{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T23:57:59Z","timestamp":1781135879991,"version":"3.54.1"},"reference-count":8,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background Endoscope tip angulation is a key determinant of procedural maneuverability, yet routine quantitative assessment is not standardized, and data are limited on how quickly new endoscopes fall below manufacturer-specified performance benchmarks during routine use. The aim of this study was to evaluate tip angulation performance in new, apparently functional endoscopes after a period of clinical use and to characterize the prevalence and pattern of below-tolerance findings by scope type.<\/jats:p>\n                  <jats:p>Methods We performed a quality improvement project to evaluate the tip angulation of newly issued endoscopes within nine months of clinical use. In phase 1, endoscopes were systematically assessed by three trained physicians using a reference chart. In phase 2, a company representative independently evaluated endoscopes using a calibrated instrument.<\/jats:p>\n                  <jats:p>Results In all, 32 new endoscopes (18 colonoscopes and 14 gastroscopes) were evaluated. All scopes were used for approximately 9 months. The mean procedure count for colonoscopes was 185.6 (\u00b112.5, range 162\u2013201) and for gastroscopes was 150.6 (\u00b112.0, range 133\u2013166). Totally, 5 out of 18 colonoscopes (27.8%) fell below manufacturer tolerance thresholds for maximal tip deflection in at least one direction. All 14 gastroscopes met manufacturer tolerance thresholds in all four directions.<\/jats:p>\n                  <jats:p>Conclusions This cross-sectional study found that a notable proportion of new colonoscopes fell below manufacturer tolerance thresholds after approximately nine months of clinical use, despite being considered apparently functional. These findings highlight the need for periodic, objective assessment of tip angulation, even in endoscopes without apparent defects. Longitudinal studies are needed to establish deterioration trajectories and inform maintenance guidelines.<\/jats:p>","DOI":"10.1055\/a-2877-9452","type":"journal-article","created":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T22:32:00Z","timestamp":1778970720000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Quantitative Assessment of Endoscope Tip Angulation Performance in New Endoscopes: A Cross-Sectional Quality Improvement Study"],"prefix":"10.1055","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6983-1804","authenticated-orcid":false,"given":"Saksham","family":"Kohli","sequence":"additional","affiliation":[{"name":"John H Stroger Jr Hospital of Cook County, Illinois, United States","place":["Chicago"],"department":["Department of Internal Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram","family":"Kotwal","sequence":"additional","affiliation":[{"name":"John H Stroger Jr Hospital of Cook County, Illinois, United States","place":["Chicago"],"department":["Division of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihir","family":"Shah","sequence":"additional","affiliation":[{"name":"John H Stroger Jr Hospital of Cook County, Illinois, United States","place":["Chicago"],"department":["Division of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daksh","family":"Ahluwalia","sequence":"additional","affiliation":[{"name":"John H Stroger Jr Hospital of Cook County, Illinois, United States","place":["Chicago"],"department":["Division of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Zhao","sequence":"additional","affiliation":[{"name":"John H Stroger Jr Hospital of Cook County, Illinois, United States","place":["Chicago"],"department":["Division of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Atluri","sequence":"additional","affiliation":[{"name":"Rush University Medical Center, Illinois, United States","place":["Chicago"],"department":["Medical Student"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seema","family":"Gandhi","sequence":"additional","affiliation":[{"name":"John H Stroger Jr Hospital of Cook County, Illinois, United States","place":["Chicago"],"department":["Division of Gastroenterology and Hepatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"E466","DOI":"10.1055\/s-0042-104115","article-title":"Evaluation of the tip-bending response in clinically used endoscopes","volume":"4","author":"E D Rozeboom","year":"2016","journal-title":"Endosc Int 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forearm-muscle load during routine colonoscopy: a pilot study","volume":"69","author":"A K Shergill","year":"2009","journal-title":"Gastrointest Endosc"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"704.e2","DOI":"10.1016\/j.gie.2020.11.001","article-title":"Biomechanical risk factors associated with distal upper extremity musculoskeletal disorders in endoscopists performing colonoscopy","volume":"93","author":"A K Shergill","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.gie.2020.09.048","article-title":"Multisociety guideline on reprocessing flexible GI endoscopes and accessories","volume":"93","author":"L W Day","year":"2021","journal-title":"Gastrointest Endosc"},{"key":"ref8","first-page":"1048.e2","article-title":"GI endoscope reprocessing: a comparative review of organizational guidelines and guide for endoscopy units and regulatory agencies","volume":"95","author":"ASGE Quality Assurance in Endoscopy Committee","year":"2022","journal-title":"Gastrointest Endosc"}],"container-title":["Endoscopy International 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