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Otero-González I, Caeiro-Rodríguez M, Rodriguez-D’Jesus A. Methods for Gastrointestinal Endoscopy Quantification: A Focus on Hands and Fingers Kinematics. SENSORS (BASEL, SWITZERLAND) 2022; 22:9253. [PMID: 36501954 PMCID: PMC9741269 DOI: 10.3390/s22239253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Gastrointestinal endoscopy is a complex procedure requiring the mastery of several competencies and skills. This procedure is in increasing demand, but there exist important management and ethical issues regarding the training of new endoscopists. Nowadays, this requires the direct involvement of real patients and a high chance of the endoscopists themselves suffering from musculoskeletal conditions. Colonoscopy quantification can be useful for improving these two issues. This paper reviews the literature regarding efforts to quantify gastrointestinal procedures and focuses on the capture of hand and finger kinematics. Current technologies to support the capture of data from hand and finger movements are analyzed and tested, considering smart gloves and vision-based solutions. Manus VR Prime II and Stretch Sense MoCap reveal the main problems with smart gloves related to the adaptation of the gloves to different hand sizes and comfortability. Regarding vision-based solutions, Vero Vicon cameras show the main problem in gastrointestinal procedure scenarios: occlusion. In both cases, calibration and data interoperability are also key issues that limit possible applications. In conclusion, new advances are needed to quantify hand and finger kinematics in an appropriate way to support further developments.
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Affiliation(s)
- Iván Otero-González
- atlanTTic Research Center for Telecommunication Technologies, Universidade de Vigo, Campus-Universitario S/N, 36312 Vigo, Spain
| | - Manuel Caeiro-Rodríguez
- atlanTTic Research Center for Telecommunication Technologies, Universidade de Vigo, Campus-Universitario S/N, 36312 Vigo, Spain
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Johnson G, Vergis A, Unger B, Park J, Gillman L. Design and Validity Evidence for a Unique Endoscopy Simulator Using a Commercial Video Game. Cureus 2021; 13:e18379. [PMID: 34725623 PMCID: PMC8553393 DOI: 10.7759/cureus.18379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/05/2022] Open
Abstract
Background Procedural simulation enhances early endoscopy training. Multiple commercial simulators are available; however, their application is limited by cost and poor user compliance. First-person "shooter" (FPS) video games are popular. In this study, we aimed to show that a novel in-house designed colonoscope controller used to play an FPS video game shares similar constructs with real-life endoscopy. Methodology Participants completed the first three levels on an FPS video game, Portal (Valve Corporation, Bellevue, WA), first using a conventional controller and then the modified endoscope controller. A total of 12 expert endoscopists and 12 surgical residents with minimal endoscopy experience were evaluated based on completion time, button presses, and hand motion analyses. Results Experts outperformed novices for completion time (expert: 944 seconds; novice: 1,515 seconds; p = 0.006) and hand movements (expert: 1,263.1; novice: 2,052.6; p = 0.004) in using the novel colonoscope controller. There was no difference in button presses or total path length traveled. Furthermore, performance did not differ using conventional game controls. Conclusions Experts outperformed novices using the endoscope but not the conventional controller with respect to the economy of movement and completion time. This result confirms that our endoscope-controlled video game shares similar paradigms with real-life endoscopy and serves as a first step toward creating a more enjoyable and cheaper alternative to commercially available endoscopy simulators.
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Affiliation(s)
| | | | - Bertram Unger
- Internal Medicine, University of Manitoba, Winnipeg, CAN
| | - Jason Park
- Surgery, University of Manitoba, Winnipeg, CAN
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Khan R, Scaffidi MA, Satchwell J, Gimpaya N, Lee W, Genis S, Tham D, Saperia J, Al-Mazroui A, Walsh CM, Grover SC. Impact of a simulation-based ergonomics training curriculum on work-related musculoskeletal injury risk in colonoscopy. Gastrointest Endosc 2020; 92:1070-1080.e3. [PMID: 32205194 DOI: 10.1016/j.gie.2020.03.3754] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 03/08/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Endoscopists are at risk of developing musculoskeletal injuries (MSIs), and few receive training on ergonomics. The aim of this study was to determine the impact of a simulation-based ergonomics training curriculum (ETC) on work-related MSI risk during clinical colonoscopy. METHODS Novice endoscopists underwent a simulation-based ETC and were compared with an historical control group who received simulation-based training without ergonomics training. The ETC included a didactic lecture and video on ergonomics in colonoscopy, feedback from supervisors on ergonomics, and an ergonomics checklist to augment feedback and promote self-reflection. Participants were assessed using the rapid entire body assessment (REBA) and rapid upper limb assessment (RULA). The primary outcome was participants' REBA scores during 2 clinical colonoscopies 4 to 6 weeks after training. RESULTS In clinical colonoscopy, the ETC group had superior REBA scores (clinical procedure 1: median score, 6 vs 11; P < .001; clinical procedure 2: median score, 6 vs 10; P < .001). In a simulated colonoscopy, the ETC group did not have significantly different REBA or RULA scores between baseline, immediately after training, and 4 to 6 weeks after (REBA: median scores of 5, 5, and 5, respectively; P > .05; RULA: median scores of 6, 6, and 6, respectively; P > .05). The control group had worsening REBA and RULA scores during the study timeline (REBA: median scores of 5 at baseline, 9 immediately after training, and 9 at 4-6 weeks after training; P < .001; RULA: median scores of 6, 7, and 7, respectively; P = .04) during simulated procedures. CONCLUSIONS A simulation-based ETC is associated with reduced risk of MSI during endoscopy. Although the REBA score was improved, the intervention group was still within the medium-risk range.
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Affiliation(s)
- Rishad Khan
- Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael A Scaffidi
- Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Joshua Satchwell
- Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Nikko Gimpaya
- Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Woojin Lee
- Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Shai Genis
- Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Daniel Tham
- Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada
| | - James Saperia
- Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Ahmed Al-Mazroui
- Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Catharine M Walsh
- Division of Gastroenterology, Hepatology, and Nutrition, Learning Institute and Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada; The Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Samir C Grover
- Division of Gastroenterology, St Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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