| 特集名 | 消化器内視鏡トレーニングのあり方 | |
|---|---|---|
| 題名 | 大腸内視鏡トレーニング | |
| 発刊年月 | 2012年 11月 | |
| 著者 | 樫田 博史 | 近畿大学医学部消化器内科 |
| 著者 | 朝隈 豊 | 近畿大学医学部消化器内科 |
| 著者 | 川崎 正憲 | 近畿大学医学部消化器内科 |
| 著者 | 永田 嘉昭 | 近畿大学医学部消化器内科 |
| 著者 | 高山 政樹 | 近畿大学医学部消化器内科 |
| 著者 | 峯 宏昌 | 近畿大学医学部消化器内科 |
| 【 要旨 】 | 大腸においては，治療は言うに及ばず，スコープ挿入すら時に困難であり，リスクを伴う．苦痛なく安全な診断・治療を行うためには，十分なトレーニングが要求される．単に手技だけではなく，正しい診断や治療方針決定を可能にするためのトレーニングであり，カンファレンスなどを通じて良い写真の撮影法・読影の仕方・鑑別診断・治療方針・最終病理診断など，総合的な理解ができるように指導する必要がある．テキストやDVDで勉強し，また学会・研究会，ライブセミナーやハンズオンセミナーに積極的に参加することにより，他人の経験を見聞きし，教えを請うことも重要である． | |
| Theme | Training System for Gastrointestinal Endoscopy | |
|---|---|---|
| Title | Training for Colonoscopic Procedures | |
| 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. |
|