The Endoscopy AccuTouch® Surgical Simulation System's Biopsy module focuses on using forceps in the working channel of the endoscope to interact with the mucosa and lesions. Interaction between the forceps and mucosa shows tissue deformation and accurately reflects tissue resistance and the amount of pressure exerted by the tool when taking a sample. Intubation of the terminal ileum is also possible. Six cases present progressively difficult anatomy, enabling graduated learning.

Extensive multimedia didactic content also expands the learning experience. Video tutorials demonstrate the function of the working channel, the use of irrigation to better visualize the colonic wall, and the taking biopsies. Indications, contraindications, and complications of biopsy are detailed, and a comprehensive pathology atlas depicts actual lesions and polyps that may be encountered during an examination.

A thorough evaluation report is automatically generated every time a user proceeds through a case. All reports are stored in a password-protected database to provide user-specific documentation of training and competency. Items that are recorded include summary parameters such as total procedural time, maximum depth of scope insertion, colonic perforations, whether retroflexion was performed, percent of colonic mucosa visualized, degree of pain experienced by the patient, and whether excessive sedation was used. The number of successful biopsies, including their type and location, is also tracked. Additional metrics include details on scope handling and visualization parameters.

Training Objectives

Upon completion of the Colonoscopy: Biopsy Module, users will be able to:

Identify pathologies, interact with the colon model, and perform a biopsy in a simulated environment
Understand the basic differences and usage between the types of forceps available
Appreciate the basic colonoscopy navigational techniques
that make biopsying in certain areas of the colon easier
Demonstrate, in a simulated environment, some of the uses of the working channel
Discuss tips and techniques for overcoming common problems specific to biopsy

Realistic Educational Aids

The Endoscopy AccuTouch® System delivers realistic, procedure-based content for cognitive and motor skills training. The system consists of a PC, an interface device with interchangeable anatomy, proxy endoscopes, and software modules for a wide range of training scenarios. Colonoscopy: Biopsy provides several teaching tools:

Forceps can be used anywhere in the simulated colon and can biopsy any part of the mucosa repeatedly.
Irrigation allows the user to loosen stool or glandular secretions from the mucosa surface and typically improves the amount of mucosa visualized during the simulated procedure.
Skills of navigation and intubation of the simulated terminal
ileum can be practiced using either direct or retroflexion techniques.
A submucoscal tenting animation demonstrates how an overzealous endoscopist may grasp too much tissue, which may lead to complications.
Clinical tips illustrate innately difficult biopsy locations and how scope angulation is required in order to take a biopsy.
Optimal distance for taking a biopsy sample is demonstrated through 3-D animation.
A Virtual Attending feature provides instructional feedback throughout the procedure.