Colorectal

Colorectal Endoscopic Submucosal Dissection Using the Double-Clips Traction Method

Dae Kyung Sohn

J Surg Innov Educ. 2024;1(2):39-41.   Published online November 27, 2024

DOI: https://doi.org/10.69474/jsie.2024.00080

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Endoscopic submucosal dissection (ESD) is an advanced endoscopic technique used to remove large adenomas or early colorectal cancers. This paper presents a step-by-step introduction of the methodology for performing colorectal ESD using the double-clips traction method. The technique is designed to enhance visualization, shorten the procedure time, and improve the safety and efficacy of colorectal ESD, especially in challenging cases involving large or fibrotic lesions. By providing reliable traction, this method helps to maintain a stable and clear field of view throughout the procedure, which is critical for the success of the dissection.

Feasibility and Competency Outcomes of a Standardized Colonoscopy Curriculum in General Surgery Residency

Dae Kyung Sohn, Sang-Ho Jeong, Seung Jae Roh, Sa-Hong Min, In-Seob Lee

Received March 18, 2026  Accepted May 3, 2026  Published online May 27, 2026  

DOI: https://doi.org/10.69474/jsie.2026.00010

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Background
Integrating structured colonoscopy training into general surgery residency programs remains both a logistical and educational challenge. This study evaluated the feasibility and educational outcomes of a standardized colonoscopy training curriculum for surgical residents using objective competency assessments and trainee perceptions.
Methods
A retrospective mixed-methods analysis was conducted among general surgery residents who participated in a standardized colonoscopy training program between 2022 and 2025. Faculty assessed objective procedural competency using the Direct Observation of Procedural Skills framework across three domains: basic manipulation, anatomical understanding, and insertion & advancement. Trainee perceptions regarding the training environment, procedural difficulty, and perceived educational value were evaluated using a post-training survey.
Results
Objective competency data from 369 residents were analyzed. Residents demonstrated high performance in the basic manipulation and anatomical understanding domains following completion of the training program. In contrast, scores in the insertion & advancement domain were comparatively lower, suggesting greater technical difficulty. Post-graduate year (PGY)-3 residents achieved significantly higher scores than PGY-2 residents in this domain (p=0.015), whereas performance in the other domains was comparable between the groups. Post-training survey responses indicated that most residents considered the training duration and group size appropriate, and more than 94% reported that the program would be beneficial for their future clinical practice.
Conclusions
A standardized colonoscopy training curriculum implemented during surgical residency was feasible and was associated with high levels of competency in fundamental endoscopic skills. However, insertion and advancement techniques remained more challenging for junior trainees, suggesting that additional practice opportunities targeting complex insertion skills may improve future training programs.