Video Tip: ESD Learning Curve | May 2021-ESD Learning Curve Video Tip

Video Transcription

Add to that, that yourself, you have to invest in yourself to learn ESD. So I'm going to tell you that my experience is that I started my interest in ESD in 2011.  I started doing animal labs between 2011 to 2014, and I did basic labs and advanced animal labs like life animals and courses. And later on, I started doing ESD in 2014.  My practice is that pick up to become a real ESD practice till 2017. And now by 2021, like last year, 2020, I did more than 300 ESD a year. But to reach that number, it took me  around nine years of starting interest, which was in 2011. So you have to have a basic  precondition. You have to be in a referral center, have experience in EMR. You don't have to be a  senior endoscopist, but you cannot start out of fellowship interested in learning EOS and  learning ERCP, but also in the meantime learning ESD. And ESD requires focus. And if you're not  feeling comfortable with ERCP and you are chasing each and every ERCP you are seeing, then you'll  not have time to learn that. So it's not about being a senior endoscopist, but I would say  two or three years out of fellowship when you're not that worried about your ERCP skill or from  the beginning you're just focused on complex polypectomies as they do in Japan. They just  either go for ERCP routes or for polypectomies route and they even divide the ESD routes into  upper and lower. Then after that, you have to make structural decision. And what I mean by that,  you're going to spend two hours, three hours in the room. The worst thing you can ever do is to  plan your first ESD case and you do it in assuming it will be finished in one hour. And you spend  three hours and everybody knocking on your door because you have another patient after that.  So you have to plan it very well. You have to have at least half an hour, have at least two,  three hours for the first case. And you have to communicate that with your system that you are  still in the planning stage. Otherwise, somebody may write a complaint about you to the hospital.  And that's happened to me at the beginning and they sent to the CEO saying, Dr. Othman,  he spent at least three hours doing an EGD. So basically you have to explain to them that this  is not an EGD and that is a ESD. And once you reach to 40 or 50 case, that would be very comfortable.  Now we start to look for your outcomes. And what are your outcomes? You want to look at your R0  resection rate. You want to look at your curative resection rate. And you want to achieve a R0 resection rate of at least 90%. Curative resection rate depends on the lesion,  but between 70% to 80% is important.

Video Summary

In the video, the speaker discusses their experience with ESD (endoscopic submucosal dissection), a technique used in endoscopy. They started their interest in ESD in 2011 and began practicing it in 2014. It took them nine years to reach a point where they were performing over 300 ESD cases a year. They emphasize the importance of investing in oneself and acquiring experience in ESD, recommending a few years out of fellowship before starting to learn ESD. They also stress the need for focus and time management during ESD procedures. The speaker emphasizes the importance of planning and communication to avoid complaints and discusses the desired outcomes of ESD, including a high R0 resection rate (90%) and curative resection rate (70-80%). No credits were provided in the transcript.

Keywords

ESD

endoscopic submucosal dissection

experience

investing in oneself

time management