Preventing cross-contamination from flexible endoscopes

May 2, 2011 by MassDevice

Recent developments in medical device design are paving the way for a new class of disposable endoscopes, disposability that will virtually eliminate the risk of cross-contamination.

Preventing cross-contamination from flexible endoscopes

By Derek Hatchett

When the ECRI Institute, an independent organization that evaluates medical devices and procedures, issued its 2011 list of the 10 most dangerous technologies in healthcare, reprocessed flexible endoscopes made the list for the second year in a row. "At minimum, endoscope reprocessing problems, when discovered, can inconvenience patients and create anxiety; at worst, they can lead to life-threatening infections," the report says. With 10s of thousands of patients undergoing such procedures each year, the issue begs resolution.

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ECRI said its list was compiled based on "a review of recent recalls; analysis of information found in the literature" and that organization’s "experience in investigating and consulting on device-related incidents." Most notable was the widespread incidence of contamination of endoscopic equipment at Veterans Administration hospitals that exposed thousands of veterans to the risk of infection, including HIV.

Recent developments in medical device design are paving the way for a new class of disposable endoscopes, disposability that will virtually eliminate the risk of cross-contamination. Endoscopes need to be small in diameter, a fact that was at odds with high-resolution photo optical equipment where bigger was synonymous with better — until recently, that is. There has been tremendous progress in the arena of small, low-cost, high-resolution camera sensors that can be used in the distal end of scopes. The camera is connected to a monitor at the proximal end of the scope by very small, low-voltage wires running the length of the scope. The technology is attaining (and soon to be surpassing) the performance of higher-cost plastic and glass optical fiber scopes.

This low-cost, disposable visualization technology has been finding acceptance in traditionally "blind" procedures, such as pulmonary sample collection. Low-resolution cameras aid clinicians in navigating to the optimal organ sample site, where the sample can be collected, sequestered and sent out for analysis. Afterward, the entire collection device is sanitarily disposed of. The only capital component of the system is the monitor, which is remote from the patient. And eventually, even the monitor will be considered disposable if costs come down sufficiently.

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