1
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Liu S, Li YY, Li D, Wang FY, Fan LJ, Zhou LX. Advances in objective assessment of ergonomics in endoscopic surgery: a review. Front Public Health 2024; 11:1281194. [PMID: 38249363 PMCID: PMC10796503 DOI: 10.3389/fpubh.2023.1281194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/04/2023] [Indexed: 01/23/2024] Open
Abstract
Background Minimally invasive surgery, in particular endoscopic surgery, has revolutionized the benefits for patients, but poses greater challenges for surgeons in terms of ergonomics. Integrating ergonomic assessments and interventions into the multi-stage endoscopic procedure contributes to the surgeon's musculoskeletal health and the patient's intraoperative safety and postoperative recovery. Objective The purpose of this study was to overview the objective assessment techniques, tools and assessment settings involved in endoscopic procedures over the past decade and to identify the potential factors that induce differences in high workloads in endoscopic procedures and ultimately to design a framework for ergonomic assessment in endoscopic surgery. Methods Literature searches were systematically conducted in the OVID, pubmed and web of science database before October 2022, and studies evaluating ergonomics during the process of endoscopic procedures or simulated procedures were both recognized. Results Our systematic review of 56 studies underscores ergonomic variations in endoscopic surgery. While endoscopic procedures, predominantly laparoscopy, typically incur less physical load than open surgery, extended surgical durations notably elevate ergonomic risks. Surgeon characteristics, such as experience level and gender, significantly influence these risks, with less experienced and female surgeons facing greater challenges. Key assessment tools employed include electromyography for muscle fatigue and motion analysis for postural evaluation. Conclusion This review aims to provide a comprehensive analysis and framework of objective ergonomic assessments in endoscopic surgery, and suggesting avenues for future research and intervention strategies. By improving the ergonomic conditions for surgeons, we can enhance their overall health, mitigate the risk of WMSDs, and ultimately improve patient outcomes.
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Affiliation(s)
- Shuang Liu
- Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
| | - Yuan-you Li
- Department of neurosurgery, West China Hospital of Sichuan University, Chengdu, China
| | - Dan Li
- College of Computer Science, Sichuan University, Chengdu, China
| | - Feng-Yi Wang
- School of Communication and Information Engineering, Chongqing University of Posts and Telecommunications, Chongqing, China
| | - Ling-Jie Fan
- Department of rehabilitation medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Liang-xue Zhou
- Department of neurosurgery, West China Hospital of Sichuan University, Chengdu, China
- The Fifth People’s hospital of Ningxia, Ningxia, China
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2
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Pawa S, Kwon RS, Fishman DS, Thosani NC, Shergill A, Grover SC, Al-Haddad M, Amateau SK, Buxbaum JL, Calderwood AH, Chalhoub JM, Coelho-Prabhu N, Desai M, Elhanafi SE, Forbes N, Fujii-Lau LL, Kohli DR, Machicado JD, Marya NB, Ruan W, Sheth SG, Storm AC, Thiruvengadam NR, Qumseya BJ. American Society for Gastrointestinal Endoscopy guideline on the role of ergonomics for prevention of endoscopy-related injury: summary and recommendations. Gastrointest Endosc 2023; 98:482-491. [PMID: 37245720 DOI: 10.1016/j.gie.2023.05.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023]
Abstract
This clinical practice guideline from the American Society for Gastrointestinal Endoscopy provides an evidence-based approach to strategies to prevent endoscopy-related injury (ERI) in GI endoscopists. It is accompanied by the article subtitled "Methodology and Review of Evidence," which provides a detailed account of the methodology used for the evidence review. This document was developed using the Grading of Recommendations Assessment, Development and Evaluation framework. The guideline estimates the rates, sites, and predictors of ERI. Additionally, it addresses the role of ergonomics training, microbreaks and macrobreaks, monitor and table positions, antifatigue mats, and use of ancillary devices in decreasing the risk of ERI. We recommend formal ergonomics education and neutral posture during the performance of endoscopy, achieved through adjustable monitor and optimal procedure table position, to reduce the risk of ERI. We suggest taking microbreaks and scheduled macrobreaks and using antifatigue mats during procedures to prevent ERI. We suggest the use of ancillary devices in those with risk factors predisposing them to ERI.
