Endoscopists spend significant amounts of time standing during endoscopic examinations and procedures. Recently, endoscopy-related musculoskeletal injuries such as thumb, lower-back, hand, and neck pains have been recognized increasingly among endoscopists.
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Factors related to the development of severe pain were body position, endoscope positioning, and gripping the endoscope during endoscopic procedures.
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, 4
Prolonged and sustained standing or sitting posture may be related to musculoskeletal injuries. Using ergonomics, we hypothesized that appropriate positioning of the endoscopist would diminish some of these musculoskeletal injuries. Recently, sit-stand workstations were designed to resolve workers’ musculoskeletal disorders, alertness, and performance.5
In this video (Video 1, available online at www.VideoGIE.org), we demonstrate sit-stand endoscopic workstations with use of a wearable chair (Archelis; NITTO Co, Ltd, Yokohama, Japan) that was developed for use in Japan to prevent laparoscopy-related musculoskeletal injuries (Fig. 1).
Figure 1A, The Archelis wearable chair. B, Endoscopist wearing the Archelis (front view). C, Endoscopist wearing the Archelis (back view).
This wearable chair was used during upper-GI endoscopic examination. The endoscopist was able to maneuver the upper-GI endoscope from both sitting and standing positions, and the position change was smooth (Fig. 2). In addition, we evaluated this chair during lower-GI endoscopic examination. The endoscopist was able to change posture with complete control. This device should be especially useful for longer examinations and procedures.
Figure 2Sit-stand endoscopic workstations with Archelis. A, Sitting position during upper-GI endoscopy. B, Standing position during upper-GI endoscopy.
Finally, we confirmed the use of a foot pedal maneuver during endoscopic submucosal dissection of the colon (Fig. 3). Precise maneuvering was possible, but the action was awkward compared with the conventional foot pedal maneuver.
Figure 3Foot pedal maneuver by endoscopist using the sit-stand endoscopic workstation during endoscopic submucosal dissection.
The newly developed wearable chair provides sit-stand endoscopic workstations, although prospective studies are needed to compare the reduction of endoscopy-related musculoskeletal injuries using sit, stand, and sit-stand workstations in the future.
Disclosure
All authors disclosed no financial relationships relevant to this publication.
Acknowledgement
Supported by a Robert W . Summers grant from the American Society for Gastrointestinal Endoscopy .
Supplementary data
- Video 1
Demonstration of sit-stand endoscopic workstations with use of Archelis during upper- and lower-GI endoscopy.
References
- Prevalence and impact of musculoskeletal injury among endoscopists: a controlled pilot study.J Clin Gastroenterol. 2009; 43: 399-404
- Musculoskeletal injuries are commonly reported among gastroenterology trainees: results of a national survey.Dig Dis Sci. 2019; 64: 1439-1447
- Procedure-related musculoskeletal symptoms in gastrointestinal endoscopists in Korea.World J Gastroenterol. 2008; 14: 4359-4364
- Optimizing ergonomics during endoscopy.VideoGIE. 2017; 2: 171
- Effects of adjustable sit-stand VDT workstations on workers’ musculoskeletal discomfort, alertness and performance.Ind Health. 2008; 46: 497-505
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Published online: August 05, 2019
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© 2019 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc.
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