Review
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World J Gastrointest Endosc. Aug 16, 2013; 5(8): 369-378
Published online Aug 16, 2013. doi: 10.4253/wjge.v5.i8.369
Training in endoscopic submucosal dissection
Roxana M Coman, Takuji Gotoda, Peter V Draganov
Roxana M Coman, Peter V Draganov, Division of Gastroenterology, Hepatology and Nutrition, University of Florida, Gainesville, Gainesville, FL 32610, United States
Takuji Gotoda, Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 160-0023, Japan
Author contributions: Coman RM did the literature search and wrote the first draft of the manuscript; Gotoda T contributed new articles to the literature search and provided critical review of the article; Draganov PV provided the concept of the article, contributed new articles to the literature search and provided critical review.
Correspondence to: Dr. Peter V Draganov, Division of Gastroenterology, Hepatology and Nutrition, University of Florida, 1600 SW Archer Rd., Room HD 602, PO Box 100214, Gainesville, FL 32610, United States. dragapv@medicine.ufl.edu
Telephone: +1-352-3922877 Fax: +1-352-3923618
Received: March 28, 2013
Revised: April 26, 2013
Accepted: June 18, 2013
Published online: August 16, 2013
Core Tip

Core tip: Endoscopic submucosal dissection (ESD) is a complex procedure associated with high complication rate. In Japan, training in ESD follows the traditional mentor/apprentice approach but significant variability in training approaches exists. We review the learning curves for ESD and describe the training algorithm proposed in Japan aiming to standardize training, and its applicability in the West. We highlight the challenges for ESD dissemination in the West, describing both the consensus and the diverging opinions between Asian and Western training models. Finally, we emphasize the need for structured training system to enhance trainee experience and, most importantly, to reduce the risks of complications and inadequate treatment.