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Affiliation(s)
- Swati Pawa
- Department of Gastroenterology, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Richard S Kwon
- Division of Gastroenterology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Douglas S Fishman
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA
| | - Nirav C Thosani
- Center for Interventional Gastroenterology at UTHealth, McGovern Medical School, Houston, Texas, USA
| | - Amandeep Shergill
- Division of Gastroenterology, Department of Medicine, University of San Francisco, San Francisco, California, USA
| | - Samir C Grover
- Division of Gastroenterology, Department of Medicine, Unity Health Toronto, St Michael's Hospital, Toronto, Ontario, Canada
| | - Mohammad Al-Haddad
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Stuart K Amateau
- Division of Gastroenterology Hepatology and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - James L Buxbaum
- Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Audrey H Calderwood
- Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Jean M Chalhoub
- Department of Gastroenterology and Internal Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York, USA
| | | | - Madhav Desai
- Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - Sherif E Elhanafi
- Division of Gastroenterology, Texas Tech University Health Sciences Center, El Paso, Texas, USA
| | - Nauzer Forbes
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Divyanshoo R Kohli
- Pancreas and Liver Clinic, Providence Sacred Heart Medical Center, Spokane, Washington, USA
| | - Jorge D Machicado
- Division of Gastroenterology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Neil B Marya
- Division of Gastroenterology and Hepatology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA
| | - Wenly Ruan
- Center for Interventional Gastroenterology at UTHealth, McGovern Medical School, Houston, Texas, USA
| | - Sunil G Sheth
- Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew C Storm
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nikhil R Thiruvengadam
- Division of Gastroenterology and Hepatology, Loma Linda University, Loma Linda, California, USA
| | - Bashar J Qumseya
- Department of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, Florida, USA
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3
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Gala K. Ergonomics in Endoscopy: A Fellow's Perspective. ACG Case Rep J 2023; 10:e00984. [PMID: 37180466 PMCID: PMC10171649 DOI: 10.14309/crj.0000000000000984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/16/2023] [Indexed: 05/16/2023] Open
Affiliation(s)
- Khushboo Gala
- Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN
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4
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Walsh CM. Enhancing Ergonomics in Pediatric Endoscopy Training and Practice. Gastrointest Endosc Clin N Am 2023; 33:235-251. [PMID: 36948744 DOI: 10.1016/j.giec.2022.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Pediatric endoscopists are at risk of work-related injuries from overuse and repetitive motions during endoscopy. Recently, there has been increasing appreciation for the importance of ergonomics education and training to help build long-term habits that prevent injury. This article reviews the epidemiology of endoscopy-related injuries in pediatric practice, describes methods for controlling exposures in the workplace, discusses key ergonomic principles that can be used to mitigate injury risk, and outlines tips for integrating education on endoscopy ergonomics during training.
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Affiliation(s)
- Catharine M Walsh
- Division of Gastroenterology, Hepatology and Nutrition and the SickKids Research and Learning Institutes, The Hospital for Sick Children, Department of Paediatrics and The Wilson Centre, Temerty Faculty of Medicine, University of Toronto, 555 University Avenue, Toronto, ON M5G 1X8, Canada.
