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. 2021 Dec;31(12):5486-5493.
doi: 10.1007/s11695-021-05757-4. Epub 2021 Oct 18.

Learning Process Effectiveness During the COVID-19 Pandemic: Teleproctoring Advanced Endoscopic Skills by Training Endoscopists in Endoscopic Sleeve Gastroplasty Procedure

Manoel Galvao Neto  1 , Jonathan Jerez  2 , Vitor Ottoboni Brunaldi  3 , David Cabrera  4 , Christian Benavides  4 , Monica Moreno  4 , Ginesio Romero  4 , Daniela Guiatara  4 , Barham K Abu Dayyeh  5
Affiliations

Learning Process Effectiveness During the COVID-19 Pandemic: Teleproctoring Advanced Endoscopic Skills by Training Endoscopists in Endoscopic Sleeve Gastroplasty Procedure

Manoel Galvao Neto et al. Obes Surg. 2021 Dec.

Abstract

Background and aims: The COVID-19 pandemic has led health institutions to cancel many of the activities including training in different fields. Most practices and training programs have been encouraged to use teleproctoring as an alternative method to enhance physician's ability and assure training. We aimed to evaluate remote training program for endoscopy sleeve gastroplasty (ESG).

Methods: Ten consecutive patients underwent an endoscopic sleeve gastroplasty procedure guided by a proctor expert using an online platform. A stepwise approach was created to assure skill acquisition.

Results: All cases were safely performed with no serious adverse events under teleproctoring. The average surgical and suturing times significantly decreased during the training model. From the first 5 cases to the last 5 ones, the endoscopic procedure time decreased from 120 to 93.4 min while suturing time from 92.8 to 68.4 min. The effect size was large in both cases, and the changes were meaningful according to the fitted learning curves.

Conclusions: The proposed teleproctoring program was effective to deliver advanced endoscopic skills such as endosuturing for ESG, despite the restrictions imposed by the COVID-19 pandemic.

Keywords: Bariatric; COVID-19; Education; Endoscopy; Gastric sleeve; Teleproctoring; Training.

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Conflict of interest statement

Manoel Galvao Neto 1 reports receiving personal fees for lectures from Erbe Elektromedizin GmbH; he is consultant for GI Dynamics, Apollo EndoSurgery, USGI, Colubris Mx, Scitech, and MITech; is Scientific Advisor for Apollo EndoSurgery and Keyron; he is speaker for Olympus LA, Erbe, and Medtronic LA. Barham Aby Dayyeh is a consultant for Boston Scientific, Medtronic, BFKW, Endogenex, Hemostasis, Spatz Medical, Endo-TAGSS Metamodix. He is the recipient of research support from Apollo Endosurgery, USGI medical, Boston Scientific, Medtronic, Endogastric Solutions, Spatz Medical, Aspire Bariatric; he is a speaker for Olympus and Johnson and Johnson. All other authors disclose no potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Schematics of the endoscopy transmission
Fig. 2
Fig. 2
Progress in the overall procedure duration. Dotted line: real values; Continue line: trend
Fig. 3
Fig. 3
Progress in the suturing duration. Dotted line: real values; Continue line: trend
Fig. 4
Fig. 4
Fitting inverse curve for learning performance
Fig. 5
Fig. 5
Endoscopic aspect of the procedure. (a) First endoscopic suturing line. (b) Formation of the tubular stomach
Fig. 6
Fig. 6
Various aspects of an ongoing teleproctored procedure. (a) Endoscopic view, (b) teleproctor (trainee’s view), (c) room view for body movements of the endoscopist and the team, (d) detail of the endoscopic body and equipment movements. Note. Written permission for publication was obtained from the identifiable individual (Dr. Manoel Galvao Neto)
Fig. 7
Fig. 7
Schematics for room setup
See this image and copyright information in PMC

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