Background: Endoscopic ampullectomy is a technically challenging, high-risk procedure with limited training opportunities. Although simulation models can assist with endoscopic skill acquisition, an ampullectomy model does not currently exist.
Objective: To develop a training model that can be used to improve technical skills, knowledge, and confidence in performing endoscopic ampullectomy.
Design: Experimental study.
Setting: Tertiary hospital innovation laboratory.
Subjects: Twenty-one endoscopists attending an endoscopic resection workshop.
Interventions: A prototype for endoscopic ampullectomy was created by computer-aided design and 3-dimensional printing of an ampullary mount and base to which a chicken heart was attached and inserted into a silicone stomach-duodenum model. Study participants performed an ampullectomy and evaluated the prototype with a pre- and postampullectomy questionnaire by using a scale of 1 to 5 (very low to very high).
Main Outcome Measurements: Evaluation of core procedural steps, technical and visual realism, and proceduralist technical knowledge and confidence.
Results: Sixteen endoscopists participated in the study. All core procedural steps were completed by 14 participants. The mean overall technical and visual realism scores were 3.1 (standard deviation [SD], 0.9) and 3.2 (SD, 0.9), respectively. Ten participants (10/15, 66.7%) thought that their technical knowledge had improved, and 11 thought that it would increase further with additional sessions (11/15, 73.3%). Mean confidence score before and after using the model was 2.2 (SD, 1.2) and 2.9 (SD, 1.1), respectively (P=.132).
Limitations: Pilot study, lack of follow-up of participants' endoscopic practice after model experience.
Conclusion: Although further studies are necessary for validation, this novel prototype appears useful for endoscopic ampullectomy training.
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http://dx.doi.org/10.1016/j.gie.2015.03.1916 | DOI Listing |
Ampullary composite gangliocytoma/neuroma and neuroendocrine tumor (CoGNET), previously called ampullary gangliocytic paragangliomas, is a rare entity, with only few reported cases in the literature. This is a multicentric retrospective cohort study of patients treated with endoscopy or surgery for ampullary CoGNET. A literature review of ampullary CoGNET was also performed.
View Article and Find Full Text PDFJ Clin Med
November 2024
Digestive and General Surgery Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
Surgical resection for ampullary lesions lacks clear guidelines. Pancreaticoduodenectomy (PD) is the standard treatment for malignant ampullary tumors but is often excessive for ampullary adenomas (AAs) due to its high morbidity and mortality. Transduodenal ampullectomy (TDA) is generally reserved for small benign lesions where endoscopic treatment fails, but its role in early ampullary cancers is debatable.
View Article and Find Full Text PDFGastrointest Endosc
December 2024
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Post-Baccalaureate, Medicine College of Medicine, National Chung Hsing University, Taichung, Taiwan. Electronic address:
Gut
December 2024
Department of Digestive and HBP Surgery, Groupe Hospitalier Pitié-Salpêtrière, Médecine Sorbonne Université APHP, Paris, France.
Objective: Ampullary neoplastic lesions can be resected by endoscopic papillectomy (EP) or transduodenal surgical ampullectomy (TSA) while pancreaticoduodenectomy is reserved for more advanced lesions. We present the largest retrospective comparative study analysing EP and TSA.
Design: Of all patients in the database, lesions with prior interventions, benign histology advanced malignancy (T2 and more), patients with hereditary syndromes and those undergoing pancreatoduodenectomy were excluded.
Eur J Med Res
November 2024
Department of Hepatobiliary and Pancreatic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 S. Yishan Road, Shanghai, 200233, China.
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