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5
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Shiang A, Wang JS, Cho DH, Kushner B, Panahi AK, Awad MM. Patient Factors Affect Ergonomic Strain of Endoscopists During Colonoscopy. Dig Dis Sci 2023; 68:736-743. [PMID: 36352078 DOI: 10.1007/s10620-022-07721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Endoscopic procedures place a great deal of muscular strain on providers, especially over the span of their careers. In this study we quantitatively analyzed the effects of patient factors such as age, body mass index, and sex on the ergonomics of endoscopists performing colonoscopies. METHODS Surface electromyography (sEMG) was used to measure ergonomic strain of physicians while performing colonoscopies in several key muscle groups. The percent of the maximum voluntary contraction (%MVC) was used as a measure of muscular strain. Data was then analyzed based on the patient characteristics above. RESULTS Endoscopists performing colonoscopies on female patients (n = 47) experienced significantly higher ergonomic strain in their right trapezius and right posterior forearm muscle groups when compared to colonoscopies performed on males (n = 35) (%MVC R-trapezius: Male: 8.2; Female: 8.9; p = 0.048); (%MVC R-posterior forearm: Male: 10.4; Female: 11.6; p = 0.0006). Operators experienced greater strain in the same muscle groups when performing colonoscopies on patients with BMI ≤ 25 (n = 25) when compared to patients with BMI > 25 (n = 57) (%MVC R-trapezius: BMI < 25: 9.7; BMI ≥ 25: 8.2; p = 0.0002); (%MVC R-posterior forearm: BMI < 25: 11.9; BMI ≥ 25: 10.8; p = 0.0001). CONCLUSION Physicians experienced greater ergonomic strain when performing colonoscopies on female patients and on patients with a BMI < 25. We believe that these factors potentially impact the tortuosity of the colon and therefore influence the difficulty of navigating the endoscope. These results may aid physicians in gauging the anticipated difficulty of colonoscopies based on patient factors. Increased awareness of their posturing and ergonomics during challenging cases will alleviate musculoskeletal injuries in the long run.
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Affiliation(s)
- Alexander Shiang
- Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8077, St. Louis, MO, 63110, USA.
| | - Jean S Wang
- Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8077, St. Louis, MO, 63110, USA
| | | | - Bradley Kushner
- Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8077, St. Louis, MO, 63110, USA
| | - Ali K Panahi
- Nova Southeastern University, Fort Lauderdale, USA
| | - Michael M Awad
- Washington University in St. Louis, 660 S. Euclid Ave, Campus Box 8077, St. Louis, MO, 63110, USA
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6
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Shergill AK. Top tips for implementing an endoscopy ergonomics program. Gastrointest Endosc 2023; 97:361-364. [PMID: 36243106 DOI: 10.1016/j.gie.2022.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/15/2022] [Accepted: 09/26/2022] [Indexed: 02/08/2023]
Affiliation(s)
- Amandeep K Shergill
- Department of Gastroenterology, San Francisco VA Hospital, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
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7
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Ghasemi MS, Siadat M, Abdulrazak B, Dehghan N, Ibarra-Mejia G, Forogh B. Design and ergonomic evaluation of a new adapted endoscope holder to reduce muscle pressure and discomfort during endoscopy. Work 2023; 76:403-410. [PMID: 36776095 DOI: 10.3233/wor-220185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Laparoscopic surgeons who regularly perform endoscopy are more likely to develop musculoskeletal disorders than other internal medicine specialists, a difference that attributed to repetitive movements, poor postures, and sub-optimal equipment design. OBJECTIVE This study aimed to design, build, and evaluate an endoscope holder for reducing the static load applied by the weight of the endoscope, in order to reduce musculoskeletal disorders risk factors in the surgeon's hand, shoulder and back issues regions. METHODS A new endoscope holder was designed according to ergonomic design principles. The designed holder was evaluated by surface electromyography (sEMG) and discomfort assessment including 15 laparoscopic surgeons. The results were analyzed with centrality statistics and compared with the independent t-test using SPSS version 22. RESULTS The evaluation of the new endoscope holder shows a statistical significant decrease in the average electrical activity of biceps brachii, triceps brachii, lateral deltoid, T9 Thoracic erector spinae, L4 Lumbar erector spinae, and external oblique after using the holder (p < 0.05). CONCLUSION The results shows that using the new endoscope holder is associated with a lower level of discomfort, as well as a lower induced muscle activity. The results also highlight the need to upgrade the holder to offer rotability in all directions (perpendicular to the ground) which will be included in the next design.
