Enhancing ergonomics in gastrointestinal endoscopy through the integration of head-mounted display

Endoscopists are at an increased risk of musculoskeletal injuries, which is known to be caused by poor endoscopic postures. However, effective ergonomic improvements in routine practice remain limited. This study systematically evaluated the ergonomic benefits of a medical head-mounted display (HMD) during gastrointestinal endoscopy. Upper gastrointestinal endoscopies were conducted both with and without the use of HMD. Experience was subjectively assessed through a NASA-Task Load Index (NASA-TLX). Biomechanical loads during the endoscopic procedures were recorded using electromyography and inertial measurement unit (IMU) sensors. A comparative analysis was performed between the cohort using HMD and the one without, focusing on perceived discomfort, muscle activity, and body posture. This study involved five gastroenterology fellows with pre-existing neck and shoulder discomfort. Partcipants performed 200 endoscopies, with 100 procedures using HMDs and 100 without. Average NASA-TLX scores of participants were lower when using HMD compared to the non-HMD cohort. Muscle strain, particularly in the sternocleidomastoid and trapezius muscles, was significantly lower in the HMD group. IMU analysis demonstrated a significant reduction in high-risk neck and torso postures in the HMD cohort. In this study, medical HMDs significantly improve endoscopist ergonomics by reducing muscle strain and correcting harmful postures. Integrating HMDs into gastrointestinal endoscopy may enhance procedural ergonomics and reduce musculoskeletal injury risk.