The Principles of Medical Device Decontamination

Reusable Flexible Endoscopes and Accessories 7

Overview

Whilst acknowledging that there are an increasing number of single use disposable endoscopes on the market, the focus of this section is on reusable flexible endoscopes, with and without lumens.

Flexible endoscopes are complex, heat sensitive medical instruments used for both diagnostic and, increasingly, therapeutic purposes. Their heat sensitivity means that they are unable to withstand normal autoclave temperatures.

Thorough disinfection or sterilisation of flexible endoscopes is essential to reduce the likelihood of transmission of infection, misdiagnosis of pathology or deterioration and malfunction of the instrument.

Those classed as semi critical instruments must be reprocessed by means of immersion in disinfectants if they cannot be sterilised or low temperature gaseous processes such as ethylene oxide. Examples of semi critical instruments include colonoscopes, gastroscopes, duodenoscopes and flexible laryngoscopes. Those classed as critical instruments (entering normally sterile body cavities) must be decontaminated as for semi critical instruments, followed by sterilisation using a process that is compatible with the endoscope. Always consult the endoscope manufacturer’s instructions for compatible processes, particularly sterilisation. Examples of critical instruments which require sterilisation, includes choledochoscopes, those used for NOTES (natural orifice translumenal endoscopic surgery), ureteroscopes and nephroscopes.

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