EndoTODAY | EndoATLAS | OPD

Parasite | Eso | Sto | Cancer | ESD

Boxim | DEX | Sono | Schedule

Home | Recent | Blog | Links

EndoTODAY ³»½Ã°æ ±³½Ç


[Live pig ESD] - ðû

´Ù¸¥ ¸ðµç ¼ú±â ±³À°°ú ¸¶Âù°¡Áö·Î ESD ¹è¿ì±âµµ stepwise·Î ÁøÇàµÇ´Â °ÍÀÌ ÀÌ»óÀûÀÔ´Ï´Ù. Á¦°¡ Á¦¾ÈÇÏ´Â ¹æ¹ýÀº (1) ESD¿¡ ÀûÇÕÇÑ ³»½Ã°æ Á¶ÀÛ¹ý ¿¬½ÀºÎÅÍ ½ÃÀÛÇÏ¿©, (2) EndoGEL ESD, (3) ex vivo pig stomach ESD, (4) live pig ESD, (5) clinical case ¼øÀ¸·Î ÁøÇàµÇ´Â °ÍÀÔ´Ï´Ù. EndoGEL ESD 3¹ø, ex vivo pig stomach ESD 3¹ø, live pig ESD 3¹ø ÈÄ clinical case¿¡ µµÀüÇÒ °ÍÀ» ÃßõÇÕ´Ï´Ù.

Live pig ESD´Â Ư¼öÇÑ ½Ã¼³°ú Àåºñ, ±×¸®°í ¸¹Àº ºñ¿ëÀÌ ÇÊ¿äÇϹǷΠÀÚÁÖ Çϱâ´Â ¾î·Æ½À´Ï´Ù. µå¹® ±âȸ¸¦ ÃÖ´ëÇÑ È°¿ëÇÒ ¼ö ¹Û¿¡ ¾ø½À´Ï´Ù. Olympus áæÓö training center K-TECÀÇ µ¿¹°½ÇÇè½ÇÀ» ÁÖ·Î ÀÌ¿ëÇÏ°í ÀÖ½À´Ï´Ù. Live pig ESD¿¡ ¾Õ¼­ ½ÇÇ赿¹°½Ç½À°ú °ü·ÃµÈ À±¸®±³À°À» ¹Þ°Ô µË´Ï´Ù. ²À ÇÊ¿äÇÑ µ¿¹°À» ÃÖ¼ÒÇÑÀ¸·Î »ç¿ëÇÑ´Ù´Â 3R ¿øÄ¢(Replacement, Reduction, Refinement)ÀÌ Áß¿äÇÕ´Ï´Ù. EndoGEL ESD ÈÆ·Ã ÈÄ live pig ESD ÈÆ·ÃÀ» ÇÒ °ÍÀ» ±ÇÇÕ´Ï´Ù.

ÇÑ unit¿¡ tainer 1¸í, trainee 2¸íÀÌ ÈÆ·ÃÀ» Çϸé ÁÁ½À´Ï´Ù. Trainee µÎ ¸íÀÌ operator¿Í assistant ¿ªÇÒÀ» ±³´ë·Î ÇÏ´Â ¹æ½ÄÀÔ´Ï´Ù. ¿ÀÀü 2½Ã°£, Á¡½É, ¿ÀÈÄ 2½Ã°£ µµÇÕ 5½Ã°£ ÇÁ·Î±×·¥À» ÃßõÇÕ´Ï´Ù.

2019-12-5. ¿Ã¸²Çª½º áæÓö training center (K-TEC).

½ÇÇ赿¹°Àº 24½Ã°£ ±Ý½ÄÀ¸·Î´Â À§°¡ ÃæºÐÈ÷ ±ú²ýÇØÁöÁö ¾Ê½À´Ï´Ù. 48½Ã°£ fluid¸¸ Á¦°øÇØ¾ß ÇÏÁö ¾ÊÀ»±î »ý°¢µË´Ï´Ù. 72½Ã°£ÀÌ¸é ´õ ÁÁ°ÚÁö¸¸ µ¿¹°À±¸®¿¡ ÀúÃ˵ÇÁö ¾ÊÀ»±î °ÆÁ¤µË´Ï´Ù. ÀûÀýÇÑ ¼öÁØÀ» ã¾Æ¾ß ÇÒ °Í °°½À´Ï´Ù.

