J Surg Res. 2026 Sep 15;327:28-38. doi: 10.1016/j.jss.2026.08.014. Online ahead of print.
ABSTRACT
INTRODUCTION: Physicians who perform colonoscopies experience a high incidence of musculoskeletal pain due to repetitive and strenuous motion, which can reduce career longevity. We designed a novel ergonomic grip that fits over the endoscope to mitigate muscle fatigue by improving ergonomics during colonoscopy. This study evaluates the efficacy of the device using surface electromyography (sEMG) to measure muscle activity during simulated colonoscopy procedures.
METHODS: Participants (n = 11) were fitted with Delsys sEMG electrodes on upper extremity muscles including flexor carpi radialis, abductor pollicis brevis, flexor digitorum superficialis, and extensor carpi radialis, selected to capture squeezing and torquing motions during colonoscopy. Baseline maximal voluntary isometric contraction trials were performed for wrist flexion, grip strength, thumb abduction, and wrist extension. Participants then performed virtual colonoscopy on the Simbionix endoscopy simulator after standardized practice. They were randomized to complete modules either unassisted or using the grip adaptor. Continuous sEMG data were collected during each trial, with rest intervals. After each trial, participants completed the NASA Task Load Index.
RESULTS: Root mean square and percent maximal voluntary contraction were lower with the grip adaptor indicating decreased activation during simulated colonoscopy. Forearm muscles were at less risk of injury by EMG analysis with flexor carpi radialis experiencing significant benefit (P < 0.05). NASA Task Load Index demonstrated reduced physical strain with the grip adaptor.
CONCLUSIONS: The grip adaptor reduces forearm muscle activity during colonoscopy and decreases perceived physical demand. This design offers a practical approach to improving endoscopist comfort and reducing risk of musculoskeletal injury.
PMID:42743899 | DOI:10.1016/j.jss.2026.08.014