Endoscopic submucosal dissection performed in living pig models with flush knife – Assessment of the initial learning curves and complications

Introduction: Endoscopic submucosal dissection (ESD) is a promising endoscopic technique for the en block resection of early, superficial, laterally spreading gastrointestinal neoplasms. However, for endoscopists at the beginning of their learning curve, the complication rate (bleeding and perforation) is unacceptably high up to 20%. We hypothesize that the strategy of learning ESD from experts, followed by training in harvested pig stomachs and then in live pig models may be useful to overcome the initial learning curve. Our study aims to prospectively determine the results, efficacy and safety of ESD performed…