scholarly journals High prevalence of musculoskeletal symptoms and injuries in third space endoscopists: an international multicenter survey

2020 ◽  
Vol 08 (10) ◽  
pp. E1481-E1486
Author(s):  
Samuel Han ◽  
Hazem T. Hammad ◽  
Mihir S. Wagh
Keyword(s):  
Logistic Regression ◽  
Clinical Practice ◽  
Third Space ◽  
Musculoskeletal Symptoms ◽  
Multicenter Survey ◽  
High Prevalence ◽  
Endoscopic Myotomy ◽  
Long Term Impact ◽  
Per Oral

Abstract Background and study aims Third space endoscopy (TSE), including per-oral endoscopic myotomy and endoscopic submucosal dissection, is technically challenging and physically demanding. The aim of this study was to assess the prevalence and types of musculoskeletal symptoms and injuries (MSI) in third space endoscopists and its impact on clinical practice. Materials, Patients and methods A 22-item survey measuring endoscopist characteristics, procedure volumes, MSI, and its effect on clinical practice was distributed to endoscopists practicing TSE. Descriptive statistics were used to depict MSI. Logistic regression was used to identify predictors for MSI related to TSE. Results The survey was completed by 45 of 110 endoscopists (40.9 %) who received the survey, representing 10 countries across four continents. Thirty-one (69 %) endoscopists reported current MSI with 71 % (n = 22/31) believing these began after starting TSE, and 48.9 % (22/45) reporting more symptoms after TSE compared to endoscopic ultrasound/endoscopic retrograde cholangiopancreatography. Common MSI included the shoulders (42.2 %), back (37.8 %), neck (33.3 %), and wrist (24.4 %). Lower extremity MSI were also reported with foot symptoms (11.1 %) being most common. A minority required disability (2.2 %), change in endoscopy scheduling (6.7 %) or surgery (2.2 %). Only 15.6 % of endoscopists had received prior ergonomics training. Logistic regression revealed no significant predictors for MSI. Conclusions Over two-thirds of endoscopists performing TSE suffer from MSI, with many reporting onset of their symptoms after starting TSE in their practice. Further studies are needed to understand and reduce the risk of MSI in TSE given the growing demand for these procedures and the potential long-term impact of this occupational hazard.

scholarly journals Experience and Technique for Zenker's Diverticulum Per Oral Endoscopic Myotomy: Z-POEM

2020 ◽  
Author(s):  
Eitan Podgaetz ◽  
Vani Konda
Keyword(s):  
Third Space ◽  
Zenker’S Diverticulum ◽  
Complication Rates ◽  
Short Term ◽  
Zenker's Diverticulum ◽  
Per Oral Endoscopic Myotomy ◽  
Endoscopic Myotomy ◽  
Invasive Techniques ◽  
Per Oral

Abstract Objective With the advent of minimally invasive surgery, incisionless surgery, and third-space endoscopy, the treatment for Zenker's diverticulum has also moved toward less invasive techniques Methods New incisionless per oral techniques can be applied for cricopharyngeal myotomy in Zenker's diverticulum. Results Five patients underwent Zenker's diverticulum per oral endoscopic myotomy (Z-POEM) without complications, minimal discomfort, and narcotic consumption, with complete resolution of their symptoms by history and Eckardt scores. Conclusions Z-POEM is performed entirely endoscopically with very little associated pain or complication rates, with short-term follow-up having excellent functional and symptomatic results.

A novel third space endoscopic procedure, per-rectal endoscopic myotomy, for Hirschsprung’s disease: Medium and long-term outcomes

Endoscopy ◽  
2020 ◽  
Author(s):  
Amol Bapaye ◽  
Parag Dashatwar ◽  
Vishnu Biradar ◽  
Shital Biradar ◽  
Rajendra Pujari
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Third Space ◽  
Stool Frequency ◽  
Segment Length ◽  
Anal Stenosis ◽  
Current Standard ◽  
Aganglionic Segment ◽  
Endoscopic Myotomy

Introduction Hirschsprung’s disease (HSCR) is congenital aganglionosis affecting hindgut and presents with constipation. Surgical pull-through is current standard but has morbidity. Per-rectal endoscopic myotomy (PREM) is a novel third space endoscopy technique for treating SS-HSCR. Methods Retrospective series of SS-HSCR patients diagnosed on history, contrast enema, rectal biopsies, anorectal manometry and treated by PREM. Aganglionic segment mapped pre-PREM. PREM performed using third space endoscopy principles. Objective – to compare stool frequency and unit laxative (UL) usage pre and post-PREM. Results N = 9; duration 4-years. Mean age – 7.5 (± 5.2) years; 7 males. Mean aganglionic segment length – 6.3 (± 4.4) cm. Mean procedure time – 96.1 (±37.9) minutes. Mean LOS – 2.5 (±0.7) days. Median follow-up –17 months (9 – 58). Stool frequency – pre – 1/4.4 (±1.5) vs. post – 1/1.2 (±0.4) days (p = 0.0004). Mean UL usage – pre – 5.4 (±4.9) vs. post – 0.4 (±0.7) units (p = 0.0002). No laxatives in 6 (66%). Single AE (anal stenosis) – dilatation. Conclusions PREM is a safe and effective minimally invasive procedure for SS-HSCR and provides long-term response.