½ÇÇ赿¹°Àº K-TEC ¼öÀÇ»ç ¼±»ý´ÔµéÀÌ Àß ÁغñÇØ ÁֽʴϴÙ. ´Ù¸¸ ½ÇÇ赿¹°À» ¼ö¼ú table¿¡ ºñ½ºµëÈ÷ ³õ¾Æ¾ß ÀÚ¿¬½º·¯¿î °¢µµ¿¡¼­ ½Ã¼úÇÒ ¼ö ÀÖ½À´Ï´Ù.

°¡¼ÒÄÝÀ» biopsy channelÀ» ÅëÇÏ¿© Åõ¿©ÇÏ´Â °ÍÀÌ ÁÁ½À´Ï´Ù. °ÅÇ°ÀÌ »ó´çÈ÷ ¸¹±â ¶§¹®ÀÔ´Ï´Ù.

Electrosurgical unit´Â º´¿ø¿¡¼­ ÈçÈ÷ »ç¿ëÇÏ´Â ERBE VIO300D°¡ ¾Æ´Õ´Ï´Ù. Olympus ESG-400À» »ç¿ëÇÕ´Ï´Ù.

Pig stomachÀº ÀÎü À§Á¡¸·¿¡ ºñÇÏ¿© µüµüÇÕ´Ï´Ù. MarkingÀº SprayCoagÀ» »ç¿ëÇÕ´Ï´Ù. Cut°¡ ¹®Á¦Àε¥, ERBEÀÇ EndoCut¿Í ºñ½ÁÇÑ PulseCut Fast ȤÀº PulseCut Slow·Î´Â Á¡¸·ÀýÁ¦°¡ µÇÁö ¾Ê½À´Ï´Ù. Á» ´õ °­ÇÑ Àü·ù¸¦ ¼±ÅÃÇØ¾ß ÇÕ´Ï´Ù. PureCut 100-120 Effect 2-3¸¦ »ç¿ëÇÒ °ÍÀ» ±ÇÇÕ´Ï´Ù. Pig stomachÀº ÃâÇ÷ÀÌ ¸¹Áö ¾Ê¾Æ¼­ ÁöÇ÷¼úÀ» ÇÏÁö ¾Ê°í ESD¸¦ ÇÒ ¼ö ÀÖ½À´Ï´Ù. µå¹°°Ô ÃâÇ÷ÀÌ ¹ß»ýÇϸé ForcedCoagÀ¸·Î ÁöÇ÷½Ãų ¼ö ÀÖ½À´Ï´Ù.

Live pig ESD¿¡¼­ ÈçÇÑ ½Ç¼ö´Â ½Ã¾ß°¡ ÁÁÁö ¾ÊÀ» ¶§, ÀýÁ¦ÇÒ targetÀÌ ¸íÈ®ÇÏÁö ¾ÊÀ» ¶§ ÀýÁ¦¸¦ ½ÃµµÇÏ´Â °ÍÀÔ´Ï´Ù. ESD´Â step by step, control and cut, fiber by fiber ¹æ½ÄÀ¸·Î ÁøÇàµÇ¾î¾ß ÇÕ´Ï´Ù. ÀûÀýÇÑ ÈíÀÔ°ú °ø±â ÁÖÀÔÀ» ÅëÇÏ¿© ½Ã¾ß¸¦ ±ú²ýÀÌ ÇÏ°í, ³»½Ã°æÀ» ¹Ð°í ´ç°Ü ÀûÀýÇÑ targetÀ» ãÀº ÈÄ, fiber¸¦ Çϳª¾¿ Çϳª¾¿ õõÈ÷ ÀýÁ¦ÇØ¾ß ÇÕ´Ï´Ù. Àý´ë ¼­µÎ¸£Áö ¸¶½Ê½Ã¿À.

