Immersive endoscopy: potential usefulness from an ergonomic perspective

BACKGROUND: In flexible endoscopy, ergonomic issues such as suboptimal monitor positioning are becoming increasingly important. Head-mounted display (HMD) technology may provide an ergonomic environment independent of room setup or endoscopist posture. This study evaluated the feasibility and ergonomic benefits of immersive endoscopy using HMD technology. METHODS: We used the Apple Vision Pro (AVP), a video see-through HMD. Participants performed an endoscopic marking task under three monitor settings: ergonomic, non-ergonomic, and immersive. Procedure time, muscle effort by wireless electromyography, and mental workload by NASA-TLX were compared. RESULTS: Eleven endoscopists participated. Compared with the non-ergonomic setting, the immersive and ergonomic settings showed significantly shorter procedure times and lower mental workload, with no difference between the immersive and ergonomic settings. Both immersive and ergonomic settings also showed significantly lower muscle activation in the trapezius, posterior neck, and left sternocleidomastoid muscles than the non-ergonomic setting. In addition, compared with the ergonomic setting, immersive endoscopy showed significantly lower activation in the trapezius, erector spinae, and right sternocleidomastoid muscles. CONCLUSIONS: Immersive endoscopy using AVP improved performance and reduced muscle effort and mental workload compared with the non-ergonomic setting, while reducing activation in specific postural muscles even compared with the ergonomic setting.