Endoscope processing technology advancements

Oct. 27, 2023

HPN asked vendors in the endoscope-reprocessing space to provide information on their latest endoscope care products and services. Here’s what they offered:

Ambu's single-use endoscopes are always sterile, helping create zero preventable harm. Ambu pioneered single-use endoscopy, introducing the first disposable bronchoscope in 2009, and continues to rethink solutions to save lives and improve patient care. 

SP departments setting out on a journey to become a high-reliability organizations (HRO) should look to Ambu as an ideal process improvement partner. The company’s single-use endoscopy platform means:

·      Scopes are not delayed waiting to be cleaned

·       No need to incur courier costs to get scopes to and from outreach clinics

·       Avoid investments in expensive high-level disinfection equipment

·       Can reinvest resources for new service lines in patient communities 

ASP’s AEROFLEX Automatic Endoscope Reprocessor (AER) is an automated system designed for endoscope reprocessing that boasts a 22-minute complete cycle time.* The AER is equipped with an integrated minimum recommended concentration (MRC) monitor, eliminating the need for test strips. Its user-friendly interface can reduce human error. The ASP AEROFLEX AER features a space-saving design, making it an optimal choice where space is at a premium. 

*In countries where distributed. Includes wash, HLD, rinses, MRC testing, and alcohol flush. For all qualified endoscopes except duodenoscopes, which require additional time. Assuming nominal conditions for water pressure, flow rate, and temperature. 

Clarus Medical’s inspection borescopes offer features to enhance an SP department's inspection process, such as picture- and video-capture capabilities for documenting their findings. Clarus borescopes provide a wide variety of interchangeable borescope lengths and diameter options to match the wide variety of sizes of medical device lumens. 
Clarus Medical’s SmartScope borescopes are designed to boost an SP team’s confidence in borescope inspections. Using AI and Computer Vision technology in real time, SmartScope borescopes assist the user with automatic annotation, severity assessments, and recommended next steps. They enable seamless problem identification, documentation, and resolution management. 
Cygnus Medical’s Oasis flexible endoscope transport trays are designed for single-use and effectively eliminate the risk of cross-contamination, simultaneously streamlining labor efforts and minimizing space requirements. Oasis trays are made from a renewable resource and are biodegradable. 

Reusable transport containers are ideal in certain scenarios but present challenges in others. When it comes to transporting flexible endoscopes, the common practice involves cleaning reusable containers using surface disinfection wipes. When these containers are nested together, inadequate disinfectant contact time can transfer the viable contaminants from the interior of one container to the exterior of the container nested within it, creating a break in the infection control chain. 

Encore Medical Device Repair: “Endoscopes can cost $50,000 or more and require careful handling,” said Kevin Liszewski, CEO, Encore Medical Device Repair. “Historically, the instrument manufacturing and repair industries have failed to educate SP teams on how to treat these instruments as assets rather than basic reusables. Encore Medical Device Repair shifts this paradigm by providing holistic, transparent device lifecycle management, while reducing unrepairable rates to drive tremendous cost savings. 

Encore is the only company cleared to use advanced device-reuse technology developed for the remanufacturing of robotic instruments. It offers an extensive instrument-handling education program, digital device registration and tracking, seamless repair and service management by specialized technicians, real-time access to service and repair status, and quarterly device program reviews to create total transparency.” 
Healthmark’s FIS-007 Flexible Inspection Scope is designed to visually inspect internal channels of potentially soiled or damaged items. The FIS-007 borescope provides enhanced light, vision, and magnification. It features a modular design with interchangeable flexible inspection scope attachments available in diameters of 1.06mm and 1.9mm. These scopes have a working length of 110cm and attach to a 13.3W x 9.9L x 4.7H cm control box, allowing for light level adjustments. 

The FIS-007 also offers users the option to document photos and videos of lumens and crevices not visible to the unaided eye (these features only available for the USB control box with FIS-007 software, which is included and installs on Windows 10 & 11 PCs). 