Live pig ESD¸¦ Çϸ鼭 õ°øÀÌ ¹ß»ýÇϸé clip closure¸¦ ½ÃÇàÇÕ´Ï´Ù. º¹°­³» °ø±â°¡ ³Ê¹« ¸¹À¸¸é ÁÖ»ç±â·Î °ø±â¸¦ Á¦°ÅÇÏ¸é µµ¿òÀÌ µË´Ï´Ù. Âü°í·Îlive pig POEM µµÁß Ãµ°øÀÌ ¹ß»ýÇÏ¸é ¾Æ¹«¸® ÁÖÀÇÇصµ pig°¡ Áï½Ã ȤÀº ¼ö½ÊºÐ À̳»¿¡ »ç¸ÁÇÑ´Ù´Â °ÍÀÌ ¹®Á¦ÀÔ´Ï´Ù. ¾î¸° µÅÁöÀÌ°í Èä°­ÀÌ À۱⠶§¹®ÀÌ ¾Æ´Ñ°¡ ½Í½À´Ï´Ù. Live pig POEM¿¡ ¾Õ¼­ EndoGEL POEMÀ» ¿¬½ÀÇÏ¸é µ¿¹°½Ç½ÀÀÌ ´õ Àß µÇÁö ¾ÊÀ»±î »ý°¢µË´Ï´Ù.


[2019-12-5. Live pig ESD at Songdo]

ÀÌÁØÇàÀÇ ½Ã¹ü ÈÄ ¿©·¯ ¼±»ý´ÔµéÀÌ ¿¬½ÀÀ» ÇÏ¿´½À´Ï´Ù.

Training room

Pig stomachÀº ÀÎü À§Á¡¸·¿¡ ºñÇÏ¿© µüµüÇÏ°í ÇÇ°¡ ´ú ³³´Ï´Ù. EndoCut°ú ºñ½ÁÇÑ º¹ÀâÇÑ Àü·ùº¸´Ù PureCut¸¦ ÀÌ¿ëÇÏ´Â °ÍÀÌ ÆíÇÒ ¼ö ÀÖ½À´Ï´Ù.

ESG-300

Á¡½É½Ã°£ ÈÄ Àá½Ã ESD case discussionÀ» ÇÏ¿´½À´Ï´Ù.

Live pig ESD hands-on¿¡ Âü¿©ÇÏ¿´´ø ÇÑ ¼±»ý´ÔÀÇ feedbackÀÔ´Ï´Ù.

¼±»ý´Ô. ¾È³çÇϼ¼¿ä. ¼Ûµµ¿¡¼­ ÁøÇàµÈ live pig ESD ÇÚÁî-¿Â¿¡ ´ëÇÑ ¼Ò°¨ ¸»¾¸µå¸³´Ï´Ù. ¿ì¼± ÁÁÀº ±âȸÀÇ ÀåÀ» ¸¶·ÃÇØ ÁֽŠÀÌÁØÇà ¼±»ý´Ô, ÇϳªÇϳª ¼¼½ÉÇÏ°Ô ÁغñÇØ ÁֽŠ¿Ã¸²Çª½º»ç¿¡ °¨»çµå¸³´Ï´Ù.

ÁøÇà ¼ø¼­: 10½Ã µ¿¹° À±¸® ±³À° (replacement, reduction, refinement) → repair center Åõ¾î → 11½Ã ESD demo (½Ã¼ú: ÀÌÁØÇà) → ESD ½Ç½À (¿ÀÀü) → 1½Ã Á¡½É ½Ä»ç → ESD case review → 2½Ã ESD ½Ç½À (¿ÀÈÄ) → 4½Ã30ºÐ Á¾·á. Àüü ÁøÇà ¼ø¼­´Â ¾î´À ÇÚÁî-¿Âº¸´Ùµµ ¾ËÂ÷°Ô ±¸¼ºµÇ¾î ÀÖ¾ú½À´Ï´Ù. ESD case review±îÁö ÁغñÇϽŠÁ¤¼º¿¡ °¨ÅºÇß½À´Ï´Ù.

ESD demo: 2013 ³â Æç·Î¿ì »ýÈ° ÀÌÈÄ¿¡ óÀ½ ESD ¸¦ Á¢ÇÏ´Â Áö¶ó ESD demo º¸¿©ÁֽŠ°ÍÀÌ ¿¹Àü Æç·Î¿ì ½ÃÀý ¾î½Ã½ºÆ® ÇÏ´ø ¶§ÀÇ ±â¾ïÀÌ ¶°¿Ã¶ó Å« µµ¿òÀÌ µÇ¾ú½À´Ï´Ù. Dual ³ªÀÌÇÁ¿Í IT ³ªÀÌÇÁ´Â Æç·Î¿ì ½ÃÀý¿¡µµ ÀÖ¾ú´ø ³ªÀÌÇÁµéÀ̶ó »ý¼ÒÇÏÁö´Â ¾Ê¾Ò½À´Ï´Ù.

