title: Possibility of ex vivo animal training model for colorectal endoscopic submucosal dissection.
abstract: OBJECTIVE
  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.
authors: 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@koto.kpu-m.ac.jp
authors: Naohisa
authors: N
authors: Yoshida
authors: Nobuaki
authors: N
authors: Yagi
authors: Yutaka
authors: Y
authors: Inada
authors: Munehiro
authors: M
authors: Kugai
authors: Kazuhiro
authors: K
authors: Kamada
authors: Kazuhiro
authors: K
authors: Katada
authors: Kazuhiko
authors: K
authors: Uchiyama
authors: Takeshi
authors: T
authors: Ishikawa
authors: Tomohisa
authors: T
authors: Takagi
authors: Osamu
authors: O
authors: Handa
authors: Hideyuki
authors: H
authors: Konishi
authors: Satoshi
authors: S
authors: Kokura
authors: Ken
authors: K
authors: Inoue
authors: Naoki
authors: N
authors: Wakabayashi
authors: Yasuhisa
authors: Y
authors: Abe
authors: Akio
authors: A
authors: Yanagisawa
authors: Yuji
authors: Y
authors: Naito
mesh_terms: D000818:Animals; D002417:Cattle; D002432:Cecum / Q000098:blood supply / Q000601:surgery*; D003106:Colon / Q000601:surgery*; D004210:Dissection / Q000193:education* / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000193:education*; D006488:Hemostasis, Surgical / Q000193:education; D066298:In Vitro Techniques; D007413:Intestinal Mucosa / Q000601:surgery*; D023421:Models, Animal; D012007:Rectum / Q000601:surgery*; D013552:Swine; D058106:Wound Closure Techniques / Q000193:education