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Possibility of ex vivo animal training model for colorectal endoscopic submucosal dissection

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Colorectal endoscopic submucosal dissection (ESD) has not been standardized due to technical difficulties and requires extensive training for reliability. Ex vivo animal model is convenient, but has no blood flow. The objective of this study is to evaluate the characteristics of various ex vivo animal models including a blood flow model for colorectal ESD training and the usefulness of practicing endoscopic hemostasis and closure using an animal model.

Methods

Harvested porcine cecum, rectum, and stomach and bovine cecum and rectum were analyzed regarding ease of mucosal injection, degree of submucosal elevation, and status of the proper muscle layer. Ex vivo animal model with blood flow was made using the bovine cecum. The vessel around the cecum was detached, and red ink was injected. Endoscopic hemostasis for perioperative hemorrhage and endoscopic closure for perforation were performed in this model.

Results

Mucosal injection was easily performed in the bovine cecum and rectum. Submucosal elevation was low in the bovine cecum, while the proper muscle layer was not tight in the porcine rectum and bovine cecum. Endoscopic hemostasis were accomplished in six (60 %) out of ten procedures of the ex vivo blood flow model. In two non-experts, the completion rates of endoscopic closure were 40 and 60 % in the first five procedures. These rates became 100 % in the last five procedures.

Conclusions

We have evaluated the characteristics of various ex vivo animal models and shown the possibility of training for endoscopic hemostasis and endoscopic closure in the ex vivo animal model.

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Acknowledgments

We thank Dr. Noriya Uedo, Dr. Toshio Uraoka, Dr. Ken Ohata, Dr. Shinji Tanaka, Dr. Kiyoaki Homma, Dr. Hirohisa Machida, Dr. Yoshinori Morita, and Dr. Naohisa Yahagi for providing helpful advice for developing the ex vivo animal model with blood flow.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan

    Naohisa Yoshida, Nobuaki Yagi, Yutaka Inada, Munehiro Kugai, Kazuhiro Kamada, Kazuhiro Katada, Kazuhiko Uchiyama, Takeshi Ishikawa, Tomohisa Takagi, Osamu Handa, Hideyuki Konishi, Satoshi Kokura & Yuji Naito

  2. Department of Gastroenterology, Kyoto Yosanoumi Hospital, Kyoto, Japan

    Ken Inoue

  3. Department of Gastroenterology, Otsu City Hospital, Shiga, Japan

    Naoki Wakabayashi

  4. Johnson & Johnson, Tokyo, Japan

    Yasuhisa Abe

  5. Department of Surgical Pathology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Akio Yanagisawa

Authors
  1. Naohisa Yoshida
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  2. Nobuaki Yagi
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  3. Yutaka Inada
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  5. Kazuhiro Kamada
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  7. Kazuhiko Uchiyama
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  9. Tomohisa Takagi
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  11. Hideyuki Konishi
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  12. Satoshi Kokura
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  13. Ken Inoue
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  14. Naoki Wakabayashi
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  15. Yasuhisa Abe
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  16. Akio Yanagisawa
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  17. Yuji Naito
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Corresponding author

Correspondence to Naohisa Yoshida.

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Yoshida, N., Yagi, N., Inada, Y. et al. Possibility of ex vivo animal training model for colorectal endoscopic submucosal dissection. Int J Colorectal Dis 28, 49–56 (2013). https://doi.org/10.1007/s00384-012-1531-6

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  • DOI: https://doi.org/10.1007/s00384-012-1531-6

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