ESD ½Ç½À: 2ÀÎ 1 Á¶ (¾Æ¸¶µµ ´çÃÊ¿£ 3ÀÎ 1Á¶) ·Î ÁøÇàµÇ¾ú´Âµ¥ ½Ç½À ³»³» Áýµµ¿Í ¾î½Ã½ºÆ®¸¦ µ¹¾Æ°¡¸é¼­ ÁýÁßÇÒ ¼ö ÀÖ¾î ÁÁ¾Ò½À´Ï´Ù. ´Ù¸¸ ESD Á¶ÀÛÀÌ Àͼ÷ÇÏÁö ¾Ê¾Æ À°Ã¼ÀûÀ¸·Î Á¶±Ý Èûµç ´À³¦Àº ÀÖ¾ú½À´Ï´Ù. 3ÀÎ 1 Á¶·Î ÁøÇàÇÑ´Ù¸é Áß°£ Áß°£ ÈÞ½Ä Å¸ÀÓÀÌ À־ ÁÁÀ» °Í °°½À´Ï´Ù. ´Ù¸¸ 3 ÀÎ ¸ðµÎ ESD °¡ óÀ½À̶ó¸é ÁýÁßµµ°¡ ¶³¾îÁú ¼ö ÀÖÀ» °Í °°½À´Ï´Ù. 3 ÀÎ 1 Á¶·Î ÁøÇàÇÑ´Ù¸é 1¸í Á¤µµ´Â ESD °æÇèÀÌ Á¶±Ý ÀÖ´Â ºÐÀÌ Æ÷ÇÔµÇ¸é ´õ ÁÁÀ» °Í °°½À´Ï´Ù.

Á¾·á½Ã°£ 4½Ã 30ºÐÀº ±³Åë üÁõÀÌ ½ÃÀ۵DZâ Àü ¸¶Áö³ë¼± °°Àº ´À³¦À̾ú½À´Ï´Ù. ÀÌ ½Ã°£ ¾È¿¡´Â ³¡À» ³»¾ß ¼­¿ï ¶Ç´Â ±âŸ °æ±â Áö¹æÀ¸·ÎÀÇ À̵¿ÀÌ ÆíÇÒ °Í °°¾Ò½À´Ï´Ù.

´Ù½Ã ÇÑ ¹ø ÁÁÀº ±âȸ ÁֽŠ¼±»ý´Ô°ú ¿Ã¸²Çª½º¿¡ °¨»çµå¸³´Ï´Ù.

Live pig ESD hands-on¿¡ Âü¿©ÇÏ¿´´ø ¶Ç ´Ù¸¥ ¼±»ý´ÔÀÇ feedbackÀÔ´Ï´Ù.

ÀÌÁØÇà ±³¼ö´Ô ±ÍÇÏ,

±³¼ö´Ô ¾È³çÇϽʴϱî?

³Ê¹« ¹Ù»Ú½ÇÅÙµ¥ Áö³­ ÁÖ ±ÍÇÑ ½Ã°£µéÀ» ³»¾î¼­ ºÎÁ·ÇÑ ÈĹ踦 °¡¸£ÃÄ Áּż­ Áø½ÉÀ¸·Î °¨»çµå¸³´Ï´Ù. ¹Ì¸® °¨»çÀÇ ¸»¾¸ µå·È¾î¾ß Çϴµ¥ ÀúÈñ °ú¿¡¼­ ÁÖ°üÇÏ´Â Çà»ç°¡ ¹Ù·Î ´ÚÃļ­ ³Ê¹« ¹Ù»Ú°Ô ÁøÇàµÇ¾î »çÁøÀ» º¸³» ÁֽŠ°Íµµ ÀÌÁ¦¾ß È®ÀÎÀ» ÇÏ¿´½À´Ï´Ù.

Áö³­ ÁÖ °æÇèÇÏ°Ô ÇØ ÁֽŠ±³À° ÇÁ·Î±×·¥À» ÅëÇØ ESD¸¦ ÇÏ´Â ¼±»ý´ÔµéÀ» ´õ ¸¹ÀÌ ÀÌÇØÇÏ°Ô µÇ¾ú°í, ¼ö¼úÀå¿¡¼­ÀÇ ³»½Ã°æ°ú ÇâÈÄ ÇÏÀ̺긮µå ¼ö¼ú¿¡ ´ëÇØ ¾ÆÀ̵ð¾î¸¦ »ý°¢ÇÒ ¶§¿¡µµ °¡¸£ÃÄ ÁֽŠÁö½ÄµéÀÌ Å« µµ¿òÀÌ µÉ °Í °°½À´Ï´Ù.

