Damaged endoscope

Preventing Infection

Internal Damage to Endoscopes is Hard to Detect, Even Harder to Clean

In these cases when you pull back a biopsy tool and you scuff or scrape or nick the inside of that working channel, it’s going to leave basically a Grand Canyon for microbes to hide in, and a small brush isn’t going to get down into those nicks that you left behind.

One of the biggest challenges to cleaning endoscopes is damage to the inside of the instruments caused by routine use or accidental nicks or burns.

So says Kris Murphy, director of chemistry at Little Falls, New Jersey-based Cantel Medical Corp., who was featured on a recent episode of the Beyond Clean podcast discussing the science of endoscope cleaning.

“It makes the scopes incredibly hard to clean, and fundamentally, if you can’t clean an endoscope, you can’t disinfect them either,” Murphy says. “One of the big primary challenges right now in the industry is how do you detect this damage and to what level of damage is important.”

As a chemist whose specialty is cleaning and disinfecting reusable medical equipment such as endoscopes and ultrasound equipment, Murphy is practiced at tracking down contamination.

“In these cases when you pull back a biopsy tool and you scuff or scrape or nick the inside of that working channel, it’s going to leave basically a Grand Canyon for microbes to hide in, and a small brush isn’t going to get down into those nicks that you left behind,” he says.

Unlike single-use endoscopes, which require no cleaning, reusable scopes are flushed with cleaning fluids at the bedside. They're then taken to a sink and washed and tested for leaks and damage. Then they go into an automated endoscope reprocessor (AER) where they are cleaned and disinfected using a powerful high-level disinfecting agent. Then they are removed, dried and stored for the next use.

Murphy says he looks forward to a time when those initial cleaning steps can be eliminated, and the devices put directly into a high-performing AER. He believes the machines can reach a high enough standard that they’ll eliminate the need for pre-cleaning.

Human error is the risk factor Murphy wants to eliminate.

“I really, really hope we come to that point where we can just take a scope out of a patient, put it in a reprocessor, and then put it in storage right after that, so there’s no human touch point,” Murphy says. “We all know working in [the medical device industry] that having a human touch point is a pretty good source of error.”

Click here to listen to or download the podcast, and click here for a Beyond Clean episode archive.

More Infection Prevention Articles
Why Medical Technologists Should be Considered for IP Roles
Prevention Strategies
The COVID-19 pandemic has exacerbated the healthcare worker shortage and infection preventionists are no exception.
What to Know About ANSI/AAMI ST108
Prevention Challenges
“Water is actually really complex in its chemistry and depending on where you are geographically, the water quality can be very different,” says the co-chair of a working group authoring the new standard.
More From Single-Use Endoscopy
Consensus Opinions on Single-Use Bronchoscope Use in China

Endoscopy Tech

Surveys yield a dozen recommendations based on the key attributes of single-use bronchoscopes.

Single-Use Therapeutic Gastroscope Obtains FDA Clearance

Emerging Technologies

The novel device features a 4.2mm working channel and expands Ambu's portfolio of single-use endoscopes for upper gastrointestinal (GI) procedures.

3 Things Worth Checking Out at AUA 2024

Public Health

Panel discussions and sessions will be in the spotlight during AUA 2024 — running May 3rd to May 6th — addressing a broad spectrum of subjects.