In making his case for the adoption of single-use duodenoscopes, Dr. Klaus Mergener described what the first duodenoscopes looked like upon their invention more than five decades ago.
The description was strikingly similar to the duodenoscopes of today.
Mergener — an affiliate professor of medicine at the University of Washington who was recently appointed chief medical officer for Pentax Medical — spoke May 22 at Digestive Disease Week 2022 in San Diego during a session called “Leading Updates in Quality and Safety.” His presentation, “Disposable Scopes Versus Better Reprocessing: Throw It Out,” made a compelling case for single-use endoscopes in gastroenterology, including the innovation they bring to a space that had lacked it for decades.
“In the last 10 years, because of the movement to disposable scopes, there has been a turbo boost of innovation,” he said.
Most importantly, however, single-use duodenoscopes protect patients from infection. Mergener — who was president of the American Society of Gastrointestinal Endoscopy — cited a recent FDA communication recommending providers transition to duodenoscopes with innovative designs, including fully disposable ones or those with disposable components.
“This was a political push for all the right reasons,” he said. “We will see the industry continue to push into this area.”
Mergener offered four main areas to consider when weighing single-use versus disposable scopes:
Postmarket studies have found 5.4 percent of reprocessed duodenoscopes harbor high-concern organisms, Mergener noted. Endoscope design, device damage, and reprocessing failures are to blame — reprocessing involves more than 100 individual steps, he added, and errors or omissions can occur in more than half of them.
Reported infection rates are “almost certainly” underestimated, Mergener said.
Regarding device quality, Mergener said more than 90 percent of ERCP procedures can be completed with commercially available single-use duodenoscopes. He encouraged attendees not to underestimate the power of scale and time they offer.
Environmental impact “is the obvious concern,” Mergener said, while displaying a graphic illustrating how much waste endoscopic procedures generate as a whole. Regarding business economics, Mergener said single-use duodenoscopes reduce capital expenditures and would be an attractive option for low-volume units.
Mergener spoke before Dr. Grace H. Elta, whose session was called “Disposable Scopes Versus Better Reprocessing: Put It In The Wash.” The segment pitted the two past ASGE presidents against one another in a debate format.
Disposable scopes, Elta said, don’t perform as well as reusables, are costly, and bad for the environment.
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