Training Simulators for Gastrointestinal Endoscopy: Current and Future Perspectives

Martina Finocchiaro, Pablo Cortegoso Valdivia, Albert Hernansanz, Nicola Marino, Denise Amram, Alicia Casals, Arianna Menciassi, Wojciech Marlicz, Gastone Ciuti, Anastasios Koulaouzidis, Martina Finocchiaro, Pablo Cortegoso Valdivia, Albert Hernansanz, Nicola Marino, Denise Amram, Alicia Casals, Arianna Menciassi, Wojciech Marlicz, Gastone Ciuti, Anastasios Koulaouzidis

Abstract

Gastrointestinal (GI) endoscopy is the gold standard in the detection and treatment of early and advanced GI cancers. However, conventional endoscopic techniques are technically demanding and require visual-spatial skills and significant hands-on experience. GI endoscopy simulators represent a valid solution to allow doctors to practice in a pre-clinical scenario. From the first endoscopy mannequin, developed in 1969, several simulation platforms have been developed, ranging from purely mechanical systems to more complex mechatronic devices and animal-based models. Considering the recent advancement of technologies (e.g., artificial intelligence, augmented reality, robotics), simulation platforms can now reach high levels of realism, representing a valid and smart alternative to standard trainee/mentor learning programs. This is particularly true nowadays, when the current demographic trend and the most recent pandemic demand, more than ever, the ability to cope with many patients. This review offers a broad view of the technology available for GI endoscopy training, including platforms currently in the market and the relevant advancements in this research and application field. Additionally, new training needs and new emerging technologies are discussed to understand where medical education is heading.

Keywords: GI endoscopy; colonoscopy; gastroscopy; medical education; medical simulation; simulators; training.

Conflict of interest statement

Nicola Marino is shareholder and cofounder at INTECH Innovative Training Technologies, mentioned in the review paper. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Skills needed for acquiring competency in gastrointestinal (GI) endoscopy—adapted from Walsh et. al. [15]. PPE: Personal Protective Equipment.
Figure 2
Figure 2
First steps of GI endoscopy simulators.
Figure 3
Figure 3
Mechanical simulators for GI endoscopy: main components.
Figure 4
Figure 4
(a) Mechanical simulators: (a) MW24 NKS Colonoscope Training Simulator from Kyoto Kagaku Co. (Image supplied by Kyoto Kagaku Co.); (b) EMS trainer from Chamberlain Group, LLC (Image supplied by Chamberlain Group, LLC, copyright 2021); (c) M40 Colonoscope Training Simulator from Kyoto Kagaku Co. (Image supplied by Kyoto Kagaku Co.); (d) Internal endoscopic view of M40 Colonoscope Training Simulator from Kyoto Kagaku Co. (Image supplied by Kyoto Kagaku Co.).
Figure 5
Figure 5
Computerized simulators for GI endoscopy: main components.
Figure 6
Figure 6
Computerized simulators: (a) Simbionix GI Mentor from 3D Systems (Image supplied by 3D Systems); (b) EndoSim from Surgical Science (Image supplied by Surgical Science); (c) EndoVison system from MedVision (Image supplied by MSE group); (d) CAE EndoVR from CAE Healthcare (Image supplied by CAE Healthcare).

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