Single-use duodenoscopes: How concerned should we be about the environment?

Gastrointest Endosc

Dartmouth Geisel School of Medicine, Hanover, New Hampshire; Department of Gastroenterology, Veterans Administration Medical Center, White River Junction, Vermont, USA.

Published: December 2022

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http://dx.doi.org/10.1016/j.gie.2022.08.014DOI Listing

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Article Synopsis
  • A large-scale survey examined the usage and experiences of healthcare providers regarding single-use duodenoscopes and those with single-use endcaps across US and Canadian endoscopy centers.
  • The survey achieved a high response rate of 70.2%, revealing that most institutions primarily utilize standard reprocessable duodenoscopes, with a significant portion adopting duodenoscopes with single-use endcaps.
  • Findings indicate that while there's some interest in transitioning to newer designs, both types of novel duodenoscopes face mechanical challenges that hinder effective endoscopic retrograde cholangiopancreatography (ERCP) procedures.
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Background: Healthcare systems contribute 5%-10% of the global carbon footprint. Given the detrimental impact of climate change on population health, health systems must seek to address this environmental responsibility. This is especially relevant in the modern era of minimally invasive procedures (MIP) where single-use instruments are increasingly popular.

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Background: Infection outbreaks associated with contaminated reusable duodenoscopes (RUDs) have induced the development of novel single-use duodenoscopes (SUDs). This study aimed to analyze the material composition and life cycle assessment (LCA) of RUDs and SUDs to assess the sustainability of global and partial SUD implementation.

Methods: A single-center study evaluated material composition analysis and LCA of one RUD and two SUDs from different manufacturers (A/B).

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Disposable Gastrointestinal Scopes: A Systematic Review.

Surg Laparosc Endosc Percutan Tech

June 2024

Department of Surgery, Division of Bariatric and Metabolic Surgery, University of South Florida, Tampa, FL.

Objective: Endoscopes are an essential tool in the diagnosis, screening, and treatment of gastrointestinal diseases. In 2019, the Food and Drug Administration issued a news release, recommending that duodenoscope manufacturers and health care facilities phase out fully reusable duodenoscopes with fixed endcaps in lieu of duodenoscopes that are either fully disposable or those that contain disposable endcaps. With this study, we systematically reviewed the published literature on single-use disposable gastrointestinal scopes to describe the current state of the literature and provide summary recommendations on the role of disposable gastrointestinal endoscopes.

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Single-use Duodenoscope: The Cleaner Standard.

J Clin Gastroenterol

December 2024

Department of Gastroenterology and Hepatology, Mount Sinai South Nassau, Oceanside, NY.

Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard in the endoscopic management of biliary disease. An average of 700,000 ERCPs are performed every year, and most are performed using a reusable flexible duodenoscope. The innovation of disposable duodenoscopes has changed the dynamic in the advanced endoscopy field of study to primarily reduce or eliminate the risk of cross-contamination between patients.

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