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CLOUD-BASED ARTIFICIAL INTELLIGENCE FOR DETECTION OF COLORECTAL NEOPLASIA – A RANDOMIZED CONTROLLED TRIAL (EAGLE TRIAL)

Rawen Kader 1, Cesare Hassan 2, Angel Lanas 3, Marcin Romanczyk 4, Tomasz Romanczyk 5, Bronislaw Kotowski 6, Carlos Sostres Homedes 3, Giacomo Bonanno 7, Benedetto Pio Mangiavillano 8, Laurence B. Lovat 1, Michal Filip Kaminski 9, Siegbert Faiss 10, Alessandro Repici 2

Affiliations

1 University College London, London, United Kingdom

2 Humanitas University, Pieve Emanuele MI, Italy

3 Universidad de Zaragoza, Zaragoza, Spain

4 Department of Gastroenterology, Academy of Silesia, Katowice, Poland

5 H-T. Centrum Medyczne Sp z o.o. Sp.k., Tychy, Poland

6 Polish Foundation of Gastroenterology, Michalow-Grabina, Poland

7 A.O. Vittorio Emanuele, Catania CT, Italy

8 Humanitas - Mater Domini, Milano, Italy

9 Maria Sklodowska-Curie Memorial Center and Institute of Oncology, Warsaw, Poland

10 Sana Klinikum Lichtenberg, Berlin, Germany

Summary

AI Generated

A prospective international multi-centre randomized controlled trial demonstrated that the cloud-based CADDIE Computer-Aided Detection system significantly improved adenoma detection rate and adenomas per colonoscopy compared to standard colonoscopy in average-risk screening and surveillance patients.

The CADDIE-assisted colonoscopy arm significantly increased adenomas per colonoscopy by 33 percent (0.62 vs 0.82, ratio 1.33, 95 percent CI 1.06-1.67, p=0.01) and adenoma detection rate by 7.3 percentage points (35.9 percent vs 43.2 percent, p=0.03) compared to standard colonoscopy.
Detection of sessile serrated lesions per colonoscopy more than tripled with CADDIE assistance (0.03 vs 0.08, ratio 3.30, 95 percent CI 1.41-7.57, p<0.01), and detection of large adenomas and large polyps approximately doubled.
The system achieved non-inferiority for Positive Percent Agreement (53.4 percent vs 53.9 percent) with no increase in unnecessary resections, demonstrating safety.
The trial included 841 participants and 22 endoscopists with baseline adenoma detection rates of at least 25 percent across eight centres in four European countries.
CADDIE is a cloud-based system that processes live endoscopy images via hospital internet network and overlays real-time bounding boxes to highlight suspected polyps.

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Abstract

Introduction

Several Randomized Controlled Trials (RCTs) have evaluated the role of artificial intelligence (AI) Computer-Aided Detection (CADe) systems to enhance polyp detection. However, these studies have focused exclusively on locally deployed hardware-based AI systems, whereas cloud-based systems may improve the accessibility and upgrading of CADe technology. ‘CADDIE’ (Odin Vision, an Olympus company) is a cloud-based CADe system that receives the live endoscopy image stream via the hospital’s internet network, where the AI algorithm processes the images, and overlays real-time bounding boxes on the endoscopy screen to highlight suspected polyps.

Aims & Methods

This prospective RCT aimed to evaluate the efficacy and safety of the novel cloud-based CADe-system in improving polyp detection.

This international, multi-centre, parallel-group RCT was conducted across eight centres in four European countries. Participating endoscopists had a baseline of >1000 colonoscopy procedures and an adenoma detection rate (ADR) of ≥25%. Patients aged ≥40 years and at average risk for colorectal cancer undergoing screening or surveillance indications for colonoscopy were recruited. Patients were randomised in a 1:1 ratio to standard colonoscopy (SoC) or CADDIE-assisted (CADe-arm) colonoscopy. The co-primary endpoints were superiority in adenomas per colonoscopy (APC) as the efficacy endpoint, and non-inferiority for the Positive Percent Agreement (PPA), defined as the percentage of resections that are histologically confirmed adenomas, SSLs and large (>10mm) hyperplastic polyps of the proximal colon, as the safety endpoint.

