Musculoskeletal Injuries in the Endoscopy Practitioner Risk Factors, Ergonomic Challenges and Prevention—Narrative Review and Perspectives

Round 1

Reviewer 1 Report

The review paper presents the ergonomic issues in endoscopy procedures. A detailed summary of previous reviews on this subject is presented, along with the causes, risks, and preventive measures to be taken during the procedures.

Overall the manuscript is clear and understandable. Some of the text in Figures are small.  I have a few minor suggestions:

1) In Table 1, the text in the last column is in small font and could be increased. The difference between Table 2 and table 3 on robotic endoscopy platforms is not clear and could be described in the table caption.

2) A reference for the image in Fig 3 is needed.

3) The review does not cover wireless capsule endoscopy, such as PillCam. Are there ergonomic issues reported with wireless capsule endoscopes? It would be good to add the ergonomic benefits, if any reported, for wireless devices. A recent review covers the commercial capsule endoscopes: Dylan Miley et al. 2021, Advanced Devices & Instrumentation, https://spj.science.org/doi/10.34133/2021/9854040

4) In Fig 2 and 3, the text within the figures are too small to read.  

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

The manuscript entitled: Prevention of musculoskeletal injuries in gastrointestinal endoscopy – structured review and perspectives, is a narrative review, which underline crucial steps in injury prevention during gastrointestinal endoscopy. The theme is important because the gastroenterologist seems to spend at least 40% of their time practicing endoscopic procedures. Unfortunately, between title and text there are some inaccuracies.

Major revision

First of all this is a narrative review not systematic review. There is not a methodology for the selection of the articles used in this review (neither flowchart). The title is misleading by using ``structured review``.

In abstract, the author said: ``We review most relevant studies…`` but there is a single author.

The title could be misleading; it is about musculoskeletal injuries developed by gastroenterologists not the patients underwent gastrointestinal endoscopy.

The article has, apart introduction and conclusions, two parts: ergonomic challenges, general problem of the endoscope layout. This is discordant with the key word of the title: prevention. This manuscript should include data about prevention issues.

The chapter discussions and conclusion includes some take home messages; is inappropriate entitled discussions.  I recommend deleting discussions and keep only conclusions (or better take home messages).

There are many technical data, which for physicians are not useful.

 

There are some minor errors language.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Thank you for your responses. The manuscript was improved.