ArticleSurgical endoscopy2019
A task and performance analysis of endoscopic submucosal dissection (ESD) surgery.
Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 21 citations in OpenAlex.
- Analysis and objective assessment of transoral robotic surgery.International journal of computer assisted radiology and surgery · 2026Article
- The Current Landscape of Endoscopic Submucosal Training in the United States.Current gastroenterology reports · 2025Review
- Validity of a virtual reality-based straight coloanal anastomosis simulator.International journal of computer assisted radiology and surgery · 2025Article
- Development of a Bioinspired Soft Robotic System for Teleoperated Endoscopic Surgery.Cyborg and bionic systems (Washington, D.C.) · 2025Article
- Novel beagle model of gastric local fibrotic target lesions for the evaluation and training of endoscopic techniques.BMC gastroenterology · 2023Article
- Intelligent surgical workflow recognition for endoscopic submucosal dissection with real-time animal study.Nature communications · 2023Article
- Hierarchical task analysis of endoscopic sleeve gastroplasty.Surgical endoscopy · 2022Article
- A partition-based optimization model and its performance benchmark for Generative Anatomy Modeling Language.Computers in biology and medicine · 2020Article
- Endoscopic submucosal dissection: a cognitive task analysis framework toward training design.Surgical endoscopy · 2020Article
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Authors and funding
14 authors at 8 institutions in 1 country.
Funding
Abstract
backgroundESD is an endoscopic technique for en bloc resection of gastrointestinal lesions. ESD is a widely-used in Japan and throughout Asia, but not as prevalent in Europe or the US. The procedure is technically challenging and has higher adverse events (bleeding, perforation) compared to endoscopic mucosal resection. Inadequate training platforms and lack of established training curricula have restricted its wide acceptance in the US. Thus, we aim to develop a Virtual Endoluminal Surgery Simulator (VESS) for objective ESD training and assessment. In this work, we performed task and performance analysis of ESD surgeries.
methodsWe performed a detailed colorectal ESD task analysis and identified the critical ESD steps for lesion identification, marking, injection, circumferential cutting, dissection, intraprocedural complication management, and post-procedure examination. We constructed a hierarchical task tree that elaborates the order of tasks in these steps. Furthermore, we developed quantitative ESD performance metrics. We measured task times and scores of 16 ESD surgeries performed by four different endoscopic surgeons.
resultsThe average time of the marking, injection, and circumferential cutting phases are 203.4 (σ: 205.46), 83.5 (σ: 49.92), 908.4 s. (σ: 584.53), respectively. Cutting the submucosal layer takes most of the time of overall ESD procedure time with an average of 1394.7 s (σ: 908.43). We also performed correlation analysis (Pearson's test) among the performance scores of the tasks. There is a moderate positive correlation (R = 0.528, p = 0.0355) between marking scores and total scores, a strong positive correlation (R = 0.7879, p = 0.0003) between circumferential cutting and submucosal dissection and total scores. Similarly, we noted a strong positive correlation (R = 0.7095, p = 0.0021) between circumferential cutting and submucosal dissection and marking scores.
conclusionsWe elaborated ESD tasks and developed quantitative performance metrics used in analysis of actual surgery performance. These ESD metrics will be used in future validation studies of our VESS simulator.
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