Single-handed controller reduces the workload of flexible endoscopy

The control of the conventional flexible endo- scope is non-ergonomic and non-intuitive. A novel single- handed interface could reduce the experienced workload, without reducing current efficiency or effectiveness of endoscope manipulation. The aim of this study is to eval- uate the workload, efficiency and effectiveness of a single- handed controller in colonoscopy, in comparison to a bimanual controller and the conventional angulation wheels. Twenty-one inexperienced students performed colonoscopies on a computer simulator using either the single-handed controller with a joystick interface, a bimanual controller with a joystick interface or the con- ventional angulation wheels. Participants performed three sessions of colonoscopies. After each session, the experi- enced workload was evaluated using a seven-component absolute scoring scale. Efficiency of the procedure was evaluated by the cecal intubation time and total-used scope length. Effectiveness was evaluated by the percentage of bowel wall visualization. The total workload of the single- handed controller was lower compared to the conventional angulation wheels for all three sessions. The total workload of the bimanual controller was lower compared to the conventional angulation wheels in the second and third session and also lower compared to the single-handed controller in the third session. There was no significant difference between the three control interfaces in time efficiency, used scope length or visualization performance. Single-handed and bimanual controllers with a joystick interface are a feasible approach to reduce the workload of colonoscopy without reducing efficiency or effectiveness of endoscope manipulation.