Successful Training in Gastrointestinal Endoscopy

8) Circumferential lesions Endoscopic submucosal dissection (Videos 21.9 and 21.10) Endoscopic full thickness resection Adjuvant thermal ablation of the resection margin Defect closure with mechanical clips Deep mural injury Surveillance Two‐stage EMR Adverse events associated with complex polypectomy Training and achieving competency in endoscopic tissue resection Summary Videos References 22 Training and Credentialing in Natural Orifice Transluminal Endoscopic Surgery (NOTES) Training Credentialing Conclusion References 23 Training in Bariatric Endoscopy Bariatric endoscopy procedures Training goals Infrastructure and personnel Pre‐procedural assessment Equipment Procedural considerations and techniques Bariatric endoscopy procedures Endoscopic management of post‐bariatric surgery complications Revisional procedures for weight regain Primary bariatric and metabolic procedures Defining competency for particular skill Conclusion References 24 Repair of Mucosal Defects Introduction Learning to close perforations Conclusion Videos References 25 Esophageal, Gastroduodenal, and Colorectal Stenting Procedure(s) to be considered Prerequisite level of expertise and skill for learning this Special considerations Specific technical and cognitive skill sets Equipment Key steps of proper technique Defining competency Maintaining skill level Videos References 26 ERCP Management of Complicated Stone Disease of the Bile Duct and Pancreas Mechanical lithotripsy Large‐diameter balloon sphincteroplasty Cholangiopancreatoscopy Electrohydraulic lithotripsy Laser lithotripsy Extracorporeal shock wave lithotripsy and pancreatic duct stones Endoscopic ultrasound as an adjunct Difficult anatomy Training modalities Competency Videos References 27 ERCP Management of Malignancy Introduction Tissue sampling at ERCP Metal stent placement Management of ampullary neoplasms Thoughts on advanced endoscopy training Videos References 28 Sphincter of Oddi Manometry Patient selection Method of SOM Technical performance of SOM (see accompanying Video 28.1) Interpretation criteria Reproducibility of SOM Complications of SOM Training in SOM Video References 29 Training for Pseudocyst Management Procedure(s) to be considered Prerequisite level of expertise and skill for learning this Special considerations Specific technical and cognitive skill sets Equipment 0.018”–0.035” guidewires (depending on needle used) Pre‐drainage evaluation Setting and tools for training Defining competency Maintaining skill level Videos References 30 Enteral Access Techniques Introduction Prerequisite expertise and skill Setting Equipment Key steps for proper technique Starting enteral nutrition Setting and tools for training Defining competency Maintenance of skills Videos References 31 Training in GI Upper Motility Techniques Esophageal manometry testing Conclusion Wireless motility capsule (WMC) testing WMC procedure WMC interpretation Assessment of gastric emptying Specific applications of WMC testing Possible complications References 32 Training in the Endoscopic Management of Anorectal Disorders Introduction Prerequisite cognitive and technical skills for trainees prior to learning DRE anoscopy and hemorrhoid treatment Specific knowledge trainees must acquire during training to perform office hemorrhoid banding Selection of particular treatment method Anticoagulation considerations Post banding analgesia Incision and drainage of acutely thrombosed external hemorrhoids Anal fissures Anal pruritus Treatment Anorectal manometry References 33 The Endoscopic Management of Immediate Complications of Therapeutic Endoscopy Introduction Assessing risk prior to procedure Intraprocedure recognition of complications Videos References

