Validity of the efficacy of the spray flushing cleaning method in flexible endoscope reprocessing

The advancement in endoscopic technology and techniques has increased its use in the diagnosis and treatment of gastrointestinal diseases. Reprocessing of reusable endoscopes remains a challenge. Inadequate reprocessing leads to bacterial contamination of the endoscope, a significant cause of endoscope-related infections. To thoroughly address the complexities of cleaning a flexible endoscope, various cleaning methods have been devised and tested across different studies. This letter evaluates one such method, spray flushing for flexible gastroscopes, developed and tested in a randomized controlled trial by Du et al. Based on the post-processing test results for this method, Du et al conclude that there is improved cleaning efficacy and reduced damage compared to manual brush cleaning. The validity and reliability of the results could be further enhanced by carefully considering the study design and a few underlying concepts that contribute to the reprocessing quality of different types of endoscopes.