What are the differences between soft endoscopes and rigid endoscopes?

With the development of science and technology, various advanced technologies have penetrated into the medical field, such as microelectronics, computer technology, ultrasound technology, and automation technology, which have led to unprecedented development in medical endoscopes. Various endoscopes have been developed, and their functions have been continuously expanded, becoming a series of products integrating inspection, diagnosis, treatment, and surgery.

Endoscopic surgery, with its advantages of minimal surgical trauma, less postoperative pain, faster recovery, small incisions, and small scars, has become the future direction of surgical development and is now widely used in clinical practice. At the same time, the cleaning, disinfection, sterilization, and standardized management of endoscopes have become particularly important and have attracted the attention of a large number of medical workers.

One、What is an endoscope?

Flexible endoscope: A type of endoscope with a soft, bendable body.

Rigid endoscope: The main body of the endoscope cannot be bent or twisted. The depth and distance that a rigid endoscope can Enter the body are far less than those of a flexible endoscope.

Flexible endoscope: Generally includes the following basic structures: the front end, the bending section, the insertion tube, the operating section, the eyepiece section, and the imaging interface section. The front end is the hard part, and the end face has multiple channels and windows, which are respectively the water and air outlet holes, the biopsy forceps outlet hole, the objective lens, and the light guide window. The water and air inlets share a common outlet. When inflating, gas Enters the body cavity through this hole to expand the cavity; when injecting water, water comes out of this hole to wash the objective lens and surgical field, keeping the field of vision clear. The negative pressure suction and biopsy forceps outlet holes are the same tube. When there is too much liquid in the cavity that hinders observation, pressing the suction button will allow the liquid to be sucked into the suction bottle through this hole; biopsy forceps and other therapeutic instruments also Enter the body cavity through this hole. The bending section is located between the front end and the insertion tube, and is composed of many annular parts forming a serpentine tube. Each pair of adjacent annular parts can move in various directions. The insertion tube is also called the body or soft tube section, and contains various pipes and wires inside. The operating section includes an angle control knob, a suction valve button, a water and air injection button, and a biopsy tube opening. The operator can operate various buttons here to complete endoscopic examination and treatment.

Rigid endoscope: According to the structural form, it can be divided into four categories: straight rod non-separable rigid endoscopes, straight rod separable rigid endoscopes, curved tube non-separable rigid endoscopes, and curved tube separable rigid endoscopes. The structure of various rigid endoscopes generally includes an outer tube (or sheath), a body, an optical fiber interface, an eyepiece connector, and an imaging interface section. Unlike flexible endoscopes, which have operating channels, some rigid endoscopes have no instrument or water and air channels in the body, such as laparoscopes, thoracoscopes, mediastinoscopes, and arthroscopes, etc.; various operating instruments need to Enter the body cavity through a separate incision, and complete the surgical operation under the monitoring and cooperation of the rigid endoscope.

Flexible endoscope: Mainly throughthe body's natural cavitiesto complete examination, diagnosis, and treatment, such asgastroscopes, colonoscopes, laryngoscopes, and bronchoscopesmainly Enter the body through the digestive tract, respiratory tract, and urinary tract.

Rigid endoscope: Mainly Entersterile tissues and organs of the body, orEnter sterile body cavities throughsurgical incisionssuch aslaparoscopes, thoracoscopes, arthroscopes, intervertebral disc endoscopes, and ventriculoscopes

Hysteroscopes, cystoscope, and colonoscopes are available in both flexible and rigid types.

Flexible endoscope: After each use, it should bethoroughly cleaned and high-level disinfected or sterilizedAfter the flexible endoscope is removed from the patient's body, pre-treatment should be performed. Immediately before disconnecting the light source and video processor, wipe off surface contaminants with cleaning solution-soaked wipes or gauze. Wipes should be used once only; repeatedly flush with water and air for at least 10 seconds. Before cleaning after each use, a leak test should be performed. If there are no conditions, a leak test should be performed at least once a day. The cleaning solution should be changed after each endoscope is cleaned. Esophageal endoscopes, gastroscopes, and colonoscopes, etc., should be thoroughly cleaned and high-level disinfected after each use; flexible endoscopes used in the biliary and urinary systems should be sterilized.

Rigid endoscope: After each use, it should bethoroughly cleaned and sterilizedAfter use, rigid endoscopes should be initially rinsed with running water to remove blood, mucus, and other contaminants. Lumen instruments should be rinsed with a pressure water gun. Detachable parts must be disassembled to the smallest unit and soaked in multi-enzyme cleaning solution. The joint parts, bending parts, and lumens of the instruments should be thoroughly scrubbed with a soft brush. When scrubbing, avoid scratching the surface.

Laryngoscopes, nasopharyngoscopes, and other rigid endoscopes that contact intact mucosa can be high-level disinfectedHowever, it should be noted that high-level disinfection of rigid endoscopes should be recleaned and disinfected before use on the same day.

In the drying process, all parts of the flexible endoscope should be placed on a dedicated drying table covered with sterile towels. Sterile towels should be changed every 4 hours. Use 75%~95% ethanol or isopropyl alcohol to irrigate all pipes, and use a pressure air gun to inflate clean compressed air into all pipes for at least 30 seconds until completely dry.

When drying rigid endoscopes and accessories using a drying cabinet, the suitable temperature for metal endoscopes and accessories is 75℃~95℃, and the suitable temperature for rubber and plastic endoscopes and accessories is 65℃~75℃; lumens should be thoroughly dried using a pressure air gun and a low-temperature vacuum drying box.

After high-level disinfection, flexible endoscopes are stored in a dedicated storage cabinet with the endoscope body suspended and the bending angle fixing button in the free position. The storage cabinet should be cleaned and disinfected once a week, and cleaned and disinfected immediately when contaminated.

High-level disinfected rigid endoscopes and accessories should be stored separately, in fixed positions, with labels, and managed by a designated person. However, sterilized flexible and rigid endoscopes should be stored and managed according to the storage requirements for sterile items.