Long-term Outcomes of Per-oral Endoscopic Myotomy in Spastic Esophageal Motility Disorders

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Zaheer Nabi ◽  
Radhika Chavan ◽  
Mohan Ramchandani ◽  
Jahangeer Basha ◽  
Nitin Jagtap ◽  
...  
Keyword(s):  
Esophageal Motility ◽  
Esophageal Motility Disorders ◽  
Long Term Outcomes ◽  
Motility Disorders ◽  
Per Oral Endoscopic Myotomy ◽  
Endoscopic Myotomy ◽  
Per Oral

Life after per-oral endoscopic myotomy: long-term outcomes of quality of life and their association with Eckardt scores

2018 ◽  
Vol 87 (6) ◽  
pp. 1415-1420.e1 ◽  
Author(s):  
Yaseen B. Perbtani ◽  
Lazarus K. Mramba ◽  
Dennis Yang ◽  
Jorge Suarez ◽  
Peter V. Draganov
Keyword(s):  
Quality Of Life ◽  
Long Term Outcomes ◽  
Per Oral Endoscopic Myotomy ◽  
Endoscopic Myotomy ◽  
Per Oral

scholarly journals Prevalence and Risk Factors for Musculoskeletal Pain and Coping Strategies in School Teachers

2021 ◽  
Vol 21 (2) ◽  
pp. 77
Author(s):  
Saravanan Murugan ◽  
Prerana Saravanan ◽  
Disha Avaiya ◽  
Ibrahim Bawa ◽  
Charmi Shah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Risk Factor ◽  
Coping Strategies ◽  
Musculoskeletal Pain ◽  
Musculoskeletal Symptoms ◽  
School Teachers ◽  
High Prevalence ◽  
And Coping ◽  
Self Administered Questionnaire

<strong>Introduction:</strong> School teachers have high prevalence of work related musculoskeletal disorders which decrease productivity at work due to sick leave and absenteeism. In India, more traditional methods of teaching are used as compared to other countries, and this difference encouraged us to determine prevalence of musculoskeletal pain, risk factors and coping strategies adopted by teachers. <strong>Methods:</strong> A self-administered Questionnaire was distributed to 810 particcipants. 567 responses were received out of which 30 questionnaires were incomplete. The self-administered Questionnaire included 31 questions under 5 categories: General Profile, Occupational profile, Health/Musculoskeletal pain profile, Perceived risk factors and Coping Strategies. Descriptive statistics of mean and standard deviation, frequency were calculated for continuous and categorical variables respectively. Binary logistic regression analysis was performed to determine the association of musculoskeletal symptoms with demograpic factors and working conditions. <strong>Results:</strong> 112 (20.9%) reported having musculoskeletal pain. Low back (48.2%) was commonly affected. 50.9% had chronic pain and 71.4% reported pain interfered with occupational routine. 48.2% reported with sleep disturbances. Commonly percieved factor was standing for prolonged periods (76.8%). Risk factor analysis using logistic regression model on cause of pain showed statistical significance (χ2 (27)=77.169, p&lt;0.005). Females were 3.952 times more likely to exhibit pain than males (OR 3.952, 95% CI 1.694- 9.217). Commonly reported coping strategy was visiting a Physiotherapist (44.6%). While 33% coped up with pain using prescribed analgesics, none of them opted to rest. Despite high prevalence and severity, only 17% had frequented absenteism to work by taking sick leave.<strong> Discussion:</strong> Prevalence rate of musculoskeletal pain was found to be higher among school teachers as per the results of this present study. Prevalence and risk factor perceptions of school teachers as reported in this study can be of significance in understanding and addressing these factors and appropriate measures to prevent and overcome them can be devised based on these results. Since the risk factors for musculoskeletal symptoms can be multifactorial in nature, the results of this present study need to be correlated with all possible mechanisms related to this population and further studies to determine the effectiveness of appropriate ergonomic modifications should be taken into consideration.

scholarly journals “An Odyssey of Third Space Endoscopy”—from Entry into the Tunnel to Entry into the Peritoneal Cavity

2019 ◽  
Vol 10 (03) ◽  
pp. 142-149
Author(s):  
Harshal S. Mandavdhare ◽  
Shubhra Mishra ◽  
Jayanta Samanta ◽  
Jimil Shah ◽  
Rakesh Kochhar
Keyword(s):  
Peritoneal Cavity ◽  
Paradigm Shift ◽  
Bowel Movement ◽  
Submucosal Tumor ◽  
Tumor Resection ◽  
Third Space ◽  
Esophageal Lumen ◽  
History Of ◽  
Endoscopic Myotomy ◽  
Per Oral

AbstractThe last decade has seen the growth of a completely new and exciting entity called the third space endoscopy (TSE) that has brought about a paradigm shift in the way we manage various disorders of the gastrointestinal tract. The journey started with per oral endoscopic myotomy (POEM) for achalasia cardia and within a decade the concept has been exploited to its best potential for disorders including submucosal tumor resection, pyloromyotomy for gastroparesis, complete division of septum without the risk of perforation in diverticular diseases of esophagus, restoration of esophageal lumen in long strictures, restoration of bowel movement in Hirschsprung’s disease, and then taking the concept to the next level of pure NOTES (natural orifice transluminal endoscopic surgery) by entering the peritoneal cavity and performing fundoplication. This review will discuss the history of TSE with brief discussion about the various applications and what has been achieved till present.

217 Per Oral Endoscopic Myotomy (POEM) for Achalasia: Long-Term Outcomes Beyond 2 Years From a Large Prospective Single-Center Us Series

2017 ◽  
Vol 85 (5) ◽  
pp. AB62-AB63
Author(s):  
Stavros N. Stavropoulos ◽  
Rani J. Modayil ◽  
Collin E. Brathwaite ◽  
Alexander Sy ◽  
Mohammad F. Ali ◽  
...  
Keyword(s):  
Single Center ◽  
Long Term Outcomes ◽  
Per Oral Endoscopic Myotomy ◽  
Endoscopic Myotomy ◽  
Per Oral
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