Post written by Tatsuma Nomura, MD, and Shinya Sugimoto, MD, from the Department of Gastroenterology, Kinan Hospital, Minamimuro, and the Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan.

We conducted endoscopy training for endoscopic angle manipulation using the transparent sheet and the EGD Simulator. The video and figure show the animation and the actual colorectal ESD. Training involves accurately moving the endoscope tip in 16 directions and also drawing circles using the tip.

Moving the endoscope tip in the intended direction is important for performing ESD, during which the endoscope tip is often moved parallel to the muscular layer. Endoscopists can improve the stability of their operative movements by facilitating the development of manual manipulation skills (ie, placement of the left thumb, middle, and ring fingers, as shown in the video), which allows for greater control over the up-and-down and left-to-right endoscopic angle levers.

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