A novel ex vivo porcine simulator for transanal endoscopic operation training.

National bowel screening programs have led to an increase in early rectal cancer and complex rectal polyp detection by using the transanal endoscopic operation (TEO). Our aim is to develop an ex vivo porcine simulator for TEO training. A video of the prototype is provided (Video 1, available online at www.giejournal.org). Porcine rectal tissue was injected with a “polyp mix” in order to simulate a rectal lesion. This was attached to a TEO device, as demonstrated in Figure 1. A simulated, partial-thickness transanal endoscopic procedure was performed by using the apparatus. The simulator re-created TEO in a realistic manner. The rectal lesion was removed with standard TEO techniques. The model also can be used to practice TEO suturing. This video demonstrates a unique way of simulating TEO that is reproducible and economically viable. The next stage is to validate this model for use in TEO skills training.