Single-use flexible bronchoscopy with the Boston Scientific^® EXALT™ Model B-an academic quaternary centre experience

The use of single-use flexible bronchoscopes (SUFBs) has increased tremendously as a consequence of the coronavirus disease 2019 (COVID-19) pandemic and concerns regarding scope contamination, despite a paucity of data relating to user satisfaction and technical reviews. This study aimed to assess the performance of Boston Scientific^® EXALT™ Model B single-use bronchoscopes in a large academic quaternary referral centre.

Following ethical approval, we prospectively collected data on bronchoscopies performed with the Boston Scientific^® EXALT™ Model B bronchoscope. Data included patient and user demographics, procedure details (location, indication, SUFB size, procedure, complications), and user satisfaction.

From 2021 to 2024, 108 procedures were performed with the EXALT^TM scope. There were 51 female patients (47.2%). The 2.8 channel scope was used in 84 (77.8%) cases while the 2.2 was used in 26 (24.1%) (two cases utilized both scope sizes). Malignancy was the most common indication. Locations included endoscopy (92.6%), intensive care unit (ICU) (1.9%), and theatre (5.6%). The most commonly performed procedure was airway inspection (n=108) while bronchoalveolar lavage (n=75), brushings (n=13), endobronchial (n=23) and transbronchial (n=4) biopsies, cryobiopsies (n=2), electrocautery (n=5), and argon plasma coagulation (n=10) were among others. Average user satisfaction (rated 1-5 in ascending order) was 4.7. The most common reason for dissatisfaction was difficulty passing tools through the working channel (n=7). Two cases required replacement with another SUFB due to image failure. No case required conversion to reusable bronchoscope. There were no bronchoscope-related complications.

Our study has shown a wide range of applications, high level of user satisfaction and low rate of technical limitations with the Boston Scientific^® EXALT™ Model B single use bronchoscope.