Innovative Dual-Network Composite Hydrogels for Endoscopic Submucosal Dissection Training

Overview

This study presents a novel 3D-printed gastric ESD training model using dual-network composite hydrogels with embedded vascular networks that realistically simulate human gastric wall layers and bleeding. Evaluation by 20 endoscopists demonstrated high realism ratings and effective procedural training across experience levels.

Background

Endoscopic submucosal dissection (ESD) is a minimally invasive technique for en-bloc resection of early gastrointestinal cancers, offering advantages over conventional endoscopic mucosal resection. However, ESD requires advanced technical skills and has a steep learning curve, with current training models limited by anatomical and biomechanical inaccuracies or ethical concerns. To overcome these challenges, the study developed a hydrogel-based simulation model replicating gastric wall stratification and vascularization to enhance training realism and competency acquisition.

Data Highlights

Key Findings

• The hydrogel model accurately replicated human gastric wall layers (mucosa, submucosa, muscularis propria) with tunable stiffness matching clinical measurements.
• Embedded hydrogel tubing simulated pressurized bleeding via dyed fluid at 25 kPa, enhancing procedural realism.
• Participants rated the model highly on a 7-point Likert scale for visual realism, anatomical accuracy, and tissue properties.
• Technical steps such as lesion marking, submucosal injection, circumferential incision, and dissection were rated as realistic by expert evaluators.
• Content validity assessments indicated the model improved operational similarity to real procedures, ease of use, training appropriateness, skill enhancement, confidence, and potential risk reduction.
• Operation times and performance metrics varied appropriately with operator experience, supporting the model’s utility for competency development.

Clinical Implications

This hydrogel-based ESD training model offers a cost-effective, anatomically and biomechanically realistic platform for endoscopists to develop and refine ESD skills. Its incorporation of vascular simulation and layered tissue properties may reduce reliance on animal models and accelerate the learning curve, potentially improving patient safety and procedural outcomes.

Conclusion

The innovative dual-network composite hydrogel model effectively simulates key aspects of gastric ESD, demonstrating high realism and educational value. It represents a promising tool to enhance endoscopic training and facilitate broader adoption of ESD techniques.

References

1. Yu, Zhao et al. 2024 -- Development and Evaluation of a Dual-Network Composite Hydrogel ESD Model