Liberman A S, Shrier I, Gordon P H
Division of Colorectal Surgery, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis, Jewish General Hospital, McGill University, 3755 Cote Ste Catherine Road, Montreal, Quebec.
Surg Endosc. 2005 Dec;19(12):1606-9. doi: 10.1007/s00464-005-0219-1. Epub 2005 Oct 12.
Repetitive tasks in the workplace are one cause of injury. This study aimed to identify injuries specific to physicians routinely performing colonoscopy, and to identify prevention strategies.
A survey was sent to all 2,173 worldwide members of the American Society for Colon and Rectal Surgery to investigate injuries or disabilities that resulted from performing colonoscopy and the methods used to prevent and alleviate symptoms related to the procedure.
The response rate was 28%. Of the respondents, 96% performed colonoscopy. At least one injury or pain believed to result from performing colonoscopy was reported by 39% of the respondents. The most frequently reported injuries were to hands and fingers (n = 257), neck (n = 65), and back (n = 52). The methods adopted to alleviate injury included changing the height of the stretcher or video monitor, changing from a standing to a sitting position, minimizing torque on the colonoscope, having an assistant perform the torque maneuver, and resting or taking time off from colonoscopy. Two respondents also created devices to make the instrument more ergonomic.
The number of colorectal surgeons encountering injury from colonoscopy highlights the need for preventive strategies. The study results suggest that it may be necessary to improve the design of colonoscopes to make them more ergonomic. Appropriate positioning of the endoscopist, patient, and monitors may diminish some of the injuries encountered.
工作场所的重复性任务是受伤的原因之一。本研究旨在确定经常进行结肠镜检查的医生所特有的损伤，并确定预防策略。
向美国结肠和直肠外科医师协会全球2173名会员发送了一项调查，以调查因进行结肠镜检查导致的损伤或残疾，以及用于预防和缓解与该手术相关症状的方法。
回复率为28%。在受访者中，96%进行结肠镜检查。39%的受访者报告至少有一种被认为是由结肠镜检查导致的损伤或疼痛。最常报告的损伤部位是手和手指（n = 257）、颈部（n = 65）和背部（n = 52）。减轻损伤所采用的方法包括改变担架或视频监视器的高度、从站立姿势改为坐姿、尽量减少结肠镜上的扭矩、让助手进行扭矩操作，以及休息或暂停结肠镜检查。两名受访者还制作了使器械更符合人体工程学的装置。
因结肠镜检查而受伤的结直肠外科医生数量凸显了预防策略的必要性。研究结果表明，可能有必要改进结肠镜的设计，使其更符合人体工程学。内镜医师、患者和监视器的适当定位可能会减少一些所遇到的损伤。
