A Newly Designed Polyvinyl Alcohol Hydrogel-Based Gastric ESD Simulator for Trainees: A Pilot Study

Abstract Background Endoscopic submucosal dissection (ESD) is a useful option for the treatment of a variety of digestive diseases but has the disadvantage of difficulty in acquiring skills. We developed a new polyvinyl alcohol hydrogel (PVA-H)-based gastric ESD simulator and evaluated its usefulness for training with a group of experts. Methods A new gastric ESD simulator was constructed with three modules (esophagus, gastric wall, and electric). The expert group tested ten ESD sessions and evaluated the simulator with questionnaires on eight items related to ESD procedures using a 7-point Likert scale. Results Compared with the real human stomach, the new ESD simulator showed no inferior success rate in lifting of the submucosal layer (5.00 [4.00–6.00]), cutting of the submucosal layer (6.00 [5.00–6.00]), visibility by bubble (4.00 [4.00–6.00]), thickness of the muscle layer (4.00 [4.00–5.00]), combination of the three layers (6.00 [6.00–7.00]), size of the ESD sheet (6.00 [5.00–6.00]), and connectivity of the electrode (6.00 [6.00–7.00]). Conclusion A new PVA-H-based gastric ESD simulator can be helpful for training before performing real human gastric ESD.