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Affiliation(s)
- Mohamad Sadegh Ghasemi
- Department of Ergonomics, Faculty of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Siadat
- Department of Ergonomics, Faculty of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Bessam Abdulrazak
- Ambient Intelligence Laboratory (AMI-Lab), Computer Science Department, Faculty of Science, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Naser Dehghan
- Ambient Intelligence Laboratory (AMI-Lab), Computer Science Department, Faculty of Science, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Gabriel Ibarra-Mejia
- Department of Public Health, College of Health Sciences, The University of Texas at El Paso, El Paso, TX, USA
| | - Bijan Forogh
- Neuromusculoskeletal Research Center, Physical Medicine and Rehabilitation Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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8
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Otero-González I, Caeiro-Rodríguez M, Rodriguez-D’Jesus A. Methods for Gastrointestinal Endoscopy Quantification: A Focus on Hands and Fingers Kinematics. SENSORS (BASEL, SWITZERLAND) 2022; 22:9253. [PMID: 36501954 PMCID: PMC9741269 DOI: 10.3390/s22239253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Gastrointestinal endoscopy is a complex procedure requiring the mastery of several competencies and skills. This procedure is in increasing demand, but there exist important management and ethical issues regarding the training of new endoscopists. Nowadays, this requires the direct involvement of real patients and a high chance of the endoscopists themselves suffering from musculoskeletal conditions. Colonoscopy quantification can be useful for improving these two issues. This paper reviews the literature regarding efforts to quantify gastrointestinal procedures and focuses on the capture of hand and finger kinematics. Current technologies to support the capture of data from hand and finger movements are analyzed and tested, considering smart gloves and vision-based solutions. Manus VR Prime II and Stretch Sense MoCap reveal the main problems with smart gloves related to the adaptation of the gloves to different hand sizes and comfortability. Regarding vision-based solutions, Vero Vicon cameras show the main problem in gastrointestinal procedure scenarios: occlusion. In both cases, calibration and data interoperability are also key issues that limit possible applications. In conclusion, new advances are needed to quantify hand and finger kinematics in an appropriate way to support further developments.
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Affiliation(s)
- Iván Otero-González
- atlanTTic Research Center for Telecommunication Technologies, Universidade de Vigo, Campus-Universitario S/N, 36312 Vigo, Spain
| | - Manuel Caeiro-Rodríguez
- atlanTTic Research Center for Telecommunication Technologies, Universidade de Vigo, Campus-Universitario S/N, 36312 Vigo, Spain
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9
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Miller AT, Herberts MB, Hansel SL, Fox JC, Hallbeck MS, League J, Hinson C, Van Dyke C, Murray JA. Procedural and anthropometric factors associated with musculoskeletal injuries among gastroenterology endoscopists. APPLIED ERGONOMICS 2022; 104:103805. [PMID: 35649298 DOI: 10.1016/j.apergo.2022.103805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 05/12/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND AIMS Musculoskeletal (MSK) injuries among gastroenterologists are common. Our study describes risk factors and consequences of injury by comparing provider-specific anthropometric and objective procedural data to self-reported injury patterns. METHODS A validated MSK symptom survey was sent to gastroenterologists to gauge prevalence, distribution, and severity of active injury. Respondents' procedural activities over 7 years were collected via an endoscopic database. RESULTS 64 surveys were completed. 54 respondents had active pain; 53.1% reported activity-limiting injury. Activity-limiting injuries lead to longer colonoscopy times (25.3 vs. 22.1 min, P = 0.03) and lower procedural volumes (532 vs. 807, P = 0.01). Hand/wrist injuries yielded longer colonoscopy insertion times (9.35 vs. 8.21 min, P = 0.03) and less hands-on scope hours (81.2 vs. 111.7 h, P = 0.04). Higher esophagogastroduodenoscopy volume corelated with shoulder injury (336.5 vs. 243.1 EGDs/year, P = 0.04). Females had more foot injuries (P = 0.04). CONCLUSION Activity-limiting MSK symptoms/injuries affect over 50% of endoscopists with negative impact on procedural volume and efficiency.