Results

Overall, 22 endoscopists and 841 participants were included in the analysis. The CADe-arm significantly increased APC by 33% (0.62 vs 0.82, Ratio 1.33 [95%CI 1.06-1.67], p=0.01) and ADR (35.9% vs 43.2%, difference of 7.3% [95%CI 0.7%-13.9%], p=0.03) compared to the SoC-arm. The mean detection of sessile serrated lesions (SSLs) (0.03 vs 0.08, Ratio 3.30 [95%CI 1.41-7.57], p<0.01), large adenomas (0.04 vs 0.09; Ratio 1.93 [95%CI 1.03-3.62], p=0.04), and large polyps (0.05 vs 0.12; Ratio 2.36 [95%CI 1.33-4.17], p<0.01) also significantly improved. A higher proportion of large polyps (27.3% vs. 37.0%) and large adenomas (15.8% vs 24.2%) were non-polypoid ‘flat’ morphology in the CADe-arm compared to the SoC-arm. Other detection metrics, including neoplastic polyps per colonoscopy (0.66 vs 0.91; Ratio 1.39 [95%CI 1.12-1.73], p<0.01) and polyps per colonoscopy (1.06 vs 1.41 (Ratio 1.35 [95%CI 1.13-1.61], p<0.01), also significantly increased.

Non-inferiority in PPA was achieved (53.4% vs 53.9%; 0.5% (-5.0%,∞)), with no increase in unnecessary resections.

Outcome	Study Arm	Patients (N)	Results	Difference (95% CI)	P-value
APC	SoC	424	0.62 ± 1.19	1	0.01
APC	CADe	417	0.82 ± 1.40	1.33 (1.06, 1.67)	0.01
ADR	SoC	424	35.9%	0	0.03
ADR	CADe	417	43.2%	7.3% (0.7%, 13.9%)	0.03
SSL-PC	SoC	424	0.03 ± 0.16	1	<0.01
SSL-PC	CADe	417	0.08 ± 0.45	3.30 (1.41, 7.57)	<0.01
PPC	SoC	424	1.06 ± 1.53	1	<0.01
PPC	CADe	417	1.41 ± 1.85	1.35 (1.13, 1.61)	<0.01

Table 1: Study results. ADR = Adenoma detection rate, APC = mean Adenomas Per Colonoscopy, PPC = Polyps Per Colonoscopy, SSL-PC = Sessile Serrated Lesions Per Colonoscopy.

Conclusion

This trial demonstrates the safety and efficacy of a cloud-based CADe-system to increase endoscopists' polyp detection across multiple metrics, notably for large adenomas, large polyps, and SSLs.

Disclosure

AR, CS, LBL, RK have received medical consultancy fees from Odin Medical Ltd

Conference

UEG Week Berlin 2025

Topics

Colorectal

Submission format

Abstract

Session

AI: Ready for transforming the clinical practice in lower GI? (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Nurse Programme (Complete Session)

EFFECTS OF GAMMA-AMINOBUTYRIC ACID SUPPLEMENTATION ON SYMPTOMS AND QUALITY OF LIFE IN IBS-D PATIENTS. PRELIMINARY RESULTS FROM A RANDOMIZED, DOUBLE BLINDED, PLACEBO CONTROLLED, CROSSOVER STUDY

Massimo Bellini

Verbal violence in the healthcare workplace and how to cope with it

Joanna Theodoridou

Accreditation for a newly recruited endoscopy nurse

Anne Vidil

Laudatio UEG Lifetime Achievement Awardee

Mario Dinis-Ribeiro

EFFECTIVENESS OF NEXT-GENERATION ENDOSCOPY TRAINING SIMULATOR FOR IMPROVING NOVICE FOREIGN ENDOSCOPISTS’ ENDOSCOPIC SUBMUCOSAL DISSECTION SKILLS: A SINGLE CENTER EXPLORATORY STUDY

Yutaka Saito

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Nurse Programme (Complete Session)

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Abstract

Event

UEG Week Berlin 2025

Session

IBD nurses: All around the gut

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Nurse Programme (Complete Session)

