Clinical Gastroenterology Vol.27 No.12(6)

Theme Training System for Gastrointestinal Endoscopy
Title Training for Colonoscopic Procedures
Publish Date 2012/11
Author Hiroshi Kashida Department of Gastroenterology and Hepatology, Kinki University
Author Yutaka Asakuma Department of Gastroenterology and Hepatology, Kinki University
Author Masanori Kawasaki Department of Gastroenterology and Hepatology, Kinki University
Author Yoshiaki Nagata Department of Gastroenterology and Hepatology, Kinki University
Author Masaki Takayama Department of Gastroenterology and Hepatology, Kinki University
Author Hiromasa Mine Department of Gastroenterology and Hepatology, Kinki University
[ Summary ] In Japan, endoscopic training usually starts in the third year after graduation. Our senior resident gastroenterology and hepatology course usually lasts three years. Gastrointestinal (GI) endoscopic training starts with individual training with a senior doctor for at least three months. Training for colonoscopic intubation with torso-like artificial models has improved greatly, and is now very useful. Therapeutic procedures are generally not conducted by beginners. However, they may learn how to conduct them by observing senior doctorsʼ techniques or by working as an assistant during the procedures. This is very important to learn indications and contraindications and to learn about the selection and usage of many kinds of devices.
At the end of the first year of endoscopic training residents are allowed to perform easier procedures such as GI hemostasis, upper simple polypectomies or hot biopsies under the supervision of senior doctors. Endoscopic submucosal dissection (ESD) techniques, are observed by trainees to gain expertise from senior doctors and to assist the operator during procedures.
In the second year of senior residency trainees may perform endoscopic mucosal resection (EMR) or mucosectomies on smaller lesions.
In the third year they are allowed to conduct gastric ESD procedures under the supervision of consultant doctors. ESD in the lower GI is very demanding, and therefore only senior doctors who have enough expertise to conduct colonoscopic insertion, EMR or piecemeal EMR (EPMR) are allowed to perform ESD procedures.
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