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Affiliation(s)
- Alexander T Miller
- Division of Gastroenterology, UC Davis Medical Center, Sacramento, CA, USA
| | - Michelle B Herberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Stephanie L Hansel
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Jean C Fox
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - M Susan Hallbeck
- Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - John League
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Chadrick Hinson
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Carol Van Dyke
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Joseph A Murray
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
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10
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Pawa S, Martindale SL, Gaidos JK, Banerjee P, Kothari S, D’Souza SL, Oxentenko AS, Burke CA. Endoscopy-related injury among gastroenterology trainees. Endosc Int Open 2022; 10:E1095-E1104. [PMID: 36032041 PMCID: PMC9403520 DOI: 10.1055/a-1869-9202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/31/2022] [Indexed: 11/26/2022] Open
Abstract
Background and study aims Endoscopy-related injury (ERI) is widespread among practicing gastroenterologists. However, less is known about the incidence among trainees. This study assesses the rate of self-reported ERI occurrence, patterns of injury, and knowledge of preventive strategies in a nationally representative sample of gastroenterology fellows. Methods A 38-item electronic survey was sent to members of the American College of Gastroenterology. One hundred and sixty-eight gastroenterology fellows were included in analyses. Descriptive and univariate analyses evaluated the likelihood of ERI by workload parameters and gender. Results ERI was reported by 54.8 % of respondents. ERI was most common in the thumb (58.7 %), hand/finger (56.5 %), and wrist (47.8 %). There was no significant difference in the reported occurrence of ERI between male and female gastroenterology fellows. However, female fellows were significantly more likely to report a greater number of body areas affected by ERI, and male fellows were more likely to report elbow pain. Most respondents (85.1 %) reported discussion about, or training in, ergonomic strategies during gastroenterology fellowship. Conclusions ERI is reported to occur as early as gastroenterology fellowship. Results of this study support this finding and highlight the need for ongoing implementation and monitoring of a formal ergonomics training program as well as development of ergonomically appropriate instruments. Implications of these findings likely extend to trainees in other procedural related specialties like orthopedics and general surgery, though further research is required. Ergonomics training in gastroenterology fellowship and monitoring of its impact on trainees reported ERI is important due to negative effects on productivity and career longevity.
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Affiliation(s)
- Swati Pawa
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, North Carolina, United States
| | - Sarah L. Martindale
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, North Carolina, United States
| | | | - Promila Banerjee
- Loyola University Stritch School of Medicine, Maywood, Illinois, United States
- Hines VA Hospital, Hines, Illinois, United States
| | - Shivangi Kothari
- University of Rochester Medical Center, Rochester, New York, United States
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11
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Bessone V, Adamsen S. Gastrointestinal endoscopy and work-related injuries: an international survey. Endosc Int Open 2022; 10:E562-E569. [PMID: 35571470 PMCID: PMC9106411 DOI: 10.1055/a-1789-0506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/03/2021] [Indexed: 02/06/2023] Open
Abstract
Background and study aims Recently, the awareness of work-related musculoskeletal injuries (MSIs) among gastrointestinal endoscopists has increased because of their effect on the private and work life of clinicians as well as on the health care system. The high injury incidence (reported to range from 37 % to 89 %) has been correlated with the intensive muscular demand required during a procedure. Patients and methods An online survey with 32 questions was conducted globally. Clinically active endoscopists (doctors and nurses) participated anonymously and voluntarily. The questionnaire included questions about endoscopist anthropometrics, experience of MSI, treatment, and preventive measures such as ergonomic training. Descriptive statistics were used to analyse the data. Results Of 204 clinicians (78 % males; 81 % > 35 years of age), 107 (53 %) stated to have experienced a work-related MSI. The most frequent locations were in the neck (n = 49), shoulder and thumb (n = 39, both). Female clinicians resulted to be significantly more prone to develop MSI. In addition, endoscopists who performed more than 15 hours of endoscopy or more than 15 procedures per week reported a significantly higher rate of MSI. Conclusions The high frequency of MSIs among gastrointestinal endoscopists highlights the importance of implementing ergonomic training. Including simple precautions before and during endoscopy may reduce the risk of developing an injury.
