by ColoWrap, on October 15, 2024
When Dr. Marybeth Spanarkel first imagined a device that could help prevent endoscopy staff injury and patient discomfort during colonoscopy, she couldn’t have possibly known how deeply personal that vision would become in her future.
What began as a hypothetical solution to the ever-prevalent ergonomic challenges in her field eventually evolved into ColoWrap—the first clinical colonoscopy compression device that prevents the need for manual abdominal pressure and patient repositioning.
But in an unfortunately ironic twist of fate, just two years into the development of her visionary device, Dr. Spanarkel suffered the very career-ending injury she hoped to prevent.
We sat down to hear our co-founder’s story in her own words:
A 1979 graduate of Duke Medical School, Dr. Spanarkel initially set out for an academic and research-focused career in medicine. However, those plans rapidly changed once she began her residency in internal medicine at the University of Pennsylvania, where she immediately gravitated toward gastroenterology.
“I enjoyed the procedures—the hands-on nature of the work,” said Dr. Spanarkel. “Gastroenterology is the perfect blend of diagnostics and procedural intervention, especially through endoscopy.”
Her love of GI was further cemented in clinical settings through a combined GI fellowship at Johns Hopkins and the National Institutes of Health (NIH). Eventually, she accepted a clinical gastroenterologist position in a private practice operating out of a large internal medicine group at Duke Regional Hospital in Durham, North Carolina.
Additionally, she was able to stay connected to her initial interest in academia by teaching Duke medical students and residents on their rotations through the hospital.
As a private practitioner, Dr. Spanarkel’s daily activities consisted of diagnostic consultations, teaching clinical procedures, and, of course, performing those procedures—most often colonoscopies—herself.
She found the work to be rewarding and compatible with the needs of raising her young family. She also quickly realized that gastroenterology was a clear source of increasing need and opportunity.
Throughout her career, screening colonoscopies rapidly increased in popularity as the GI field began to better understand their importance in diagnosing and reducing colorectal cancer.
Her caseload, which already consisted of a steady rotation of upper endoscopy and therapeutic interventions, rapidly became dominated by colonoscopy—a procedure that can often prove to be ergonomically difficult.
During colonoscopy, the colonoscope is advanced from the patient’s rectum, through the colon, to the patient’s cecum. The most common complication is called looping, and it occurs when the colonoscopy stretches and distends the colon.
This is typically resolved by the physician torquing the colonoscope and through the manual application of pressure to the patient’s abdomen. Looping is the primary cause of patient pain, complications, and failed procedures, and it also poses a unique risk to endoscopy staff: musculoskeletal injuries.
Dr. Spanarkel found herself wondering about a potential solution to looping and arrived at the initial concepts of what would later evolve into ColoWrap.
She brought her fledgling idea to her sons, John and James Hathorn, who offered their entrepreneurial expertise to develop a prototype, conduct sector research, launch the start-up, and bring their mother’s vision to life. Dr. Spanarkel stayed on board as one of ColoWrap’s senior medical advisors and became a passionate advocate for ergonomic advances in colonoscopy.
However, just two years into the development of ColoWrap, Dr. Spanarkel experienced any gastroenterologist’s worst nightmare. She had a minor fall from the bed and used her right arm to brace herself to avoid hitting the floor. Within 24 hours, she was nearly paralyzed in her arm, and an emergency MRI showed a herniated disc and comprehension of the C5C6 nerve.
After neck surgery and a rigorous physical therapy regimen, Dr. Spanarkel was able to regain roughly 90% of her arm’s initial strength. But as far as gastroenterology goes, 90% may as well have been zero.
“Once I recovered, I could once again raise my arm to brush my teeth or blow dry my hair, but I certainly couldn’t hold a colonoscope,” Dr. Spanarkel recounts. “I was immediately out of business at the age of 60. A forced, premature retirement due to a sudden injury resulting in a permanent disability.”
In addition to the abrupt end to her private practice career, Dr. Spanarkel also had to forfeit the teaching positions she held at both Duke and UNC. “As much as I loved to see patients and teach students, I wouldn’t have been able to take over a scope in the event of an emergency during a procedure. I was out of a job.”
With suddenly a lot more time on her hands, Dr. Spanarkel dove headfirst into research with ColoWrap and became an outspoken messenger of the product’s efficacy. A particular area of interest of hers was the ongoing conversation of gender equality in medicine.
“There’s been a lot of attention on getting women into leadership positions, maternity rights, pay gaps, etc., but we also need to address how looping creates a physical risk to women in gastroenterology.”
A recently published study found that female gastroenterologists reported a significantly higher risk of injury (63.4%) than their male counterparts (40.9%), citing smaller hand sizes, lower muscle mass, and an overall lack of ergonomic education as potential causes.
This phenomenon is further exacerbated by the overall elevated risk for musculoskeletal injury in females and the numerous studies documenting female patients’ clear preference for female gastroenterologists.
ColoWrap has been proven to significantly reduce the risk of musculoskeletal (MSK) injuries in endoscopy staff. By minimizing the need for manual pressure and repositioning, in some cases up to 90%, ColoWrap can help avoid stress, strain, and gastroenterologist injury while shortening colonoscopy procedure time and minimizing patient discomfort.
Part of Dr. Spanarkel’s steadfast commitment to reducing the risk of endoscopy is rooted in her own injury, which ended her professional career, but there is another, equally personal motivator in her life. Her youngest daughter, Kelly, is an early-career GI, who currently performs a high volume of procedures.
“I have a vested interest in reducing ergonomic risk for the next generation of GI doctors. I’m not only devoted to women in GI; I have a daughter in the field!”
Looking to the future, Dr. Spanarkel is optimistic about the future of ColoWrap and its potential to transform colonoscopy practices. “It’s a relatively simple, non-invasive, and non-pharmacological approach,” she explains.
What started as one gastroenterologist’s mere “what-if” has now evolved into ColoWrap—the first clinical solution to mitigate the need for manual abdominal pressure during colonoscopy, delivering a safer environment for patients and practitioners alike.
Presentation by Gastroenterologist, Dr. Marybeth Spanarkel: Endo Staff Under Pressure: Understanding Colonoscopy-Related Ergonomic Hazards
To hear more from Dr. Spanarkel on the topic of ergonomic hazards in colonoscopy today, check out her presentation at the 2024 AORN Global Surgical Conference & Expo.