EFFECTS OF GAMMA-AMINOBUTYRIC ACID SUPPLEMENTATION ON SYMPTOMS AND QUALITY OF LIFE IN IBS-D PATIENTS. PRELIMINARY RESULTS FROM A RANDOMIZED, DOUBLE BLINDED, PLACEBO CONTROLLED, CROSSOVER STUDY

Massimo Bellini

Verbal violence in the healthcare workplace and how to cope with it

Joanna Theodoridou

Accreditation for a newly recruited endoscopy nurse

Anne Vidil

Laudatio UEG Lifetime Achievement Awardee

Mario Dinis-Ribeiro

EFFECTIVENESS OF NEXT-GENERATION ENDOSCOPY TRAINING SIMULATOR FOR IMPROVING NOVICE FOREIGN ENDOSCOPISTS’ ENDOSCOPIC SUBMUCOSAL DISSECTION SKILLS: A SINGLE CENTER EXPLORATORY STUDY

Yutaka Saito

UEG Presentation

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EFFECTS OF GAMMA-AMINOBUTYRIC ACID SUPPLEMENTATION ON SYMPTOMS AND QUALITY OF LIFE IN IBS-D PATIENTS. PRELIMINARY RESULTS FROM A RANDOMIZED, DOUBLE BLINDED, PLACEBO CONTROLLED, CROSSOVER STUDY

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EFFECTS OF GAMMA-AMINOBUTYRIC ACID SUPPLEMENTATION ON SYMPTOMS AND QUALITY OF LIFE IN IBS-D PATIENTS. PRELIMINARY RESULTS FROM A RANDOMIZED, DOUBLE BLINDED, PLACEBO CONTROLLED, CROSSOVER STUDY

Christian Lambiase 1, Lorenzo Cancelli 1, Antonio Grosso 1, Riccardo Tedeschi 1, Francesco Rettura 1, Andrea Bottari 1, Giulia Valdiserra 2, Letizia Campigli 2, Luca Antonioli 2, Matteo Fornai 2, Nicola de Bortoli 1, Massimo Bellini 1

Affiliations

1 University of Pisa, Pisa, Italy|||Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy

2 University of Pisa, Pisa, Italy

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Abstract

Introduction

Emerging evidence suggests a possible role for γ-aminobutyric acid (GABA) in the development of irritable bowel syndrome with diarrhea (IBS-D), as well as its possible therapeutic use.

Aims & Methods

This study primary aimed to assess the efficacy of a GABA-based supplement in patients with IBS-D in terms of improvement in quality of life. Secondary aims included assessing its impact on psychological wellbeing and gastrointestinal symptoms.
In this double-blind, placebo-controlled, single center, crossover pilot study, 20 IBS-D patients were randomized to receive a food supplement containing GABA and Melissa officinalis or a placebo, at the dosage of one tablet three times daily for two treatment periods of 4 weeks each, separated by a 2-week washout period. Before and after each treatment, patients were assessed through:

IBS Symptom Severity Scale (IBS-SSS). Responders were those with a ≥50-point reduction in IBS-SSS.
Short Form Health Survey 36 (SF-36) multidimensional questionnaire.
Hospital Anxiety and Depression Scale (HADS).

Pre- and post-treatment values were compared using a paired t-test; treatment comparisons used mixed models analysis.

Results

Eighteen patients completed the study (10 females, age 30.3±10.3 years).
A significant reduction of IBSS-SSS total score, as well as in all individual items, was observed in the GABA group (Table 1). A reduction of at least 50 points was achieved in 66.7% of patients treated with GABA and in 33.3% of those treated with placebo. Mixed models analysis showed a significant improvement with GABA compared to placebo in the IBS-SSS total score (p=0.01) and in the «Bowel satisfaction» item (p=0.005).
A significant improvement on the «Mental health» (p=0.007) and «Bodily pain» (p=0.09) items and in the mental composite score (MCS) of the SF-36 (0.037, Table 1) was observed with GABA. Mixed models analysis showed a significant improvement with GABA compared to placebo in the «Physical limitations» (p=0.033) and «Emotional limitation» (p=0.028) domains of SF-36.
GABA supplementation significantly improved the «HAD-Anxiety» score compared to baseline (6.7±3.0 Vs 5.1 ±2.7, p=0.02, Table 1) even though at mixed model analysis there was no significant effect.