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Affiliation(s)
- Veronica Bessone
- Department of Endoscope Engineering, Ambu Innovation GmbH, Augsburg, Germany
| | - Sven Adamsen
- Department of Clinical Application Ambu A/S, Ballerup, Denmark
- Digestive Disease Centre, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
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12
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Ono H, Hori Y, Tsunemi M, Matsuzaki I, Hayashi K, Kamijima M, Ebara T. Promoting endoscopists' health through cutting-edge motion analysis technology: Accuracy and precision of ergonomic motion tracking system for endoscopy suite (EMTES). J Occup Health 2022; 64:e12355. [PMID: 36069285 PMCID: PMC9449985 DOI: 10.1002/1348-9585.12355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/29/2022] [Accepted: 08/22/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Endoscopists often suffer from musculoskeletal disorders due to posture-specific workloads imposed by precise maneuvering or long procedural duration. An ergonomic motion tracking system for endoscopy suite (EMTES) was developed using Azure Kinect sensors to evaluate the occlusion, accuracy, and precision, focusing mainly on upper and lower limb movements. METHODS Three healthy male participants pointed the prescribed points for 5 s on the designated work envelopes and their coordinates were measured. The mean occlusion rate (%) of the 32 motion tracking landmarks, standard deviation (SD) of distance and orientation, and partial regression coefficient (β) and R2 model fit for accuracy were calculated using the time series of coordinates data of the upper/lower limb movements. RESULTS The mean occlusion rate was 5.2 ± 10.6% and 1.6 ± 1.4% for upper and lower limb movements, respectively. Of the 32 landmarks, 28 (87.5%) had occlusion rates of 10% or less. The mean SDs of 4.2 mm for distance and 1.2° for orientation were found. Most of the R2 values were over 0.9. In the case of right upper/lower limb measurement for orientation, β coefficients ranged from 0.82 to 1.36. CONCLUSION EMTES is reliable in calculating occlusion, precision, and accuracy for practical motion-tracking measurements in endoscopists.
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Affiliation(s)
- Hiroaki Ono
- Department of Occupational and Environmental HealthNagoya City University Graduate School of Medical Sciences/Medical SchoolNagoyaJapan
| | - Yasuki Hori
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Mafu Tsunemi
- Department of Occupational and Environmental HealthNagoya City University Graduate School of Medical Sciences/Medical SchoolNagoyaJapan
- Department of NursingYamashita HospitalIchinomiyaJapan
| | - Ippei Matsuzaki
- Department of GastroenterologyYamashita HospitalIchinomiyaJapan
| | - Kazuki Hayashi
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Michihiro Kamijima
- Department of Occupational and Environmental HealthNagoya City University Graduate School of Medical Sciences/Medical SchoolNagoyaJapan
| | - Takeshi Ebara
- Department of Occupational and Environmental HealthNagoya City University Graduate School of Medical Sciences/Medical SchoolNagoyaJapan
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Abstract
Optimal endoscopic operations incorporate ergonomic principles into the endoscopy environment benefiting endoscopists, endoscopy unit personnel, and patients. A high prevalence of occupational musculoskeletal injuries is well established among endoscopists and gastroenterology nurses. Ergonomics can be integrated into all facets of the endoscopy unit including scheduling, endoscopy unit design, training programs, and investment in technology. Preprocedure, intraprocedure, and postprocedure areas should aim to deliver patient safety, privacy, and comfort, while also supporting endoscopists and staff with adjustable rooms and effective work flows. Team-wide educational initiatives can improve ergonomic awareness. These strategies help mitigate risks for musculoskeletal injuries and can lead to increased productivity. The COVID-19 area brings novel challenges to endoscopy.
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Affiliation(s)
- Anna M Lipowska
- Division of Gastroenterology and Hepatology, University of Illinois at Chicago, 840 South Wood Street, CSB Suite 741 (MC 716), Chicago, IL 60612, USA.
| | - Amandeep K Shergill
- Division of Gastroenterology and Hepatology, San Francisco Veterans Affairs Medical Center and University of California, 4150 Clement Street, VA 111B/ GI Section, San Francisco, CA 94121, USA
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Harris-Adamson C, Shergill AK. Endoscopist injury: shifting our focus to interventions. Gastrointest Endosc 2021; 94:260-262. [PMID: 34024633 DOI: 10.1016/j.gie.2021.03.928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/27/2021] [Indexed: 02/08/2023]
Affiliation(s)
- Carisa Harris-Adamson
- Department of Medicine, University of California, San Francisco, California, USA; School of Public Health, University of California, Berkeley, California, USA
| | - Amandeep K Shergill
- Department of Medicine, Division of Gastroenterology, University of California, San Francisco, San Francisco VA Medical Center, San Francisco, California, USA
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