Validation of a novel swine model for training in EUS-FNA (with videos)

BACKGROUND AND OBJECTIVES: EUS-FNA is applied widely in clinical practice, but there remains a lack of authentic training models. The present study aimed to develop a novel swine training model and to perform a preliminary assessment of its feasibility and efficacy. MATERIALS AND METHODS: To create an internal lesion-like target, empty shells of iodine-125 seeds were implanted into the caudate lobe of the liver in Bama minipigs. A training program involving 10 trainees was subsequently carried out, in which a total of 60 needlings were performed, composed of 6 for each trainee obtained during two training steps. Comparisons of procedure-related variables were conducted between the two. Trainees completed a questionnaire to assess their basic endoscopic experiences and reasonability of the model. RESULTS: A target region of 2.0 cm × 2.0 cm in diameter was successfully established on the caudate lobe in all implanted pigs. In the training program, the average procedure time decreased from the first to the second step and the average time for the total 30 needlings' obtainment was significantly shorter for the second training step (23.8 ± 4.5 min vs. 40.9 ± 9.0 min, P < 0.001). For the second step, there was also a significant improvement in total success rate (86.7% vs. 56.7%, P = 0.020) and accuracy rate (76.7% vs. 43.3%, P = 0.017). All trainees scored the effectiveness of the model highly and all reported improved confidence after the training. CONCLUSION: This novel swine training model could authentically mimic clinical EUS-FNA, providing an effective in vivo practice tool for novices before clinical practice.