Recording forces exerted on the bowel wall during colonoscopy: in vitro evaluation

Abstract

A novel system for distributed force measurement between the bowel wall and the shaft of a colonoscope is presented. The system, based on the piezoresistive method, involves the integration of soft miniature transducers to a colonoscope to enable a wide range of forces to be sensed. The attached sensing sheath does not restrict the propulsion of the colonoscope nor notably alter its flexibility. The addition of the sensor sheath increases the colonoscope diameter by 15-20% depending on the type of the colonoscope (adult or paediatric). The transducer's accuracy is +/-20 grammes if it is not subjected to extensive static forces. Under large static force conditions the errors may increase to +/-50 grammes. The tactile force measuring sensors have provided preliminary results from experiments on a model of the large bowel. The force measurements confirm the predictions on the location and magnitude of the forces and that most of the forces are exerted whilst the instrument is looping.

Ergonomics and GI endoscopy

“…1,6,7,[9][10][11][12][13][14][15][16][17] After review of Google Scholar results and the references from relevant articles, an additional 9 articles were identified. [2][3][4][5][18][19][20][21][22] One article, previously published in abstract form, was included in this review, and has subsequently been published.…”

“…The few studies that directly evaluated hand forces during endoscopy demonstrated high forces because of gripping or pinching the endoscope, and pushing-pulling and torquing of the insertion tube. 10,12,21 There may also be sustained awkward postures during endoscopy, including extension or rotation of the spine if the video monitor is placed too high or to the side of the endoscopist. 14,19 In a survey of endoscopists who perform ERCP, 67% of rooms reviewed by a study kinesiologist and occupational therapist were thought to be poorly designed because of awkward placement of the monitor or use of nonadjustable patient beds, and ergonomic room design was significantly associated with no complaint of injury.…”

Minimizing occupational hazards in endoscopy: personal protective equipment, radiation safety, and ergonomics

“…Studies measuring forces during colonoscopy have demonstrated high peak forces, especially during colonoscope insertion, which may reach levels associated with an increased risk of injury to the thumb and wrist. [33][34][35][36] A quantitative analysis of these risk factors and the potential for upper extremity biomechanical overload was recently conducted by using the Occupational Repetitive Actions (OCRA) index in 6 Italian endoscopists. 37 The OCRA index is an ergonomic riskassessment tool that considers all repetitive tasks in a work cycle and stratifies the risk of injury into 3 levels: green (no risk), yellow (low risk), and red (risk).…”

Construct validation of a physical model colonoscopy simulator

“…We selected the Kyoto Kagaku model because, unlike the Koken, it is configurable, allowing trainees to be tested on more than 1 simulated case. 16 In real colonoscopy, novices typically have lower completion rates, [17][18][19][20][21] take longer to reach the cecum, [19][20][21] and are more likely to exert excessive force on the patient's colon 22,23 compared with experienced colonoscopists. Therefore, a construct valid simulator should reproduce these effects.…”