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How intentional ergonomic design can help reduce musculoskeletal injuries in endoscopy
Performing endoscopies daily is physically demanding for practitioners. Research shows that endoscopy-related musculoskeletal injury (ERI) incidents range from 14% to 97% among endoscopists. The most common injury sites include the neck, back, and shoulders across all endoscopy specializations, with injuries to the hands, thumbs, and wrists being particularly prevalent among gastroenterologists (GIs)1
.
“Doing endoscopy and performing screening endoscopy are repetitive tasks that can be quite demanding for tendons in the hands and wrists,” says Prof. Raf Bisschops, Gastroenterologist and Professor of Medicine at UZ Leuven. This high rate of injury is unsurprising, given that GIs spend nearly half (40%) of their working time performing endoscopies. One European study found that GIs perform an average of 20 procedures per week, amounting to approximately 25 hours of weekly endoscopy time. While some endoscopists may dismiss a sore wrist or a tight shoulder,
for others, the impact is significant – not only on their physical health but also on the wider healthcare system. Between 10% and 60% of endoscopists have sought medical care to address ERIs (Endoscopy- Related Injuries), with 29% requiring corrective surgery1
. One study
reported that 30% of respondents needed a leave of absence due to ERIs, while another study found that such injuries accounted for a total of 210 lost working days . Among GI endoscopists, ERIs are more prevalent in female
practitioners. Prof. Roberta Maselli, Counselor of Women in Endoscopy and Head of Gastroenterology and Digestive Endoscopy at Humanitas San Pio X Hospital in Milan, notes that she has personally known female practitioners who left the field because of its physical demands. “The scopes that we are using every day were designed with a man’s hands and body in mind,” says Prof. Maselli. “As women, we are different. The shape and primarily the size of our hands is smaller, making us more prone to musculoskeletal injuries in the long term.” There are various ways to reduce and prevent ERIs in GI endoscopy.
These include ergonomic training for practitioners, improved layouts in practice rooms and theaters, and redesigning endoscopic equipment to better suit practitioners’ needs. Responding to the concerns of healthcare professionals, PENTAX Medical developed the i20c Video Colonoscope Series. After consulting with endoscopists, PENTAX Medical measured the average hand and finger dimensions to optimize the fit of the PENTAX Medical ErgoFeel™ control body. Features such as newly designed spokes requiring less
force to move the distal end and flat steering wheels for tip angulation have improved access and operability. Ms. Annabel Shaw, Consultant Colorectal and General Surgeon at
Croydon University Hospital in London, trialed the i20c and found it better suited to her smaller hand size. “With the improved ergonomics of the control, you notice far less fatigue during long procedures,” says Ms. Shaw. “The i20c significantly helps when performing longer therapeutic procedures.” PENTAX Medical’s goal was to enhance the endoscopy experience
for practitioners, particularly those prone to fatigue during lengthy procedures. Key design changes include a redesigned control body size for stress-free operation across various hand sizes, adjustments to air/ water and suction valves for seamless operation, rearranged remote buttons and multi-way trigger functionality for easier access and operation. Additionally, in response to clinical demands for colonoscopy, the TriDrive™ Technology which includes Adjustable Stiffness has redefined handling of colonoscopes. “I think it’s very important for industries to collaborate with clinicians
to advance technology and improve standards, ultimately delivering better patient care,” says Ms. Shaw. “This includes innovations in the design and ergonomics of endoscopes, allowing practitioners to use the equipment more comfortably for longer periods.” What the industries can do – and what PENTAX Medical is addressing
– is to rebuild systems while considering the diverse healthcare practitioners involved in this journey, including women,” says Prof. Maselli.
For more information on PENTAX Medical’s i20c Endoscope Series, scan the QR code to watch the video:
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