CAN SINGLE-USE VERSUS STANDARD DUODENOSCOPE IMPROVE ERGONOMICS IN ERCP?A COMPARATIVE SIMULATION-BASED PILOT STUDY

Abstract

Background and Aims: Musculoskeletal disorders (MSDs) and injuries (MSIs) are frequent in gastrointestinal endoscopy. The aim of this study was to assess potential ergonomic advantages of lighter single-use duodenoscope compared to standard reusable one for endoscopists performing Endoscopic Retrograde Cholangiopancreatography (ERCP). Methods: Three experienced endoscopists performed an ergonomic preclinical comparative protocol-guided simulation study of a single-use and a standard reusable duodenoscopes using an anatomic bench model. Surface EMG signals from left forearm and arm muscles were recorded. A commercial inertial sensor-based motion capture system was applied to record body posture as well. Results: A significant lowering of root mean square amplitude and amplitude distribution of biceps brachii signal (ranging from 13% to 42%) was recorded in all the participants when using single-use duodenoscope if compared to reusable one. An overall reduction of muscle activation amplitude and duration was also associated with the single-use duodenoscope for forearm muscles, with different behaviors among subjects. Participants spent most of the time in wrist extension (>80%) and ulnar deviation (>65%). A consistent pattern of functional range of motion employed for completing all procedures was observed. Conclusions: Our study showed that a lighter scope has a promising effect in reducing upper arm muscle activity during ERCP procedure with potential benefit on musculoskeletal health in the ERCP setting.