Third-space endoscopy, including peroral endoscopic myotomy (POEM) and endoscopic submucosal dissection (ESD), has become an established therapeutic option for various gastrointestinal disorders. A newly developed slim therapeutic gastroscope aims to improve maneuverability and, provide easier access to the submucosal space but also to enhance ergonomic aspects of tedious therapeutic procedures The aim of this study was to evaluate the subjective workload and usability of the novel slim therapeutic gastroscope during third space procedures. Secondary outcomes included technical and clinical performance as well as adverse events.

This was a prospective, single-arm, single-center study comprising 30 patients undergoing third-space endoscopy in a high-volume center in Germany. Subjective workload and usability were assessed with the NASA-Task load index (NASA-TLX) and the System Usability Score (SUS), respectively. Clinical outcomes and adverse events were recorded prospectively. 

The slim gastroscope showed a low NASA-TLX and high SUS score which correlates with a low subjective workload and high usability. POEM showed a tendency towards lower NASA-TLX and higher SUS compared to ESD. For ESD, en-bloc and curative R0 resection rate was 100%. No device-related adverse events occurred.

Table-1: 

Summarize the NASA-TLX and SUS scores for all cohorts, as well as E- and Z-POEM, G-POEM and ESD. The NASA-TLX was very low across the cohorts showing a low subjective workload with the new endoscope with a tendency towards lower score in the ESD cohort compared to E- and Z-POEM. The SUS was very high across the cohorts signaling a high usability of the scope with again higher score for POEM compared to ESD.

A novel slim gastroscope offers high usability with a low subjective workload for third space procedures without compromising clinical performance. The slim gastroscope has the potential to reduce the ergonomic strain on endoscopists during complex therapeutic interventions.