Abstract
Background Endoscopy-related musculoskeletal injuries (ERIs) are commonly reported but their
exact prevalence and clinical impact remain obscure. We conducted a systematic review
and meta-analysis of the current literature aiming to answer these questions.
Methods The MEDLINE, EMBASE, and SCOPUS databases were searched for studies evaluating ERIs
in gastroenterologists and surgeons. The co-primary outcome was the prevalence of
ERIs (i.e. carpal tunnel syndrome, de Quervain’s tenosynovitis, and hand numbness).
The second co-primary outcome was the prevalence of endoscopy-related pain syndromes.
Results 12 studies, including 4563 respondents, were included. The majority of respondents
were men (n = 3321; 72.8%) and most were right-handed (86.2%). The career prevalence
of carpal tunnel syndrome (pooled from 10 studies) was 5.3% (95%CI 1.5%–8.9%; I
2 = 97.1%), while the prevalence of de Quervain’s tenosynovitis (five studies) was
8.5% (95%CI 0.1%–17.0%). The pooled prevalences of thumb pain, neck pain, and back
pain were 25.4%, 23.1%, and 19.7%, respectively, but the prevalence varied according
to the type of questionnaire used. Only 341/864 respondents (39.5%) had received prior
training in ergonomics, while 623/889 respondents (70.1%) expressed a desire for further
training in ergonomics. Overall, there is a moderate risk of bias in the present literature.
Conclusion ERIs, including carpal tunnel syndrome, de Quervain’s tenosynovitis, and endoscopy-related
pain, are very common. These injuries can be severe, requiring surgery, and lead to
loss of productivity. Most gastroenterologists report an unmet need for training in
the proper ergonomics of endoscopy.
