Inspection of endoscope instrument channels after reprocessing using a prototype borescope.

Area of Science:

• Medical device reprocessing
• Endoscopy quality assurance
• Infection control

Background:

• Visual inspection of endoscope channels is a proposed quality assurance step.
• The prevalence of findings in various endoscopes after implementing an inspection protocol is unknown.
• Previous studies noted concerns about simethicone residue after reprocessing.

Purpose of the Study:

• To assess the nature and severity of findings in endoscope instrument channels after reprocessing.
• To evaluate the effectiveness of manual forced-air drying and overnight vertical storage.
• To determine the utility of borescope inspection for auditing reprocessing.

Main Methods:

• A pilot study used a prototype borescope to inspect 59 routinely used endoscopes (gastroscopes, colonoscopes, duodenoscopes, echoendoscopes).
• Inspections were performed after high-level disinfection and drying.
• Video recordings were reviewed for moisture, debris, discoloration, scratches, channel shredding, biofilm, and simethicone residue.

Main Results:

• Scratches were found in 86% of endoscopes, and channel shredding in 59%.
• Intrachannel debris was present in 23% of inspections.
• Manual forced-air drying eliminated moisture, unlike storage alone (0% vs. 28%).
• No biofilm or simethicone residue was visually detected.

Conclusions:

• Internal defects in endoscope channels are common.
• Manual forced-air drying is highly effective for eliminating channel moisture.
• Video borescope inspection can audit reprocessing effectiveness and identify damaged endoscopes.