Assessment of the Risk of Musculoskeletal Disorders Associated with the Practice of Endoscopic Retrograde Cholangiopancreatography (ERCP).

Abstract

Purpose: Musculoskeletal disorders are a major public health concern. Digestive endoscopy exposes practitioners to a high risk of musculoskeletal disorders, with an estimated prevalence ranging from 40 to 90%, a figure likely to increase as procedures become more complex. The available studies are mainly observational and self-reported. Quantitative studies assessing the impact of digestive endoscopy, particularly endoscopic retrograde cholangiopancreatography, on musculoskeletal disorders risk under real working conditions remain scarce.

Methods: We used the KIMEA® tool to quantify the musculoskeletal strain endured by two skilled endoscopists during ten endoscopic retrograde cholangiopancreatography procedures. This system estimates musculoskeletal disorders risk using the RULA method by analyzing movements with a depth camera and inertial sensors placed on the wrists.

Results: The analysis of the movements yielded an average global RULA score of 4.2, indicating a moderate risk of musculoskeletal disorders. Musculoskeletal strain was predominant in the forearms, particularly in the wrists, which maintained constrained postures for over 50% of the intervention duration. The strain was asymmetrical, with a predominance on the left wrist. Results were consistent across procedures.

Conclusions: This study highlights the excessive musculoskeletal strain placed on endoscopists' forearms during endoscopic retrograde cholangiopancreatography. The KIMEA® tool represents an interesting tool in quantifying ergonomic stress in digestive endoscopy. Further studies with larger sample sizes are needed to confirm these findings, evaluate the influence of factors such as age, experience, and gender, and to promote the integration of ergonomic measures to prevent musculoskeletal disorders.