Fluid injection The non‐lifting lesion Retroflexion EMRC Lesions involving the ileocecal valve Lesions at the appendiceal orifice Lesions at the anorectal junction (Video 21.8) Circumferential lesions Endoscopic submucosal dissection (Videos 21.9 and 21.10) Endoscopic full thickness resection Adjuvant thermal ablation of the resection margin Defect closure with mechanical clips Deep mural injury Surveillance Two‐stage EMR Adverse events associated with complex polypectomy Training and achieving competency in endoscopic tissue resection Summary Videos References 22 Training and Credentialing in Natural Orifice Transluminal Endoscopic Surgery (NOTES) Training Credentialing Conclusion References 23 Training in Bariatric Endoscopy Bariatric endoscopy procedures Training goals Infrastructure and personnel Pre‐procedural assessment Equipment Procedural considerations and techniques Bariatric endoscopy procedures Endoscopic management of post‐bariatric surgery complications Revisional procedures for weight regain Primary bariatric and metabolic procedures Defining competency for particular skill Conclusion References 24 Repair of Mucosal Defects Introduction Learning to close perforations Conclusion Videos References 25 Esophageal, Gastroduodenal, and Colorectal Stenting Procedure(s) to be considered Prerequisite level of expertise and skill for learning this Special considerations Specific technical and cognitive skill sets Equipment Key steps of proper technique Defining competency Maintaining skill level Videos References 26 ERCP Management of Complicated Stone Disease of the Bile Duct and Pancreas Mechanical lithotripsy Large‐diameter balloon sphincteroplasty Cholangiopancreatoscopy Electrohydraulic lithotripsy Laser lithotripsy Extracorporeal shock wave lithotripsy and pancreatic duct stones Endoscopic ultrasound as an adjunct Difficult anatomy Training modalities Competency Videos References 27 ERCP Management of Malignancy Introduction Tissue sampling at ERCP Metal stent placement Management of ampullary neoplasms Thoughts on advanced endoscopy training Videos References 28 Sphincter of Oddi Manometry Patient selection Method of SOM Technical performance of SOM (see accompanying Video 28.1) Interpretation criteria Reproducibility of SOM Complications of SOM Training in SOM Video References 29 Training for Pseudocyst Management Procedure(s) to be considered Prerequisite level of expertise and skill for learning this Special considerations Specific technical and cognitive skill sets Equipment 0.018”–0.035” guidewires (depending on needle used) Pre‐drainage evaluation Setting and tools for training Defining competency Maintaining skill level Videos References 30 Enteral Access Techniques Introduction Prerequisite expertise and skill Setting Equipment Key steps for proper technique Starting enteral nutrition Setting and tools for training Defining competency Maintenance of skills Videos References 31 Training in GI Upper Motility Techniques Esophageal manometry testing Conclusion Wireless motility capsule (WMC) testing WMC procedure WMC interpretation Assessment of gastric emptying Specific applications of WMC testing Possible complications References 32 Training in the Endoscopic Management of Anorectal Disorders Introduction Prerequisite cognitive and technical skills for trainees prior to learning DRE anoscopy and hemorrhoid treatment Specific knowledge trainees must acquire during training to perform office hemorrhoid banding Selection of particular treatment method Anticoagulation considerations Post banding analgesia Incision and drainage of acutely thrombosed external hemorrhoids Anal fissures Anal pruritus Treatment Anorectal manometry References 33 The Endoscopic Management of Immediate Complications of Therapeutic Endoscopy Introduction Assessing risk prior to procedure Intraprocedure recognition of complications Videos References
12 IV: Challenges for the Future 34 Assessing Manpower Needs in Gastroenterology and Digestive Endoscopy Modeling manpower Physician workforce estimates Gastroenterology workforce modeling Future projections in gastroenterology: lessons from the past Endoscopic demands for screening colonoscopy Conclusions Acknowledgments References 35 International Opportunities for Obtaining Endoscopy Training Introduction Available opportunities Benefits Drawbacks Training in Japan A successful training model Conclusion References 36 Virtual Tools for Training Introduction GI procedure videos Video 37 Providing Resources and Opportunities for Retraining for Practicing Endoscopists References 38 Evolving Role of GI Societies and Industry in Training Endoscopists to Perform New Techniques Background Evolving role of industry Evolving role of GI societies Future directions and challenges Video References 39 The Importance of Skills Assessment and Recording Personal Outcomes in the Future of Training The initial training period Credentialing Competence in practice Impact of practice measurements on the training process and future directions Conclusion References
13 Index