Table 1. Comparison between pre- and post-treatment in placebo and GABA arms of the study.

	Variable	Placebo Before treatment	Placebo After treatment	p-value	GABA Before treatment	GABA After treatment	p-value
IBS-SSS	Abdominal pain	47.4±24.8	36.0±23.5	0.006	54.7±23.1	32.2±26.4	0.004
	Days with abdominal pain	48.3±27.5	42.2±31.2	0.238	50.6±29.0	33.3±28.9	0.004
	Abdominal distention	52.6±30.5	44.2±26.9	0.045	56.2±28.5	36.1±27.4	0.008
	Satisfaction with bowel habits	76.9±19.9	74.4±20.8	0.491	73.1±23.8	55.1±31.0	0.007
	Bowel interference	65.1±24.5	62.3±25.2	0.591	68.5±19.9	54.1±26.6	0.018
SF-36	Total score	290.3±98.6	259.2±100.5	0.017	303.0±93.9	210.9±114.5	<0.001
	Mental Health	59.3±15.7	67.1±10.5	0.030	60.2±15.9	68.9±16.0	0.006
	Bodily pain	58.8±20.1	61.0±18.2	0.565	58.8±17.0	69.9±20.4	0.009
	MCS	49.8±2.4	50.1±2.4	0.564	49.7±2.7	50.9±2.4	0.042

Conclusion

In this pilot study, GABA and Melissa officinalis supplementation showed a higher overall improvement in IBS-D symptoms (IBS-SSS total) and particularly in bowel habits satisfaction compared to placebo. GABA supplementation was superior to placebo in improving daily functioning, especially regarding physical and emotional limitations in IBS-D patients. GABA may be a valuable therapeutic option deserving further investigation in larger trials.

Disclosure

No conflicts of interest to declare

Event

UEG Week Berlin 2025

Topics

Colorectal

Submission format

Abstract

Session

Lower GI motility III

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Nurse Programme (Complete Session)

EFFECTS OF GAMMA-AMINOBUTYRIC ACID SUPPLEMENTATION ON SYMPTOMS AND QUALITY OF LIFE IN IBS-D PATIENTS. PRELIMINARY RESULTS FROM A RANDOMIZED, DOUBLE BLINDED, PLACEBO CONTROLLED, CROSSOVER STUDY

Massimo Bellini

Verbal violence in the healthcare workplace and how to cope with it

Joanna Theodoridou

Accreditation for a newly recruited endoscopy nurse

Anne Vidil

Laudatio UEG Lifetime Achievement Awardee

Mario Dinis-Ribeiro

EFFECTIVENESS OF NEXT-GENERATION ENDOSCOPY TRAINING SIMULATOR FOR IMPROVING NOVICE FOREIGN ENDOSCOPISTS’ ENDOSCOPIC SUBMUCOSAL DISSECTION SKILLS: A SINGLE CENTER EXPLORATORY STUDY

Yutaka Saito

UEG Presentation

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Verbal violence in the healthcare workplace and how to cope with it

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Verbal violence in the healthcare workplace and how to cope with it

Joanna Theodoridou 1

Affiliations

1 None, None, Greece

Summary

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Abstract

Event

UEG Week Berlin 2025

Topics

Nurses

Session

Staff safety and management

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Nurse Programme (Complete Session)

EFFECTS OF GAMMA-AMINOBUTYRIC ACID SUPPLEMENTATION ON SYMPTOMS AND QUALITY OF LIFE IN IBS-D PATIENTS. PRELIMINARY RESULTS FROM A RANDOMIZED, DOUBLE BLINDED, PLACEBO CONTROLLED, CROSSOVER STUDY

Massimo Bellini

Verbal violence in the healthcare workplace and how to cope with it

Joanna Theodoridou

Accreditation for a newly recruited endoscopy nurse

Anne Vidil

Laudatio UEG Lifetime Achievement Awardee

Mario Dinis-Ribeiro

EFFECTIVENESS OF NEXT-GENERATION ENDOSCOPY TRAINING SIMULATOR FOR IMPROVING NOVICE FOREIGN ENDOSCOPISTS’ ENDOSCOPIC SUBMUCOSAL DISSECTION SKILLS: A SINGLE CENTER EXPLORATORY STUDY

