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Status of Training in the Use of Lumen-Apposing Metal Stents for Therapeutic Endoscopic Ultrasound During Advanced Endoscopy Fellowship: A Survey Questionnaire
Journal article   Open access   Peer reviewed

Status of Training in the Use of Lumen-Apposing Metal Stents for Therapeutic Endoscopic Ultrasound During Advanced Endoscopy Fellowship: A Survey Questionnaire

Yasi Xiao, Maham Hayat, Abdul S. Mohammed, Abdullah Abbasi, Sagar Pathak, Saurabh Chandan, Daryl Ramai, Deepanshu Jain, Muhammad K. Hasan, Mustafa A. Arain, …
iGIE : innovation, investigation and insights, Vol.4(4), pp.338-344.e3
12/2025
DOI: 10.1016/j.igie.2025.09.003
PMCID: PMC12850793
PMID: 41647815
url
https://doi.org/10.1016/j.igie.2025.09.003View
Published (Version of record) Open Access

Abstract

Background and Aims The lumen-apposing metal stent (LAMS) has revolutionized therapeutic endoscopic ultrasound (EUS). However, there is a paucity of data on the optimal approaches to training on the use of LAMS. This survey study aimed to evaluate the status of training in LAMS among advanced endoscopy fellowship (AEF) trainees. Methods AEF (academic year 2023-2024) trainees were invited to complete a 15-questions survey on LAMS training. The questions included the following domains: demographics, exposure to LAMS prior to AEF, number of observed and hands-on participation using the LAMS for pancreatic fluid collection drainage (EUS-PFCD), choledochoduodenostomy (EUS-CD), gallbladder drainage (EUS-GBD), gastrojejunostomy (EUS-GJ) and EUS-directed transgastric endoscopic retrograde cholangiopancreatography (EDGE). Trainees were asked about their level of confidence in performing these procedures independently upon completion of their AEF. Results Forty-three out of 92 trainees completed the survey. Trainees reported performing a median of 400 (interquartile range [IQR]: 305-525) EUS and 405 (IQR: 345-500) ERCPs. Most (88.4%) had exposure to hands-on LAMS training in explant/inanimate models during their AEF. More than half of trainees (23; 53.5%) reported hands-on participating in >10 EUS-PFCD cases; but ≤ 2 for each of the non-PFCD indications. While most trainees (88.4%) reported feeling confident in their ability to perform EUS-PFCD independently, only 34.9% and 39.6% indicated being confident for EUS-GJ and EUS-CD, respectively. Trainees who were confident had a significantly higher mean number of hands-on cases during AEF training when compared to their non-confident counterparts. Conclusion This study demonstrates significant variability in LAMS training exposure during AEF, with low hands-on opportunities for non-PFCD indications. Additional research is needed to establish optimal approaches to training in LAMS procedures.

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