Simulation of different upper gastrointestinal bleeding types for practicing hemostasis in flexible endoscopy

Introduction: Gastrointestinal bleeding is the most frequent cause of emergency endoscopy Life threatening complications might arise, depending on the etiology and intensity of the hemorrhage Endoscopic diagnostics and simultaneous therapy are the first line treatment of upper gastrointestinal bleeding Practicing emergency situations is essential but actually no adequate and realistic option for training exists so far Aims & Methods: Aim of this project is the development of a training model with modular exchangeable bleeding sources, followed by a multicenter evaluation by endoscopists of each skill level The model is completely free of animal material The artificial organs consist of latex and silicone and are equipped with artificial vessels for bleeding simulation and can be attached to a bleeding pump Via 3D printing, exchangeable modules for fast integration of the bleeding sources are created An artificial mucosa is prepared according to a novel protocol Results: Multiple types of bleeding sources (reflux esophagitis, esophageal varices, gastric and duodenal ulcer) can be implemented into a model for esophagogastroduodenoscopy The following therapeutic interventions are conductible: variceal banding, stent application, injection, clipping, thermal processes and application of topical substances for hemostasis Four centers agreed to conduct an evaluation of this training model Due to the COVID-19 pandemic, the evaluation could not be performed yet, but will be completed until the UEG week Conclusion: Our training model enables practicing endoscopic diagnostics and therapy of upper gastrointestinal bleeding and offers a combination of realistic conditions and a broad spectrum of interventions