The Perception of Gastroenterology Fellows towards the Relationship between Hand Size and Endoscopic Training

Abstract

Some endoscopic trainees find it difficult to manipulate an endoscope's controls, possibly due to small hand size. To assess this, a survey was mailed to all gastroenterology fellows in the US. Two hundred twenty-seven of 1,295 (17.5%) fellows responded. Median surgical glove size was 7.5. Ninety-three respondents (41.0%) considered their hand too small for a standard endoscope's handle; 176 (78.2%) felt that hand size affects the ability to learn endoscopy. Seventy-seven (34.2%) would use smaller handled endoscopes if available. Of the 38 respondents with glove sizes < or =6.5, 37 (97.4%) were female. These respondents were more likely to consider their hand too small (P < 0.001), want to use smaller handled endoscopes (P < 0.001), and feel that training programs should offer them (P = 0.009). These results suggest that a significant number of trainees, especially women, perceive that their hands are too small for standard endoscopes and believe that hand size plays a role in learning and performing endoscopy.

Ergonomics and GI endoscopy

“…1,6,7,[9][10][11][12][13][14][15][16][17] After review of Google Scholar results and the references from relevant articles, an additional 9 articles were identified. [2][3][4][5][18][19][20][21][22] One article, previously published in abstract form, was included in this review, and has subsequently been published. 21 One abstract was provided by one of the investigators in this study (K.M.).…”

“…Seven articles 1-7 addressed the prevalence of endoscopist injury. Five articles 9,11,17,18,22 evaluated or discussed possible risk factors and mechanisms of injury. One online study 19 evaluated postures during endoscopy, whereas 4 articles 10,12,20,21 evaluated the forces applied during endoscopy, and 6 articles [13][14][15][16]22,23 provided recommendations to reduce injury during endoscopy.…”

“…17 A survey of U.S. gastroenterology fellows asked respondents their impression of how their hand size (median surgical glove size 7.5) affected their capacity to learn endoscopy. 18 The response rate was 17.5% (227 fellows). Forty-one percent considered their hand too small for a standard endoscope's control section and 62% thought their hand size impaired their ability to perform endoscopy.…”

Robotic flexible endoscope

“…Single-handed operation of the wheels is difficult due to size, position and force requirements, especially with small hands. In a survey of U.S. gastroenterology fellows, 41% of the respondents considered their hands too small for a standard endoscope's control section [Cohen et al, 2008]. Some endoscopists release the grip of the right hand on the shaft and use it to turn the smaller outer wheel.…”

Robotic steering of flexible endoscopes

“…Single-handed operation of the wheels is difficult due to size, position and force requirements, especially with small hands. In a survey of U.S. gastroenterology fellows, 41% of the respondents considered their hands too small for a standard endoscope's control section [41]. Some endoscopists release the grip of the right hand on the shaft and use it to turn the smaller outer wheel.…”