Related Experiment Video
Updated: Sep 7, 2025
Induction of Intestinal Graft-versus-host Disease and Its Mini-endoscopic Assessment in Live Mice
Published on: February 11, 2019
Biopsy channel of the endoscope as a potential source of infectious droplets during GI endoscopy
Mark F Coughlan1, Mandeep S Sawhney2, Douglas K Pleskow2
1Center for Advanced Biomedical Imaging and Photonics, Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Background And Aims:
During endoscopy, droplets with the potential to transmit infectious diseases are known to emanate from a patient's mouth and anus, but they may also be expelled from the biopsy channel of the endoscope. The main goal of our study was to quantify droplets emerging from the biopsy channel during clinical endoscopy.
Methods:
A novel light-scattering device was used to measure droplets emanating from the biopsy channel. An endoscopy model was created, and in vitro measurements were carried out during air insufflation, air and water suctioning, and the performance of biopsy sampling. Similar measurements were then made on patients undergoing endoscopy, with all measurements taking place over 2 days to minimize variation.
Results:
During in vitro testing, no droplets were observed at the biopsy channel during air insufflation or air and water suctioning. In 3 of 5 cases, droplets were observed during biopsy sampling, mostly when the forceps were being removed from the endoscope. In the 22 patients undergoing routine endoscopy, no droplets were observed during air insufflation and water suctioning. Droplets were detected in 1 of 11 patients during air suctioning. In 9 of 18 patients undergoing biopsy sampling and 5 of 6 patients undergoing snare polypectomies, droplets were observed at the biopsy channel, mostly when instruments were being removed from the endoscope.
Conclusions:
We found that the biopsy channel may be a source of infectious droplets, especially during the removal of instruments from the biopsy channel. When compared with droplets reported from the mouth and anus, these droplets were larger in size and therefore potentially more infectious.
Insights
The endoscope biopsy channel can expel infectious droplets, particularly when instruments are removed. These droplets are larger and potentially more infectious than those from the mouth or anus, posing an infection risk during endoscopy.
Area of Science:
- Gastroenterology
- Infectious Disease Transmission
- Medical Device Safety
Background:
- Droplets from patient's mouth and anus during endoscopy can transmit infections.
- The endoscope biopsy channel is a potential, unquantified source of infectious droplet expulsion.
Purpose of the Study:
- To quantify droplets emerging from the endoscope biopsy channel during clinical procedures.
- To assess the infectious potential of droplets from the biopsy channel.
Main Methods:
- Utilized a novel light-scattering device to measure droplet expulsion.
- Conducted in vitro experiments using an endoscopy model with various maneuvers.
- Performed measurements on patients undergoing routine endoscopy and procedures like biopsy sampling and snare polypectomy.
Main Results:
- No droplets were observed from the biopsy channel during in vitro air insufflation or suctioning.
- Droplets were detected in vitro during biopsy sampling, primarily upon instrument removal.
- In patients, droplets were observed during air suctioning in one case, and frequently during biopsy sampling and snare polypectomy, especially when instruments were removed.
Conclusions:
- The endoscope biopsy channel is a significant source of infectious droplets.
- Droplet expulsion is most prominent during the removal of instruments from the biopsy channel.
- These droplets are larger and potentially more infectious than those originating from the mouth or anus.
Related Concept Videos
01:17Transmission-based Precautions I: Contact, Enteric, and Droplets
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:28Endoscopic Procedures III: Video Capsule Endoscopy
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:30Endoscopic Studies I: Bronchoscopy and Thoracoscopy
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
01:25Endoscopic Procedures II: Colonoscopy