12 IV: Challenges for the Future 34 Assessing Manpower Needs in Gastroenterology and Digestive Endoscopy Modeling manpower Physician workforce estimates Gastroenterology workforce modeling Future projections in gastroenterology: lessons from the past Endoscopic demands for screening colonoscopy Conclusions Acknowledgments References 35 International Opportunities for Obtaining Endoscopy Training Introduction Available opportunities Benefits Drawbacks Training in Japan A successful training model Conclusion References 36 Virtual Tools for Training Introduction GI procedure videos Video 37 Providing Resources and Opportunities for Retraining for Practicing Endoscopists References 38 Evolving Role of GI Societies and Industry in Training Endoscopists to Perform New Techniques Background Evolving role of industry Evolving role of GI societies Future directions and challenges Video References 39 The Importance of Skills Assessment and Recording Personal Outcomes in the Future of Training The initial training period Credentialing Competence in practice Impact of practice measurements on the training process and future directions Conclusion References

13 Index

14 End User License Agreement

1 Chapter 1 Table 1.1 Anticipated expanded applications of endoscopy simulation in 2010... Table 1.2 A look at endoscopy training in 2030.

2 Chapter 3 Table 3.1 Preprocedure quality indicators. Table 3.2 ASA classification. Table 3.3 Intraprocedure quality indicators. Table 3.4 Postprocedure quality indicators.

3 Chapter 6 Table 6.1 Listed are the core motor and cognitive skills trainees must acqu... Table 6.2 How skills can be taught and assessed? Table 6.3 Competency metrics for continuous assessment Table 6.4 Assessment of Competence in Endoscopy (ACE) tool. This survey is ...

4 Chapter 7 Table 7.1 Key skill sets for learning EUS. Table 7.2 Resources for learning EUS.Table 7.3 Benchmark data for the yield of EUS FNA for diagnosing pancreatic...

5 Chapter 8Table 8.1 Trainer assessment score of trainees' performance.

6 Chapter 9Table 9.1 Rate of capsule retention based upon indication for CE examinatio...

7 Chapter 11Table 11.1 Indications for cholangioscopy.

8 Chapter 12Table 12.1 Thermal effects on human tissue [1].Table 12.2 Generic correlation between power and duration of application of...

9 Chapter 14Table 14.1 Recommendations for dosages of drugs commonly used for IV sedati...Table 14.2 Reversal agents for benzodiazepines and opioids and recommended ...Table 14.3 Indications for upper endoscopy.Table 14.4 Pediatric gastrocopes.Table 14.5 Equipment compatible with pediatric endoscope (2 mm channel).Table 14.6 Indications for colonoscopy.Table 14.7 Pediatric colonoscopes.Table 14.8 Relative contraindications to PEG placement in children.Table 14.9 Common sclerosing agents and indications for therapeutic pediatr...Table 14.10 Recommended minimum numbers for achieving competency in pediatr...

10 Chapter 15Table 15.1 Methods of training in contrast‐enhanced endoscopy.

11 Chapter 16Table 16.1 Sources of GI hemorrhage categorized by location and whether the...Table 16.2 CURE Hemostasis Group basic guide to anatomy, type of blood supp...Table 16.3 Injectables for endoscopic hemostasis.Table 16.4 Comparison of longitudinal progress of simulator‐trained GI fell...Table 16.5 Teaching aides for hemostasis and their usefulness.Table 16.6 CURE MPEC settings for nonvariceal UGI hemostasis.Table 16.7 CURE guidelines for hemoclipping with or without injection of no...Table 16.8 CURE Hemostasis settings and guidelines for MPEC hemostasis of b...Table 16.9 Challenges for GI hemostasis and potential solutions.Table 16.10 Current UCLA guidelines for minimal thresholds for assessing co...

12 Chapter 17Table 17.1 Endoscope outer diameter and channel size.

13 Chapter 18Table 18.1 Comparison of ASGE and ESGE guidelines.Table 18.2 Five‐step approach to patients with FB ingestion.

14 Chapter 19Table 19.1 List of recommendations for training in Endoscopic Submucosal Di...

15 Chapter 23Table 23.1 Summary of bariatric endoscopy—categories, specific procedures, a...Table 23.2 Typical equipment used in bariatric endoscopy.Table 23.3 Complications after bariatric surgery.Table 23.4 Endoscopic bariatric and metabolic therapies (EBTM) for obesity.

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