The Minimally Invasive Esophagectomy (MIE) App: a novel teaching tool for minimally invasive esophagectomy

Background: Minimally invasive esophagectomy (MIE) is an alternative to open surgery for patients requiring esophageal resection. Despite the potential of MIE to reduce patient morbidity, the complexity of the procedure has made it challenging to learn, therefore limiting widespread adoption. An interactive computer- and smartphone-based application has been developed to facilitate comprehensive teaching of MIE. Methods: The entire Ivor-Lewis MIE procedure was broken down into fundamental steps. A text-based atlas was created to guide the learner through all phases of the operation. Surgical videos of the associated steps were also captured and annotated. Finally, a 3-dimensional (3D) modeling platform was used to create a simulated environment in which learners can test their knowledge of the procedure. Results: Our application delivers an easy-to-use, multi-platform learning tool. It combines didactic text-based learning with high-definition videos and a realistic, interactive simulator. Conclusions: The MIE App allows individuals to learn and simulate each fundamental step of Ivor-Lewis MIE. It provides accompanying videos as well as a detailed text-based atlas. The application is available through multiple platforms (PC/Mac, Android, and iOS) and provides objective evaluation via an interactive competency assessment tool. We hope that this application will serve as an adjunct to traditional operating room exposure, allowing for accelerated adoption of MIE.