Ç×»ó ȯÀÚ¸¦ ¸ÕÀú »ý°¢ÇÏ½Ã°í ¿©·¯ ÈÄÇеéÀ» ¸ðµÎ ¾Æ³¢½Ã°í °¡¸£ÃÄÁֽô ¼±»ý´ÔÀÇ ¿­Á¤°ú ¼ö°í¸¦ Ç×»ó Á¸°æÇÏ¿À¸ç, Àúµµ º»¹Þ¾Æ¼­ Á¦°¡ ¾Ë°í ÀÖ´Â °ÍÀ» ´Ù¸¥ »ç¶÷µé°ú ³ª´­ ¼ö ÀÖµµ·Ï ³ë·ÂÇÏ°Ú½À´Ï´Ù.


[2022-12-10. Live pig ESD at Songdo]

 20221210 Live pig ESD and BOXIM at Olympus Songdo K-TEC training center 

9:00-9:20 line tour

9:20-9:40 Introductory lecture (°ø¼º¹Î)

9:40-10:00 Case review (ÀÌÁØÇà)

10:00-12:30 ¿ÀÀü live pig ESD (°ø¼º¹Î, ¼ÛÁÖÇý)

10:00-12:30 BOXIM training (ÀÌÁØÇà)

12:30-13:30 Lunch

13:30-16:00 ¿ÀÈÄ live pig ESD (°ø¼º¹Î, ¼ÛÁÖÇý)

13:30-16:00 BOXIM training (ÀÌÁØÇà)



[2023-6-24] Live pig ESD hands-on training at Olympus K-TEC

Trainee 9¸í: »ï¼º¼­¿ïº´¿ø 1,2³âÂ÷ fellow 4¸í (±èż¼, ±è¹ÎÁö, À̺¸°æ, ÀÌÇÏÁø), °­ºÏ»ï¼ºº´¿ø 2³âÂ÷ fellow 2¸í (Á¶¿¹Áø, ¹Ú¼­Çö), ¼­¿ï´ëº´¿ø 2³âÂ÷ fellow 3¸í (¿À¹ÌÁø, Á¶±âÀç)

9:00-9:20 Effect of renal insufficiency on the short and long-term outcomes of endoscopic submucosal dissection for early gastric cancer: a propensity score-matched analysis (±èż¼. Digestive Endoscopy 2023;35:869)

Overall survival

Disease specific survival

9:20-10:00 Case discussion (ÀÌÁØÇà)

10:00-12:30 Morning training

12:30-13:00 Á¡½É

13:00-15:00 Afternoon training


[2023-9-22] Live pig ESD hands-on training at Olympus K-TEC


[FAQ]

[2022-1-1] ¿¬¸»¿¬½Ã ¿©·¯ºÐ°ú ¼Û³âÀλ縦 ³ª´©¾ú½À´Ï´Ù. ±× Áß °¡Àå ¹Ý°¡¿î °ÍÀº ÇÑ Á¦ÀڷκÎÅÍÀÇ ¸ÞÀÏÀ̾ú½À´Ï´Ù. Fellow trainingÀ» ¸¶Ä¡°í ÃëÁ÷ ù ÇØ 45°³ÀÇ gastric ESD¸¦ ¼º°øÀûÀ¸·Î ¸¶Ä£ °ÍÀº ´ë´ÜÇÑ ¼º°úÀÔ´Ï´Ù. EndoGEL ESD, ex-vivo pig stomach ESD, live pig ESD, clinical case ESD¸¦ ¿­½ÉÈ÷ °¡¸£Ä£ º¸¶÷ÀÌ ÀÖ½À´Ï´Ù. ÃàÇÏÇÏ°í ´õ¿í ¼ºÀåÇϱ⠹ٶø´Ï´Ù.


[References]

1) EndoTODAY SMC ³»½Ã°æ simulator ±³À° ½Ã½ºÅÛ °³¹ß - °æÇè°ú ¿ª»ç

2) EndoTODAY ESD animal model training - °æÇè°ú ¿ª»ç

© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng. (since 1999-8-23)