Clin Endosc.  2012 Nov;45(4):350-357.

Ex Vivo and In Vivo Models for Endoscopic Submucosal Dissection Training

• Parra-Blanco A
• Gonzalez N
• Arnau MR

Abstract

Endoscopic submucosal dissection is a technically challenging but highly effective technique for the treatment of well selected early neoplasms in the digestive tract. Although it is frequently performed in East Asian countries, the Western world has not adopted this technique yet, probably due in part to the difficulty to learn it. Ex vivo and in vivo animal models are invaluable tools to overcome at least the beginning of the learning curve, although the initial step is the acquisition of basic knowledge about early diagnosis of neoplasias, and observing real procedures in expert centers. The practical issues, advantages, and disadvantages of the ex vivo and in vivo models are discussed.

Keyword

Endoscopic submucosal dissection; Animal models; Training

MeSH Terms

Asian Continental Ancestry Group
Early Diagnosis
Gastrointestinal Tract
Humans
Learning Curve
Models, Animal
Western World

Figure

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  Fig. 1 Ex vivo gastric porcine model.

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  Fig. 2 Open stomach after cleaned and dried.

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  Fig. 3 Tattooing with India ink to make measured markings in the ex vivo model.

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  Fig. 4 Closure of the incision.

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  Fig. 5 The tattooed area can be observed endoscopically.

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  Fig. 6 Ex vivo colon model. In this case, not only the rectum, but a significant portion of the colon has also been left. The colon has been wrapped with aluminum foil in order to increase electrical conductivity (courtesy of Alfredo Zepeda, Equipos Médicos Zepeda, Chile).

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