Musculoskeletal strain is a major occupational burden in gastrointestinal endoscopy, with many endoscopists developing work-related overuse injuries during their careers. Even with this high prevalence, real-time data on muscular exertion during clinical procedures remain limited to date. This study analysed muscular activity and rate of perceived exertion (RPE) while performing EGD with single-use and reusable gastroscopes under matched conditions.

Two trained endoscopists  (m/f) performed a total of 16 EGDs. For each endoscopist, four single-use (aScope™ Gastro, Ambu A/S) procedures were matched to four reusable (GIF-HQ190, Olympus) procedures based on similar ASGE complexity levels and comparable procedure durations. A wearable multi-sensor electromyographic shirt (ErgoShirt, Myontec Ltd.; sampling rate 1000 Hz) was used to record real-time muscle activation of the endoscopists while performing the procedures. Perceived exertion was assessed immediately after each procedure using the Borg scale (ranging between 6 and 20, e.g. 9: “very light“,16: „very very hard“). To obtain the muscle load, data was processed using MATLAB (Mathworks), with descriptive analysis.

 The average duration of the procedures was 7 minutes, with an average ASGE complexity of 2 for the procedures performed by the male physician and of 1 for the ones of the female endoscopist,  The male physician reported a mean RPE of 9 (“very light”) when using the  single-use vs. 11(“light”)  for reusable procedures. The female examiner reported a mean RPE of 9 for single-use versus 10 for reusable. EMG analysis supported these findings: with reusable gastroscopes, muscle activation was classified more in overload and risk zones relatively to the procedure duration compared to single-use scopes.

This preliminary study demonstrated a relevant exertion within endoscopy procedures and an ergonomic advantage of lighter single-use gastroscopes by reduced muscular exertion and lower perceived workload. They data lead to the conclusion that lighter scopes as single-use gastroscopes may help mitigate long-term musculoskeletal strain in endoscopists.