S1255 Colonoscopy Compression Device Significantly Reduces Ergonomic Risk for Endoscopy Staff: A Multi-Center Study

Introduction: Colonoscopy procedures often expose endoscopy staff to ergonomic risks, such as musculoskeletal (MSK) disorders, due to manual abdominal pressure and frequent patient repositioning. ColoWrap, an external compression device designed to provide adjustable abdominal pressure and mitigate looping during colonoscopies, reduces the need for manual staff interventions. Previous studies have shown that using ColoWrap decreases the frequency of nurse-reported MSK pain. This study aimed to quantify ergonomic risks during colonoscopies performed with and without the ColoWrap device, using the validated Colonoscopy Staff Strain Index (CSSI). Methods: This multi-site study analyzed 388 colonoscopy procedures performed by 8 endoscopists across 6 hospital sites. Data were collected over 2 periods: 1 month prior to ColoWrap adoption (297 procedures, baseline group) and during its use (91 procedures, ColoWrap group). The analysis included only endoscopists who performed at least 5 procedures in both groups. Procedures where ColoWrap was applied mid-procedure were excluded. CSSI scores, calculated from manual abdominal pressure and patient repositioning metrics, were used to assess ergonomic risk. Scores above 1.0 are considered to indicate increased risk of staff ergonomic injury. Patient populations were similar between groups, except for body mass index (BMI), reflecting physician preference for using ColoWrap in patients with higher BMI. Results: The mean CSSI score significantly decreased from 2.4 ± 4.3 in the baseline group to 1.0 ± 2.6 in the ColoWrap group (P = 0.0003). Procedures with excessive ergonomic risk (CSSI >5) were less frequent in the ColoWrap group (7.8% vs 17.0%, P = 0.02). ColoWrap also reduced the need for manual abdominal pressure (16.4% vs 42.1%, P < 0.0001) and decreased patient repositioning (1.1% vs 7.7%, P = 0.007). These findings highlight the significant ergonomic benefits of using ColoWrap, even in cases likely perceived as more challenging. Conclusion: The ColoWrap device significantly reduces ergonomic risks associated with colonoscopy procedures, as demonstrated by lower CSSI scores, fewer high-risk procedures, reduced manual abdominal pressure, and minimal patient repositioning. These compelling results underscore ColoWrap’s potential to enhance staff safety, even in procedures anticipated to be more difficult. Future research should explore its long-term effects on reducing musculoskeletal injuries among endoscopy staff.