{
  "abstract": "Objective Operator technical skill is recognised as a critical determinant of surgical outcomes. However, no equivalent recognition for quality of endoscope tip manipulation (tip-control) exists. We aimed to create an ex-vivo snare tip soft coagulation (STSC) model to objectively quantify endoscopist tip-control.Method This prospective interventional study was conducted at Ghent University Hospital. Participants applied STSC to a training model simulating four endoscopic mucosal resection (EMR) defects on a slice of ham. Accuracy (correct/total-hits) and speed (correct-hits/s) were assessed from a video by a single-blinded rater using a web-based scoring system.Results 22 endoscopists participated. Interventional endoscopists demonstrated significantly higher accuracy (87.0%) and speed (0.184 correct-hits/s) compared with trainees (74.5%, 0.106 correct-hits/s; both p<0.001) and non-interventional consultants (77%, 0.141 correct-hits/s; p<0.001). The tip-control of trainees and non-interventional consultants was not significantly different. Endoscopists having performed ≥1000 colonoscopies, performing SMSA-4 polypectomies or ≥50 EMRs/year showed superior tip-control. Endoscopists with >5 years of endoscopic experience did not have better tip-control (accuracy 88.0%(p=0.07), speed 0.132 hits/s (p=0.36)) when compared with those with ≤4 years of experience.Conclusion This inexpensive ex vivo STSC simulation model effectively quantified endoscopic tip-control, correlating with endoscopist expertise and clinical profiles. The model could support the shift towards competency-based education, potentially improving patient outcomes.Trial registration number NCT05660317.",
  "authors": [
    {
      "affiliations": [
        "UZ Brussel, Brussel, Belgium",
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium"
      ],
      "name": "Lynn K Debels"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy"
      ],
      "name": "Andrea Sorge"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium"
      ],
      "name": "Maria Eva Argenziano"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium"
      ],
      "name": "Vikash Lala"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Università Politecnica delle Marche, Ancona, Italy"
      ],
      "name": "Michele Montori"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium"
      ],
      "name": "Pieter Jan Poortmans"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium"
      ],
      "name": "Sander Smeets"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Institute of Pancreatic Diseases, Semmelweis University of Medicine, Budapest, Hungary"
      ],
      "name": "Tamas Tornai"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium"
      ],
      "name": "Hans Van Vlierberghe"
    },
    {
      "affiliations": [
        "Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium",
        "Department of Gastroenterology and Hepatology, AZ Delta vzw, Roeselare, Belgium"
      ],
      "name": "Lobke Desomer"
    },
    {
      "affiliations": [
        "Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK"
      ],
      "name": "Roland Valori"
    },
    {
      "affiliations": [
        "Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK"
      ],
      "name": "John Anderson"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium",
        "Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium"
      ],
      "name": "David J Tate"
    }
  ],
  "title": "Endoscopic tip-control measured by a snare tip soft coagulation training model correlates with endoscopist profile and therapeutic expertise (The HAM Study)",
  "uid": "d1bcebc9-7754-525b-afe1-57755e0964ea"
}