Reusable Accessories Research Articles

Perspectives and awareness of endoscopy healthcare professionals on sustainable practices in gastrointestinal endoscopy: results of the LEAFGREEN survey.

Gastrointestinal (GI) endoscopy is one of healthcare's main contributors to climate change. We aimed to assess healthcare professionals' attitudes and the perceived barriers to implementation of sustainable GI endoscopy. The LEAFGREEN web-based survey was a cross-sectional study conducted by the European Society of Gastrointestinal Endoscopy (ESGE) Green Endoscopy Working Group. The questionnaire comprised 39 questions divided into five sections (respondent demographics; climate change and sustainability beliefs; waste and resource management; single-use endoscopes and accessories; education and research). The survey was available via email to all active members of the ESGE and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) in March 2023. 407 respondents participated in the survey (11% response rate). Most participants (86%) agreed climate change is real and anthropogenic, but one-third did not consider GI endoscopy to be a significant contributor to climate change. Improvement in the appropriateness of endoscopic procedures (41%) and reduction in single-use accessories (34%) were considered the most important strategies to reduce the environmental impact of GI endoscopy. Respondents deemed lack of institutional support and knowledge from staff to be the main barriers to sustainable endoscopy. Strategies to reduce unnecessary GI endoscopic procedures and comparative studies of single-use versus reusable accessories were identified as research priorities. In this survey, ESGE and ESGENA members acknowledge climate change as a major threat to humanity. Further improvement in sustainability beliefs and professional attitudes, reduction in inappropriate GI endoscopy, and rational use of single-use accessories and endoscopes are critically required.

Evaluation and Application of a Passive Air Sampler for Atmospheric Volatile Organic Compounds

In this study, we propose a passive air sampler (PAS) that mainly consists of activated charcoal sorbent, a radial diffusive body, and a protective shield for the outdoor monitoring of volatile organic compounds (VOCs). Due to its reusable accessories and small size, this PAS is cost-effective and highly convenient for outdoor deployment. The estimated sampling rates (SRs) for 28 VOCs were very close to the theoretical values over a 6-month field test. We evaluated the performance of the PAS with benzene, toluene, ethylbenzene, and xylenes (BTEX) and determined the method detection limits (MDLs) (0.02–0.04 µg m–3), recovery values (95.3 ± 9.8–99.8 ± 7.5%), repeatability (3.2 ± 2.2–4.6 ± 2.9%), and uncertainties (10.1 ± 3.8–12.9 ± 4.5%), which are comparable to those of previously reported samplers and meet the requirements of European Standards (EN) 13528. The deployment times for obtaining reliable time-weighted average (TWA) atmospheric concentrations of BTEX ranged from 2 days to a minimum of 3 months according to corresponding background concentrations in the ambient air. Moreover, the atmospheric concentrations of BTEX measured by the sampler in this study compared favorably with values from both active and passive sampling methods, with R2 ≥ 0.97 (p < 0.0001). Finally, a 12-month field test was performed after evaluating the sampler, and the results showed apparent seasonal variations of atmospheric VOC concentrations, which were dominated by the sampling location and wind direction.

Polypectomy devices

Polypectomy devices

ASGE Technology Status Evaluation Report: disposable endoscopic accessories

ASGE Technology Status Evaluation Report: disposable endoscopic accessories

Transmission of infection by gastrointestional endoscopy: May 2001

Transmission of infection by gastrointestional endoscopy: May 2001

Reprocessing of gastrointestinal endoscopic accessories.

In this paper, the minimal standards for the disinfection of endoscopes and endoscopic accessories, as defined by the OMED's Minimal Standards for Disinfection, are described. Given the difficulties of disinfecting reusable accessories, disposable accessories are desirable and marketed by many companies. However, they are less economical than the reusable accessories available. Presently, both disposable and reusable forceps are marketed and those that are to be reused must be disinfected according to the Minimal Standards for Disinfection. This paper will discuss the factors to consider in choosing single-use or reusable accessories, such as economy, reliability of disinfection and durability of function. The one-time biopsy cost of reusable and disposable accessories that can be satisfactorily disinfected will also be compared. This paper concludes that the accessories used for endoscopic retrograde cholangiopancreatography are less reliably disinfected, less expensive and less durable compared with biopsy forceps.

