Endoscopic submucosal dissection training with pig models in a Western country

AIM:To test a strategy for endoscopic submucosal dissection(ESD) training in animal models designed to overcome the initial learning curve.METHODS:ESD was attempted in ex vivo and in vivo pig models.Thirty ESD procedures were attempted in the esophagus(n=9) or the stomach(n=21).The ex vivo model was used until initial competence was achieved.In the in vivo model,several ESD procedures were performed in up to 3 sessions.The following variables were analyzed:specimen size,complete and en bloc resection rate,t...