Development and Evaluation of an Ergonomically Optimized Scope‐Holder for Flexible Endoscopy (With Video)

OBJECTIVES: Growing endoscopy demand has increased physical workload and injury risk among endoscopists, while current ergonomic solutions remain limited. We developed a newly motion-optimized endoscope-holding device (scope-holder) designed to reduce muscular burden, allowing each operator to adjust the scope position according to individual preference. This study assessed its ergonomic impacts in a simulated setting. METHODS: Clinical endoscopists and nonmedical participants without any medical background were recruited to collect data. Each participant performed a simulated endoscopic marking task with and without the scope-holder. We compared the procedure time of the task, evaluated muscle efforts in the upper arm, forearm, and shoulder using wireless electromyography, as well as mental workload using NASA-TLX across the two settings. RESULTS: A total of 26 participants, including 17 clinical endoscopists and 9 nonmedical participants, were enrolled. In the overall cohort, the scope-holder assisted group significantly reduced activation of biceps brachii (p < 0.001), trapezius (p < 0.001), flexor carpi ulnaris (p = 0.049) muscles and NASA-TLX scores (p = 0.003). Additionally, the assisted group achieved a shorter procedure time (p = 0.018) compared with the non-assisted group. Subgroup analysis showed reduced muscle load in both clinical endoscopists and nonmedical participants (p < 0.05), with additional improvements in mental workload (p = 0.004) and the procedure time (p = 0.027) observed only in nonmedical participants, whereas clinical endoscopists showed no significant difference in mental workload (p = 0.299) and procedure time (p = 0.229). CONCLUSIONS: Our newly developed scope-holder, designed to accommodate the operator's natural scope motion, effectively reduced physical and mental workload. It offers a practical solution to improve ergonomics in endoscopic clinical practice.