Advantages of Reusable Accessories

Despite scant evidence supporting the use of disposable accessories, these devices have been widely disseminated. Manufacturers and governmental regulators, the most devout proponents of one-time use accessories, have framed the issue in economic terms-parsimonious practitioners reusing disposable accessories at the risk of cross-contamination, mechanical failure and product liability. This simplistic view represents revisionist history and ignores the long tradition of reusing these devices. This article reviews the numerous studies that support the safe and cost effective reuse of disposable and reusable accessories.

Overview of the Problem: Reprocessing Versus Disposal of Endoscopic Accessories

The decision to reuse or not reuse endoscopic accessories appears simple on the surface. Further reflection, however, reveals that the decision to purchase reusable accessories or reuse disposable accessories is complex and controversial. This article clarifies key issues surrounding the use of disposable and reusable endoscopic accessories. Discussion includes the advantages and disadvantages of disposable and reusable accessories, the issues surrounding reprocessing of reusable equipment, and the issues surrounding the reuse of disposable accessories.

Methodology of Reprocessing Reusable Accessories

Accessory devices used for gastrointestinal endoscopy are often complex and because they enter sterile body cavities, or contact blood because of invasive procedures, they should be sterile before being used for a patient procedure. The complexity of such reusable accessory devices is reviewed, and the critical aspects of cleaning, sterilization, and quality assurance are discussed. The effectiveness of adequate reprocessing between patient use is critical to prevent transmission of infectious diseases from one patient to another.

7037 Quality control on biopsy forceps reprocessing.

Questions and fears have been raised concerning the efficacy of endoscopic accessories reprocessing: Just how clean are cleaned instrument really ?''. The aim of this study was to confirm the sterility of reusable colonoscopic biopsy forceps after cleaning and sterilization. Material: 75 biopsy forceps (FB 24U-1 Olympus) were cleaned and sterilized according to ESGE (autoclaving 134°C for 18 min) or Japanese (autoclaving 134°C for 5 min) protocols. 15 new biopsy forceps were used as controls. Method: sterility studies were divided in 5 different evaluations: 15 reprocessed forceps and 3 controls for each campaign of sterility test. Tests were performed in a clean room in sterile conditions by an independent evaluation center, governmentally registered for quality control of sterility of medical devices. Biopsy forceps were introduced in a glass container filled with sterile Tryptone Soy Broth. Closed containers were submitted to an ultrasonic treatment during 10 min outside of a clean room, then incubated for 14 days at 37°C. Environmental controls and quality control of culture medium were carried on before, during and after the culture. Results: 73 of 75 biopsy forceps used in clinical investigation were sterile after cleaning and steam sterilization. Two samples of the first sterility test were contaminated by Aspergillus flavus, an environmental mold. At the same time, one other mold (Alternaria sp.) was isolated from an airborn control of the incubator. One control forceps of the fifth sterility test was contaminated by Staphylococcus epidermidis, bacterial strain of the environment. The efficacy of European and Japanese protocols was similar. Comments: this study underlines the technical difficulty of sterility test carried on endoscopic accessories as the handling of long and flexible forceps is very difficult, even in well-trained hands. As strains were found in few samples both from clinically used and controlled forceps, these two contaminants were most probably due to a culture operative failure. Conclusions: 1/ evaluation of quality control should be performed in a registered laboratory for evaluation of medical devices – 2/ even in these conditions, cross contamination, during evaluation procedure, could occur – 3/ whatever are the debris'' found in forceps, they are microbiologically harmless for our patients – 4/ all single-use or reusable accessories carried on the same level of safety.

Reusable Biopsy Forceps

Some healthcare practitioners have recommended the use of disposable medical accessories as standard practice. Advantages of using disposable medical equipment include the potential for infection prevention, convenience, and decreased reprocessing and storage costs. Disadvantages of reusable accessories include the initial cost, "down time" required for repair and, most importantly, the potential for spreading infection. In this study, the investigators provide a cost analysis of reusable biopsy forceps for a 12-month period from April 1993 through March 1994. This prospective, descriptive study evaluated purchase price, number of uses, repair history, and cleaning costs for reusable biopsy forceps used in the endoscopy unit of a large multi-specialty clinic. Results of the study revealed that the reusable biopsy forceps became cost-effective after seven uses.