Most Flexible Endoscope Repairs Can Be Prevented.

Flexible endoscopes are a significant investment for veterinary practices, and they can become even more so if they require regular repairs due to damage.

At STERIS, we have extensive experience in flexible endoscope repairs, giving us a good overview of the most common damages to this type of device.

Did you know that a large majority of the most common damages can be prevented? We work in partnership with healthcare providers to improve the care and handling of flexible endoscopes which reduces the occurrence of common damages.

Being aware of the most common damages to these devices and training your team to apply proper care and handling techniques can save your practice the cost of sending endoscopes out for repair. It also reduces the risk of your practice being left without an endoscope while it’s out for maintenance.

Let’s look at some of the most common damages & how we can improve our everyday care and handling to prevent these.

Fluid Invasion

Example of common damages:

• Holes or cuts in the bending rubber or tubing – commonly caused when the endoscope comes in contact with sharp objects at any time during its cycle of use (i.e. forceps, metal drain covers, lidocaine sprayer, cleaning brushes)
• Leaks at control knobs – commonly caused by placing the control body with the knobs facing down – this can bend the angulation shaft and damage the knobs – cracks on control knobs from impact are commonly observed
• Biopsy channel leaks – commonly caused by punctures or cuts of the channel from the use of damaged instruments – severe kinks in channels can turn into leaks if not repaired Light Guide Tube

These types of damages can be costly to repair, and most importantly- if not detected immediately they can cause even further damage resulting in lengthy and expensive repairs.

Preventative actions are key when it comes to this type of damage. There are several easy to implement preventative methods to ensure that these types of damages can be prevented at the point of use and cleaning:

1. Do not over- angulate the insertion tube both when in use or while the scope is being cleaned and disinfected
2. Always inspect the scope prior to and after use – check for cracks or damages in the bending rubber. If you notice any damage- send for repair immediately. This will prevent more serious damage to the device
3. Always leak test the device prior to use. Both a dry and wet leak test is required to confirm that there are no internal leaks or damages present, if a leak is present the scope must not be submerged in water
4. Always clean and disinfect the scope in accordance with the manufacturers instructions and use the recommended solutions and cleaning brushes
5. Inspect all flexible endoscopic forceps prior to use – damaged instruments can cause kinks in the channels which can result in leaks. Also, make sure you always use instruments which are compatible with the biopsy channel diameter of the scope. Never force instruments down the biopsy channel
6. Ensure all staff performing all parts of the Decontamination process are trained in accordance with the correct procedure

Damage to the distal Tip

Example of common damages:

• Cracked C-cover – caused by impact
• Chipped lenses – caused by impact
• Bent or sharp air/water nozzle – commonly caused by impact or cleaning with a sharp object
• Damaged lens glue – commonly caused by abrasive cleaning or chemical breakdown

Applying preventive care and handling:

1. When handling the scope during procedure – especially with larger scopes such as equine gastroscopes, always take care when retracting the scope from the animal, ensure that you always place your hand close to the distal tip to prevent the end falling to the floor as part of the extraction process. If you are handling a larger scope (over 1.5m) communicate with the person handling the scope to confirm that one of you will catch the distal end once it has been withdrawn from the patient
2. When cleaning or transporting the scope -use a distal tip protector which is a small tip protector used to protect the end of the scope
3. During the cleaning process – only use brushes specifically developed for flexible endoscopes. Using sharp objects or unsuitable cleaning accessories can damage the air/water nozzle and working channel
4. Use the right cleaning products – Unsuitable chemicals can breakdown the glue keeping the lenses in place. Always use the cleaning products recommended by the manufacturer, and contact the manufacturer if you are unsure about what cleaning solutions to use
5. Ensure all staff that are handling the scope are trained in ‘Care and Handling’ and have been trained in accordance with the correct procedures

Want to know more about how you can prevent damages to your flexible endoscopes? We are always happy to provide support and guidance, contact us today to find out more!