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KMID : 1038120200530030334
Clinical Endoscopy
2020 Volume.53 No. 3 p.334 ~ p.338
Three-Dimensional Flexible Endoscopy Can Facilitate Efficient and Reliable Endoscopic Hand Suturing: An ex-vivo Study
Omori Jun

Goto Osamu
Higuchi Kazutoshi
Umeda Takamitsu
Akimoto Naohiko
Suzuki Masahiro
Kirita Kumiko
Koizumi Eriko
Noda Hiroto
Akimoto Teppei
Kaise Mitsuru
Iwakiri Katsuhiko
Abstract
Background/Aims: Three-dimensional (3D) flexible endoscopy, a new imaging modality that provides a stereoscopic view, can facilitate endoscopic hand suturing (EHS), a novel intraluminal suturing technique. This ex-vivo pilot study evaluated the usefulness of 3D endoscopy in EHS.

Methods: Four endoscopists (two certified, two non-certified) performed EHS in six sessions on a soft resin pad. Each session involved five stitches, under alternating 3D and two-dimensional (2D) conditions. Suturing time (sec/session), changes in suturing time, and accuracy of suturing were compared between 2D and 3D conditions.

Results: The mean suturing time was shorter in 3D than in 2D (9.8¡¾3.4 min/session vs. 11.2¡¾5.1 min/session) conditions and EHS was completed faster in 3D conditions, particularly by non-certified endoscopists. The suturing speed increased as the 3D sessions progressed. Error rates (failure to grasp the needle, failure to thread the needle, and puncture retrial) in the 3D condition were lower than those in the 2D condition, whereas there was no apparent difference in deviation distance.

Conclusions: 3D endoscopy may contribute to increasing the speed and accuracy of EHS in a short time period. Stereoscopic viewing during 3D endoscopy may help in efficient skill acquisition for EHS, particularly among novice endoscopists.
KEYWORD
Endoscopic suturing, Learning curve, Three-dimensional endoscopy
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