Yutaka Saito

UEG Presentation

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

Accreditation for a newly recruited endoscopy nurse

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Accreditation for a newly recruited endoscopy nurse

Anne Vidil 1

Affiliations

1 None, None, France

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Abstract

Event

UEG Week Berlin 2025

Topics

Nurses

Session

Education: Important tool for quality in endoscopy

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Nurse Programme (Complete Session)

EFFECTS OF GAMMA-AMINOBUTYRIC ACID SUPPLEMENTATION ON SYMPTOMS AND QUALITY OF LIFE IN IBS-D PATIENTS. PRELIMINARY RESULTS FROM A RANDOMIZED, DOUBLE BLINDED, PLACEBO CONTROLLED, CROSSOVER STUDY

Massimo Bellini

Verbal violence in the healthcare workplace and how to cope with it

Joanna Theodoridou

Accreditation for a newly recruited endoscopy nurse

Anne Vidil

Laudatio UEG Lifetime Achievement Awardee

Mario Dinis-Ribeiro

EFFECTIVENESS OF NEXT-GENERATION ENDOSCOPY TRAINING SIMULATOR FOR IMPROVING NOVICE FOREIGN ENDOSCOPISTS’ ENDOSCOPIC SUBMUCOSAL DISSECTION SKILLS: A SINGLE CENTER EXPLORATORY STUDY

Yutaka Saito

UEG Presentation

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Laudatio UEG Lifetime Achievement Awardee

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Laudatio UEG Lifetime Achievement Awardee

Mario Dinis-Ribeiro 1

Affiliations

1 IPO Porto, Porto, Portugal

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Abstract

Event

UEG Week Berlin 2025

Topics

Immunology

Session

Opening Plenary

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Nurse Programme (Complete Session)

EFFECTS OF GAMMA-AMINOBUTYRIC ACID SUPPLEMENTATION ON SYMPTOMS AND QUALITY OF LIFE IN IBS-D PATIENTS. PRELIMINARY RESULTS FROM A RANDOMIZED, DOUBLE BLINDED, PLACEBO CONTROLLED, CROSSOVER STUDY

Massimo Bellini

Verbal violence in the healthcare workplace and how to cope with it

Joanna Theodoridou

Accreditation for a newly recruited endoscopy nurse

Anne Vidil

Laudatio UEG Lifetime Achievement Awardee

Mario Dinis-Ribeiro

EFFECTIVENESS OF NEXT-GENERATION ENDOSCOPY TRAINING SIMULATOR FOR IMPROVING NOVICE FOREIGN ENDOSCOPISTS’ ENDOSCOPIC SUBMUCOSAL DISSECTION SKILLS: A SINGLE CENTER EXPLORATORY STUDY

Yutaka Saito

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EFFECTIVENESS OF NEXT-GENERATION ENDOSCOPY TRAINING SIMULATOR FOR IMPROVING NOVICE FOREIGN ENDOSCOPISTS’ ENDOSCOPIC SUBMUCOSAL DISSECTION SKILLS: A SINGLE CENTER EXPLORATORY STUDY

Takeshi Uozumi 1, Seiichiro Abe 1, Reona Kawamura 1, Yasuhiko Mizuguchi 1, Ryoji Ichijima 1, Satoru Nonaka 1, Yutaka Saito 1

Affiliations

1 National Cancer Center Hospital, Tokyo, Japan

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Abstract

Introduction

Endoscopic submucosal dissection (ESD) was developed in Japan decades ago and is now widely used as a minimally invasive treatment in Western countries. On-the-job training is the major method for acquiring ESD skills; thus, learning ESD is difficult for foreign endoscopists, who have less opportunity to perform it in their country. ENDONIX (Olympus, Tokyo, Japan) is a laptop-based next-generation 3D printed endoscopy simulator that allows basic and advanced endoscopy training. This study aims to evaluate the effectiveness of ENDONIX training for improving novice foreign endoscopists’ ESD skills.

