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Improved model for teaching interventional EUS.

BACKGROUND
A swine model was previously developed for teaching endoscopic ultrasound (EUS). The purpose of this study was to improve this model and develop a method for creating focal lesions for EUS imaging and intervention.


METHODS
Experiments were performed in farm pigs (Sus scrofa) under general anesthesia. Under real-time EUS guidance attempts were made to create a submucosal lesion and a focal mediastinal lesion, to perform EUS-guided fine-needle aspiration of the pancreas, and to confirm the site of injection during "sham" EUS-guided celiac block.


RESULTS
A hypoechoic, submucosal mass was created in the stomach, which was then imaged by EUS and punctured trans-gastrically. Injection of saline solution in the mediastinum created a pseudo-mediastinal lymph node. A needle was then advanced trans-esophageally into the mediastinum to mimic EUS-guided fine-needle aspiration of a mediastinal lymph node. Abdominal exploration of the pigs after euthanasia confirmed injection of the sham celiac block around the celiac ganglion.


CONCLUSION
The swine model is not only useful for teaching normal EUS anatomy, but it may be a useful model for teaching EUS-guided intervention.