P0339 - Does Sitting vs Standing Endoscopist Position Makes a Difference in the Colonoscopy Quality?

Cesar Ortiz, MD¹, Patricia Yunen, MD², Carlota Cabrer, MD³, Cynthia Contreras, MD⁴, Paola Peña, MD¹, Leandro Tapia, MD⁵, Fernando Contreras, MD^1
1Centro de Gastroenterologia Avanzada, Santo Domingo, Distrito Nacional, Dominican Republic; ²Centro de Diagnóstico Medicina Avanzada y Telemedicina, Santo Domingo, Distrito Nacional, Dominican Republic; ³Centro de Diagnostico Medicina Avanzada y Telemedicina, Santo Domingo, Distrito Nacional, Dominican Republic; ⁴TriHealth, Cincinnati, OH; ⁵Hospital Germans Trias i Pujol, Barcelona, Catalonia, Spain

Introduction: Gastroenterologists invest about 45% of their time in endoscopic procedures, and ergonomics continues to be an overlooked aspect of the practice. Survey-based studies report that the prevalence of musculoskeletal symptoms ranges from 37-89%; with pain in the lower back being the most frequently reported. There is also an increased risk of developing and aggravating chronic venous insufficiency. Sitting during a colonoscopy lessens the strain on the lower back and legs; however, only a small number of endoscopists do it. This study aims to see if differences exist in the quality parameters of the procedure between standing versus sitting colonoscopies.

Methods: Colonoscopies performed standing were compared to those in a sitting position. The quality parameters analyzed were the insertion rate and time to reach the cecum and ileum, the total procedure time, and the mean number of polyps found. We correlate the outcomes using a T-test, assuming significance when p< 0.05.

Results: Out of a total of 658 cases, 52.6% (n=346) of endoscopists were standing, while 47.4% (n=312) were sitting. The insertion rate to the cecum and ileum was 100% in both groups. When the colonoscopist was standing, the ileum insertion time was faster (m= 5 min and 14 sec) compared to sitting (m= 6 min and 31 secs) (t (612) = 4,26, p< 0.001). The total procedure time procedure, while the endoscopist is seated in the meantime, increased compared to when standing (21.33 vs. 19.66min, p=0.008) but did not affect mean polyp count (1.3 vs. 1.3, p=0.5). When we compared only procedures with a Boston Scale over 7, there was no difference between sitting or standing in total procedure time (21 vs. 19.5mins, p=0.06) or mean polyp detection (1.3 vs. 1.3, p=0.5). No complications were reported. There was no need to reposition either the colonoscopist or the patient.

Discussion: Our study revealed comparable successful insertion rates in both the cecum and terminal ileum. Although a slight increase in insertion time was observed when the procedure was performed in a seated position, there was no significant difference in the overall duration of the procedure with an optimal colonic preparation. However, further research is needed to explore the potential long-term implications of standing versus sitting colonoscopy. Considering its similar effectiveness, sitting colonoscopy could potentially be implemented as a standard practice.


Disclosures:


Cesar Ortiz, MD¹, Patricia Yunen, MD², Carlota Cabrer, MD³, Cynthia Contreras, MD⁴, Paola Peña, MD¹, Leandro Tapia, MD⁵, Fernando Contreras, MD¹. P0339 - Does Sitting vs Standing Endoscopist Position Makes a Difference in the Colonoscopy Quality?, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.