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A novel postgraduate endoscopic course using a large animal model of secondary Crohn's disease stricture

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Abstract

Background

The increasing complexity of advanced endoscopic techniques places a high demand on the endoscopist’s expertise. Thus, live porcine models have been more frequently used for training. We briefly describe a hands-on postgraduate endoscopic course regarding a novel method of treatment of anastomotic strictures in a porcine model.

Methods

The porcine model of Crohn’s disease anastomotic stricture with two artificial side-to-side ileo-colonic anastomoses was used. Participants performed endoscopic stricturotomy under supervision at one of two equipped endoscopic stations. Available animals were endoscopically re-examined 3 months after the course.

Results

Twelve anastomoses were prepared for the course. Eleven circumferential stricturotomies together with horizontal cut and clip placement were conducted. All anastomoses were passable for the scope after the procedure, and no case of perforation or bleeding occurred. All anastomoses available for re-examination remained passable for the endoscope after 3 months.

Conclusion

We successfully organised the first endoscopic hands-on course for the training of endoscopic stricturotomy on a large animal model.

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Acknowledgements

The authors would like to thank Dr. Gursimran S. Kochhar from Allegheny General Hospital, Pittsburgh, PA, USA for accepting our invitation to be an instructor for the postgraduate endoscopic course. This event study was supported by the Czech Society of Gastroenterology, IBD-COMFORT foundation, Olympus and Boston Scientific.

Funding

The development of the animal model was supported by the Czech Health Research Council (NV19-08-00449) and by Institutional Support (RVO: 67985904).

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Correspondence to Martin Lukas.

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Disclosures

Martin Lukas, Martin Kolar, Ondrej Ryska, Stefan Juhas, Jana Juhasova, Jaroslav Kalvach, Jaroslav Pazin, Tereza Kocisova, Ondrej Foltan, Hana Kristianova, Jan Ptacnik, Ivana Vitkova, Martin Bortlik, and Milan Lukas have no conflicts of interest or financial ties in relation to the subject of this manuscript to disclose.

Ethical Approval

All procedures were carried out according to the guidelines for the care and use of experimental animals, and approved by the Resort Professional Commission of the Czech Academy of Sciences for Approval of Projects of Experiments on Animals (protocol number 40/2018 and 79/2019).

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Supplementary Information

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Supplementary file1 (MP4 521706 KB). Video 1: Preview of the commented demonstrative stricturotomy performed by the invited main instructor Dr. Gursimran Kochhar from Pittsburgh, PA, USA, accompanied by a narration by the authors.

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Lukas, M., Kolar, M., Ryska, O. et al. A novel postgraduate endoscopic course using a large animal model of secondary Crohn's disease stricture. Surg Endosc 35, 3199–3204 (2021). https://doi.org/10.1007/s00464-021-08360-x

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