Integrating Ergonomics into Endoscopy Training: A Guide for Faculty and Fellows

Abstract

Endoscopic procedures are physically demanding. Endoscopy-related musculoskeletal injuries (ERIs) can stem from repetitive high-force movements, especially when coupled with nonneutral body positions. 1 Shergill A.K. McQuaid K.R. Rempel D. Ergonomics and GI endoscopy. Gastrointest Endosc. 2009; 70: 145-153 Abstract Full Text Full Text PDF PubMed Scopus (69) Google Scholar ,2 Pawa S. Banerjee P. Kothari S. et al. Are all endoscopy-related musculoskeletal injuries created equal? Results of a national gender-based survey. Am J Gastroenterol. 2021; 116: 530-538 Crossref PubMed Scopus (12) Google Scholar Despite trainees commonly reporting ERIs and expressing interest in ergonomics-specific training, endoscopy ergonomics is not routinely taught during fellowship. 3 Villa E. Attar B. Trick W. et al. Endoscopy-related musculoskeletal injuries in gastroenterology fellows. Endosc Int Open. 2019; 7: E808-E812 Crossref PubMed Google Scholar ,4 Ruan W. Walsh C.M. Pawa S. et al. Musculoskeletal injury and ergonomics in pediatric gastrointestinal endoscopic practice. Surg Endosc. 2023; 37: 248-254 Crossref PubMed Scopus (1) Google Scholar This gap represents an opportunity. We present an approach for teaching ergonomics during endoscopy training and outline key ergonomic principles to promote development of safe and effective technique at the start of endoscopists’ careers, enhance endoscopy safety, and help extend career lifespans. Additional system-wide considerations, such as endoscopy case volume, endoscope and endoscopy unit design, and alternatives to endoscopy, are beyond the scope of this trainee-focused perspective.