Aims & Methods

This prospective, single-center, exploratory study was conducted at National Cancer Center Hospital (NCCH) between January 2024 and January 2025. Foreign endoscopists who had performed fewer than three ESD cases and participated in an international training program at NCCH were included. Participants were assigned 1:1 to either the Group A (Day 1-14: ENDONIX training with ESD observation followed by Day 15-28: ESD observation alone) or Group B (Day 1-14: ESD observation alone followed by Day 15-28: ENDONIX training with ESD observation). During the training period, participants performed three basic and one advanced training program on ENDONIX every day. On Days 1, 15, and 29, the endoscopists performed ESD for a 2cm lesion at the lesser curvature of the middle gastric body using a non-animal ESD model (G-Master, KOTOBUKI MEDICAL, Tokyo, Japan), and their technical performance was assessed at each time point. All procedures were supervised by a single experienced endoscopist (TU). The primary endpoint was the improvement in dissection speed (mm/min²) from Day 1 to Day 15 between the groups. Paired t-test was used to compare the corresponding continuous variables.

Results

		Group A	Group B	P value
Day 1	mean (SD) [95% CI], mm2/min	12.2 (2.8) [6.8 – 17.7]	13.4 (2.2) [9.1 – 17.7]	0.75
Day 15	mean (SD) [95% CI], mm2/min	18.6 (2.8) [13.2 – 24.1]	12.6 (1.4) [9.9 – 15.4]	0.10
Day 29	mean (SD) [95% CI], mm2/min	27.4 (2.8) [22.0 – 32.8]	18.4 (1.6) [15.2 – 21.5]	< 0.05

A total of 10 foreign endoscopists were enrolled in this study. The median age was 34 in Group A and 28 years in Group B. Nationalities in Group A were Spanish (n=3), Portuguese (n=1), and Chinese (n=1); in Group B, Spanish (n=4) and Ukrainian (n=1). All Group A endoscopists specialized in gastroenterology; Group B included four gastroenterologists and one oncologist. No significant differences were found between groups in baseline endoscopic experience. All participants completed predetermined ENDONIX training during the study period. ESD was performed on all designated days using G-Master, and en-bloc resection was achieved for the target lesions on without intraoperative perforation or damaging the resected specimen. The mean dissection speed significantly increased from Day 1 to Day 15 in Group A (“ENDONIX training with ESD observation”) (12.2 vs 18.6, p < 0.05). No significant differences were observed from Day 1 to Day 15 in Group B (“ESD observation alone”) (13.4 vs. 12.6, p = 0.81), while the mean dissection speed significantly increased from Day 15 to Day 29 (12.6 vs. 18.4, p < 0.05). Although the difference on Day 15 was not statistically significant between the groups (18.6 vs. 12.6, p = 0.10), Group A demonstrated a significantly higher dissection speed than Group B on Day 29 (27.4 vs. 18.4 p < 0.05), (Table 1).

Conclusion

The systematic endoscopy training with the ENDONIX platform improved the novice foreign endoscopists’ ESD skills. Dissection speed increased in the period receiving systematic ENDONIX training, highlighting the importance of systematic endoscopy training.

Disclosure

None

Conference

UEG Week Berlin 2025

Submission format

Abstract

Session

Endoscopy: New techniques and training (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

More Like This:

Nurse Programme (Complete Session)

EFFECTS OF GAMMA-AMINOBUTYRIC ACID SUPPLEMENTATION ON SYMPTOMS AND QUALITY OF LIFE IN IBS-D PATIENTS. PRELIMINARY RESULTS FROM A RANDOMIZED, DOUBLE BLINDED, PLACEBO CONTROLLED, CROSSOVER STUDY

Massimo Bellini

Verbal violence in the healthcare workplace and how to cope with it

Joanna Theodoridou

Accreditation for a newly recruited endoscopy nurse

Anne Vidil

Laudatio UEG Lifetime Achievement Awardee

Mario Dinis-Ribeiro

EFFECTIVENESS OF NEXT-GENERATION ENDOSCOPY TRAINING SIMULATOR FOR IMPROVING NOVICE FOREIGN ENDOSCOPISTS’ ENDOSCOPIC SUBMUCOSAL DISSECTION SKILLS: A SINGLE CENTER EXPLORATORY STUDY

Yutaka Saito