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Background <p>Good exposure of the submucosal visual field is a prerequisite for successful endoscopic submucosal dissection (ESD). There are few reports on ESD training using orthodontic rubber band combined with magnetic ring traction (ORB-MR). This study evaluated the efficacy of ORB-MR traction for ESD training.</p> Methods <p>This study utilized an ex vivo porcine gastric model. Doctors experienced in endoscopic mucosal resection (&gt; 100 cases), but not in ESD, were randomly divided into conventional and ORB-MR-assisted ESD groups. The practicality of ORB-MR traction was evaluated and procedure outcomes were compared between the two groups. The cumulative sum (CUSUM) method was used to construct the learning curves of ORB-MR and traditional ESD trainees respectively.</p> Results <p>A questionnaire survey of the ORB-MR-ESD group showed good satisfaction with ORB-MR. Per-Protocol analysis showed that the resection speed was faster in the ORB-MR group compared to the ESD group (11.61 ± 3.79 mm<sup>2</sup>/min vs. 6.66 ± 2.29 mm<sup>2</sup>/min, <i>p</i> &lt; 0.001). Additionally, the former group exhibited a shorter operative time, lower submucosal injection volume, better visual field satisfaction, and a lower muscle injury rate. The learning curve of the ORB-MR physician reached the learning inflection point in case 9, while the learning inflection point of the traditional ESD physician appeared later, at case 13.</p> Conclusions <p>ORB-MR traction proved feasible and practical for ESD. It shortened the learning curve for ESD trainees and exhibited potential as a valuable method for ESD training.</p>

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Orthodontic rubber band combined with magnetic ring as a traction device for improving endoscopic submucosal dissection training

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月10日

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  • Linfu Zheng,
  • Longping Chen,
  • Fuqiang Wang,
  • Zhilin Liu,
  • Xingjie Gao,
  • Linxin Zhou,
  • Kun Lin,
  • Zaixia Wang,
  • Baoxiang Luo,
  • Dazhou Li,
  • Wen Wang

摘要

Background

Good exposure of the submucosal visual field is a prerequisite for successful endoscopic submucosal dissection (ESD). There are few reports on ESD training using orthodontic rubber band combined with magnetic ring traction (ORB-MR). This study evaluated the efficacy of ORB-MR traction for ESD training.

Methods

This study utilized an ex vivo porcine gastric model. Doctors experienced in endoscopic mucosal resection (> 100 cases), but not in ESD, were randomly divided into conventional and ORB-MR-assisted ESD groups. The practicality of ORB-MR traction was evaluated and procedure outcomes were compared between the two groups. The cumulative sum (CUSUM) method was used to construct the learning curves of ORB-MR and traditional ESD trainees respectively.

Results

A questionnaire survey of the ORB-MR-ESD group showed good satisfaction with ORB-MR. Per-Protocol analysis showed that the resection speed was faster in the ORB-MR group compared to the ESD group (11.61 ± 3.79 mm2/min vs. 6.66 ± 2.29 mm2/min, p < 0.001). Additionally, the former group exhibited a shorter operative time, lower submucosal injection volume, better visual field satisfaction, and a lower muscle injury rate. The learning curve of the ORB-MR physician reached the learning inflection point in case 9, while the learning inflection point of the traditional ESD physician appeared later, at case 13.

Conclusions

ORB-MR traction proved feasible and practical for ESD. It shortened the learning curve for ESD trainees and exhibited potential as a valuable method for ESD training.