Abstract
Pertaining to the provision of medical service, it is often understood that surgeons, physicians, doctors, and other medical care providers are the ones who administer that service. It is important to remember that they are people as well, who are also in need of care and consideration. More specifically, gastroenterologists (GIs) are often subjected to physical pain and burnout due to the nature of the colonoscopy procedures they carry out. My technical research involved fabricating an ergonomically favorable medical device for GI’s that reduces the incidence of right-hand overuse injuries during colonoscopy procedures. The sociotechnical portion of the research includes analyzing and quantifying ‘physician burnout’ specifically in the field of gastroenterology. The Social Construction of Technology (SCOT) framework is implemented to the research, signifying the colonoscope as an artifact that influences many different social groups in the medical and clinical environment.
Gastroenterologists perform roughly 22 colonoscopies per week; during a procedure, the right hand is responsible for manually inserting and guiding the colonoscope tubing through the digestive tract. These procedures are not ergonomically favorable, often requiring strenuous postures and excessive pinch forces. With the current colonoscope design, female GIs are at a disadvantage because the modern colonoscope testing apparatus is a one-size-fits-all, not accounting for variance in hand size. To address these issues, the technical Capstone team determined that a medical device solution should be implemented to the modern colonoscope design, reducing pinch forces below a 10 N threshold, and reducing torque 10% below a 1.75 Nm threshold. The device is designed, developed, tested, re-designed, and re-tested until the prototype met the pre-defined criteria.
The Capstone team underwent a series of prototype iterations through the Spring semester, and decided on our 3D-printed Prototype Diego. The device is a cylindrical handle with a compressive switch mechanism, held in the right hand, and it functions to grab the colonoscope tubing during a colonoscopy. The team also acquired force sensor data from subjects who conducted colonoscopies with and without the device. It was determined that maximum forces generated in the fingers were significantly minimized when using the device to conduct a colonoscopy. A finite element analysis was also conducted to ensure the structural integrity of the device.
With the issue of injury and burnout still being prevalent, the question remains; ‘What are some of the main factors that contribute to the decline of practicing GIs?’ One of the factors is the colonoscope device itself, as it plays a critical role in GI injury, employee relations within the hospital environment, and patient care and comfort. The sociotechnical report explored the SCOT framework and highlights how the colonoscope, and technologies associated with it, affect the different social groups involved, including GIs and their co-workers, hospital administrators, design engineers, and the patients on the receiving end. Potential solutions and considerations pertaining to a change in colonoscope design are discussed.
The device that is created by the design engineers must not drastically change the function of the colonoscope, while reducing the prevalence of the injuries they sustain. A medical device must also be affordable and accessible enough for hospitals and administrators to consider for use, but a products quality and structural integrity should not be compensated for low costs. The patient is also to be considered when designing a medical device, as they are the only group who directly experience its full function.
The proposed mechanical solution will address the injury-related problems GIs experience, as well as other potential problems related to hospital administration and patient interaction. With fewer GIs taking time off, this will reduce the general stress and burnout felt by the greater gastroenterology community. With this comes prolonged careers, improved patient experience, and a level playing field for both men and women in gastroenterology.
