Frequency and Costs of Echo Endoscope Repairs: Results of a Survey of Endosonographers

Abstract

The need for repair of endoscopic ultrasound (EUS) equipment appears to be frequent and expensive. To better quantify the costs associated with echo endoscope failure, a survey of endosonographers was carried out. A survey questionnaire concerning echo endoscope damage and repair and consequences of echo endoscope downtime over a 12-month period was sent to members of the American Society of Gastrointestinal Endoscopy who had cited an interest in EUS. Responses were received from 56 of 138 institutions where EUS was carried out (41 %). A median of 325 EUS procedures had been carried out in the past year and a median of two endosonographers were employed who used an average of three echo endoscopes. Two-thirds of institutions trained fellows. A total of 225 repairs were reported for leaks (47 %), mechanical failures (33 %), images or optics difficulties (26 %), or other problems (1 %). Mechanical radial-scanning echo endoscopes tended to break, on average, after 68 procedures, while curved linear-array echo endoscopes failed after an average of 107 procedures. Echo endoscope failures led to rescheduling of procedures at three-quarters of institutions. Institutions paid an average of $ 10 534 over 12 months for echo endoscope repairs. The average repair cost per procedure was $ 41. There was an inverse relationship between quantity of procedures and the per-procedure repair rate ( P < 0.05). Direct and indirect costs of echo endoscope repairs are significant. Instrument failures are multifactorial; however instrument complexity, instrument age, and institutional inexperience may contribute to repair costs.