KARL STORZ’s no-wrap containers are a superior option for sterilizing and protecting KARL STORZ products. These sterilization containers provide a simple yet effective system for protecting endoscopic equipment and instrumentation during sterilization, transport, and storage. They are available in a multitude of sizes and configurations and are custom-designed to accommodate KARL STORZ endoscopes, camera heads, and instruments. KARL STORZ containers are universally validated for use in low- and high-temperature sterilization systems. By eliminating the need for blue wrap, they also provide significant cost savings and waste reduction to healthcare facilities currently using traditional blue-wrap trays. 
Medrica’s Tip Protectors are available in individually packaged sterile and non-sterile formats. The semi-rigid expandable mesh protects the tip/lens of endoscopes from front and side impact, including other sensitive surgical instruments. The Tip Protector also allows moisture to escape, eliminating potential bacteria growth (Pseudomonas species) that can occur with foam or solid protectors. It is not abrasive, will not scratch any part of the scope/lens, will fit many different sizes of instruments, and will not fall off during transport and storage. 
Medtrica’s flexible scope sleeves provide a barrier from physical contact. By wicking moisture away, the disposable sleeve prevents moisture build up and potential bacteria growth on the insertion tube. The scope sleeve also provides a surface for the placement of labels showing detailed scope cleaning information for references, without having to place the label on the scope body (labels can be easily removed from the sleeve and placed on a patient’s chart, etc.). It does not need to be taped directly onto the endoscope boot. 
Metrex’s enhanced EmPower detergent is a specialized cleaning solution formulated for thorough removal of diverse soils such as protein, starch, oil, and fat. With a low-foam design for enhanced visibility and an improved shelf life, EmPower supports both efficient reprocessing and effective inventory management. Beyond its cleaning power, the company has ensured its compatibility with common medical device materials including metal, plastic, glass, and rubber. EmPower aims to assist SP departments in streamlining workflow, offering both quality and reliability. 
Olympus America’s OER-Elite automatic endoscope reprocessor (AER) is designed to simplify the user experience and reduce human errors. Smart Navigation guides users step-by-step on how to connect endoscopes, manage and replace consumables, and troubleshoot errors. Its Channel Monitoring System monitors connection set-up, and built-in log data management helps users effectively manage endoscope reprocessing records. According to Olympus America, this design approach helps users overcome human factor limitations with a goal to realize reprocessing consistency. Improper use of OER-Elite endoscope reprocessor may pose an infection control risk to patients and/or operators. 
Ruhof Corporation’s Endozime SLR is the only multi-tiered enzymatic cleaner designed to molecularly displace synthetic lipids, allowing them to be rinsed off while dissolving blood, fat, carbohydrates, and protein. Synthetic lipids—including silicone, simethicone etc.—form an oily substance that coats the insertion tubes and internal channels of an endoscope. This oil does not break down during cleaning but redeposits itself in different areas becoming impossible to remove. Used as preventative maintenance or as needed, Endozime SLR stops synthetic lipid residues from accumulating on the outer sheath and inner channels of scopes, biopsy forceps and all surgical instruments. 
Ruhof Corporation’s ScopeValet TipGuard is an endoscopic tip protector that provides a simple, safe, and highly effective method of protecting the delicate optics of an endoscope during transport and storage. The open design of the ScopeValet TipGuard allows the tip of the scope to aerate, decreasing the likelihood of microbiological growth. Effectively protecting the entire distal end of the endoscope, TipGuard keeps the distal tip from protruding through the tip protector, unlike current boot sponges. Fitting onto a wide variety of scopes of multiple diameters (2.5mm to 14mm), the ScopeValet TipGuard is disposable--individually packaged for one-time use—thereby minimizing cross-contamination. 
STERIS’ DuoSwift combination squeegee brush is designed to work smarter, not harder. Its unique design features a tapered, nylon-bristled brush on one end and a series of flexible disks (squeegees) on the other. A recent study reports that the STERIS DuoSwift has superior brushing efficacy and efficiency compared to other market-leading endoscope cleaning brushes. DuoSwift provides cleaning action that removes more bioburden in a single pass. 
STERIS’ SPM Endo Workflow Solution provides the ability to marry the IFU and reprocessing requirements for every scope in our inventory with the competency level of each staff member and how the reprocessing area is outfitted to perform the work. The result is the ability to deliver specific work instructions for what the scope requires and how that work should be understood and accomplished. “We have found great success using SPM’s Configurable Guided Workflows,” said John Kimsey, VP, Processing Optimization and Customer Success, STERIS. 

At each point of the workflow, from bedside pre-cleaning, leak testing, manual cleaning, brush selection, and the times and standards for each, the prescribed work and methodology is provided to the technician and the system records that the work is done properly and that the needed outcomes have been achieved. As a result, the system then provides electronic procedure- and audit-ready documentation of all activities related to reprocessing our flexible scopes. 

TBJ’s Model 30-96-2TB SPCS scope pre-cleaning sink is specifically designed for use in GI labs and SP departments for pre-cleaning flexible endoscopes. The unit includes two elongated trough-style sink bowls allowing for the extended linear positioning of endoscopes during the pre-cleaning process. AAMI guidelines suggest that endoscopes be positioned in the sink without tight coiling during the pre-cleaning process. TBJ’s trough-style sinks enable scopes to be positioned with little or no coil for less restrictions during the flushing process. Water and cleaning solutions are more effective during the flushing process when coiling is reduced or eliminated. The sink bowl depths are at an ergonomic 8” to 10” and the height adjustment feature of the sink allows each user to position the sink top at a height desirable to their specific comfort zone. 
Torvan Medical’s CleanStation reprocessing sink with touchscreen-powered eSink system is designed to help take the guesswork out of endoscope processing. Auto-fill functionality with enzymatic dosing control (dosing pump included) ensures every endoscope wash cycle has the correct concentration of enzymatic detergent. Temperature control and monitoring gives the confidence that water temperature always matches enzymatic requirements. Integrated touchscreen lets the user set and adjust the height of the sink, operate the eDrain electronic drain system, adjust the overhead light, and control other options, all from a single intuitive interface. 

Coming soon is Torvan Medical’s fully automated eSink, with automated endoscope flushing and programmable workflow software to help reprocessing technicians work faster, easier, and more accurately.