Technical & clinical evaluation of a novel slim gastroscope in third-space procedures: Feasibility, subjective workload & system usability assessment.

Background and study aims: Third-space endoscopy, including peroral endoscopic myotomy (POEM) and endoscopic submucosal dissection (ESD), has become an established therapeutic option for various gastrointestinal disorders. A newly developed slim therapeutic gastroscope aims to improve maneuverability and provide easier access to the submucosal space and also to enhance ergonomic aspects of tedious therapeutic procedures. The aim of this study (The Slim Scop3 Trial) was to evaluate the subjective workload and usability of the novel slim therapeutic gastroscope during third space procedures. Secondary outcomes included technical and clinical performance as well as adverse events (AEs). Patients and methods: This was a prospective, single-arm, single-center study comprising 30 patients undergoing third-space endoscopy in a high-volume center in Germany. Subjective workload and usability were assessed with the NASA-Task load index (NASA-TLX) and the System Usability Score (SUS), respectively. Clinical outcomes and AEs were recorded prospectively. Results: The slim gastroscope showed a low NASA-TLX and high SUS score, which correlates with a low subjective workload and high usability. POEM showed a tendency toward lower NASA-TLX and higher SUS compared with ESD. For ESD, the en-bloc and curative R0 resection rate was 100%. No device-related AE events occurred. Conclusions: A novel slim gastroscope offers high usability with a low subjective workload for third space procedures. The slim gastroscope has the potential to reduce ergonomic strain on endoscopists during complex therapeutic interventions.