Cennamo Vincenzo, Botter Alberto, Landi Stefano, Graziosi Francesca, Bassi Marco, Dabizzi Emanuele, Ghersi Stefania, Cerone Giacinto, Bonfiglioli Roberta
Department of Gastroenterology and Interventional Endoscopy, Bellaria-Maggiore Hospital, AUSL Bologna, Bologna, Italy.
Department of Electronics and Telecommunication, Politecnico di Torino, Turin, Italy PoliToBIOMed Lab, Politecnico di Torino, Laboratory for Engineering of the Neuromuscular System (LISiN), Torino, Italy.
Endosc Int Open. 2024 Mar 18;12(3):E419-E427. doi: 10.1055/a-2231-7393. eCollection 2024 Mar.
Musculoskeletal disorders (MSDs) and injuries (MSIs) are frequent in gastrointestinal endoscopy. The aim of this study was to assess potential ergonomic advantages of a lighter single-use duodenoscope compared with a standard reusable one for endoscopists performing endoscopic retrograde cholangiopancreatography (ERCP). Three experienced endoscopists performed an ergonomic, preclinical, comparative protocol-guided simulation study of a single-use and a standard reusable duodenoscope 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. 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 a single-use duodenoscope compared with a 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. Our study showed that a lighter scope has a promising effect in reducing upper arm muscle activity during ERCP with potential benefit on musculoskeletal health in the ERCP setting.
肌肉骨骼疾病（MSDs）和损伤（MSIs）在胃肠内镜检查中很常见。本研究的目的是评估与标准可重复使用十二指肠镜相比，更轻便的一次性十二指肠镜对于进行内镜逆行胰胆管造影（ERCP）的内镜医师的潜在人体工程学优势。三名经验丰富的内镜医师使用解剖学实验台模型，对一次性和标准可重复使用十二指肠镜进行了一项符合人体工程学、临床前、对比方案指导的模拟研究。记录了左前臂和手臂肌肉的表面肌电信号。还应用了基于商业惯性传感器的运动捕捉系统来记录身体姿势。与可重复使用的十二指肠镜相比，使用一次性十二指肠镜时，所有参与者肱二头肌信号的均方根幅度和幅度分布均显著降低（范围为13%至42%）。一次性十二指肠镜还与前臂肌肉的肌肉激活幅度和持续时间的总体降低有关，不同受试者之间存在不同表现。参与者大部分时间处于手腕伸展（>80%）和尺侧偏斜（>65%）状态。观察到完成所有操作所采用的功能活动范围的一致模式。我们的研究表明，更轻便的内镜在ERCP期间对减少上臂肌肉活动具有显著效果，对ERCP环境下的肌肉骨骼健康具有潜在益处。
