How to avoid endoscope damage

How to Avoid Endoscope Damage

Endoscope damage is more than just equipment malfunction. It can also delay patient treatment, cause employee overtime, increase costs, or Cancel appointments, resulting in reduced revenue. At a recent webinar, two members of the Olympus service and repair team shared advice on how to prevent the most common endoscope damage, minimizing the impact on equipment, staff, and patients.

Distal End Damage

"Approximately 85% of endoscope repairs are preventable," says Luis Mariani, an Olympus endoscope service expert. The distal end is the most vulnerable part of the endoscope, accounting for nearly 45% of all endoscope damage. The distal end houses the protective cap, charge-coupled device, camera, light guide lens, and nozzles for air and water.

Mariani says, "Damage to any of these components can lead to image problems, light problems, or even leave patient residue." "A cracked lens cap or nozzle that enters the patient's body can be a very serious problem, as patient debris can get stuck in the crack of the material." The key to cleaning endoscopes is to use lint-free cloths; gauze should not be used to wipe the distal end, as it may cause fiber debris to Enter the instrument.

The main cause of distal end damage is impact with the floor or peripheral equipment. "Impact can occur during transport, inspection, or maintenance and can have serious consequences," says Eric Smith, an Olympus endoscope support expert. The air/water nozzle has a small opening for irrigation of the objective lens, which can be deformed by impact.

Most endoscope damage occurs during transport and is preventable. Endoscopes should be transported in covered containers, with the distal end isolated from any objects that could damage the endoscope, and protected from impact to the endoscope connector and control section."The distal end is the first and the last,"says Mr. Smith. "It's the first thing I pick up and protect when handling an endoscope, and it's the last part I put down when placing the endoscope in a sink or cabinet."

Transport carts can ensure that the endoscope is always secure and allow for proper coiling. "The minimum diameter of the bend should not be less than 6 inches," says Mr. Smith. "You shouldn't put anything else, especially sharp objects, in the cart with the endoscope." Place the endoscope with the knobs facing up, the control knobs in the free and unlocked position, and the control section and endoscope connector together. The experts say that it is very beneficial to develop the habit of being careful when placing the endoscope in the sink.

Fluid Ingress

Reducing fluid ingress (accounting for nearly 25% of endoscope damage) can save thousands of dollars. To prevent this type of damage, users should submerge the entire endoscope in water for leak testing. "Once the endoscope is submerged, you want to turn both knobs so you can move it up and down and side to side to make sure the bending section doesn't leak," says Mariani. "Most leaks occur in the flexible part of the endoscope's distal end."

Proper leak testing includes ensuring that the leak tester is compatible, the endoscope is correctly positioned, and the sink Size is adequate. The sink should be at least 16 inches by 16 inches. The Size of the sink plays a big role in endoscope positioning," says Mr. Smith.

Leaks can lead to electronic malfunctions or malfunctions, rust and corrosion inside the endoscope connector and control section, affecting the angle system. "Proper leak testing can mean avoiding small problems from escalating into major repairs," says Mr. Smith. Severe fluid ingress usually requires a complete overhaul.

If the user does not find a leak after submerging the endoscope in water, the equipment should be disassembled, the maintenance unit turned off, the plug on the leak attachment unplugged, and listened for air Enter. "If you don't hear that sound, you may need to retest for leaks, as this may be a sign of a leak," says Mr. Smith.

Users should test the air compressor by pressing the pin inside the waterproof cap. "You can feel a little bit of air gushing out. If not, it's likely because the plug isn't properly connected to the maintenance unit," says Mr. Mariani. It is important to ensure that the waterproof cap is dry, as any residual liquid will be pushed into the endoscope by the compressed air. "It may only be a little bit of liquid at a time, but over time, the liquid will accumulate and eventually cause the endoscope to malfunction," says Mr. Smith. Users should observe the expansion of the bending section of the endoscope to ensure that compressed air is entering the endoscope.

Placing a damaged endoscope in a fully automatic endoscope washer can lead to fluid ingress. Users should use brightly colored electrical tape to seal leaks. Repeating the leak test after applying the tape can identify other leaks.

"When you're dealing with a leaky endoscope, the most important step is to keep the leak detector connected throughout the entire cleaning and disinfection process," says Mr. Smith. "Positive air pressure will help prevent liquid from entering the endoscope through the leak point." Users should manually disinfect leaky endoscopes while keeping the leak detector connected and running.

Other Common Damage

Insertion tube damage accounts for 10% of endoscope damage, manifested as bending, dents, and tears. If improperly positioned, it is easy to cause the insertion tube to bend. "We follow the rule of 'see what, say what'," says Mariani. "If you see someone applying unnecessary force to the insertion tube, remind him or her in a friendly way and explain what can happen when the insertion tube is damaged."

Tears on the surface of the insertion tube are mainly caused by sharp objects such as forceps and needles during endoscope delivery. They may not be obvious, but there are scratches on the material, which may contain residue, thus posing an infection risk to the patient. A dented insertion tube will also hinder the ability of cleaning attachments to pass through the biopsy channel and may affect internal components.

Biopsy channel damage accounts for 10% of endoscope damage. This channel is surrounded by other channels, fibers, and cables, so any direct damage or puncture may damage surrounding components. "Imagine if a pair of open forceps were withdrawn through the biopsy channel, you can see how this would cause serious damage," says Mr. Mariani. Tiny bubbles caused by small punctures in the channel are often overlooked during leak testing, and scratches and abrasions in the channel present many challenges for cleaning.

To prevent channel damage, users should ensure that cleaning attachments are in good condition, of the correct type, and functioning properly. Each channel of the endoscope should be thoroughly cleaned, even if not used during the procedure. The device should be switched off during insertion and removal, and inserted and removed with short strokes. Proper cleaning helps maintain the endoscope in good condition, particularly during bedside pre-processing in the operating room after a procedure. A disposable air/water cleaning adapter can be used to flush the air/water channel during bedside pre-processing.

Correct storage is key to maintaining endoscope functionality. Endoscopes should be stored in a closed, well-ventilated cabinet to prevent damage and aid drying. The cabinet should be equipped with a high-efficiency filter.

Approximately 8% of repairs fall into other categories, including chemical damage. Chemical damage can be prevented by removing chemical residues according to the manufacturer's instructions. Excessive pressure or misalignment when connecting the endoscope to the light source can also cause damage.

Taking some extra precautions during endoscope reprocessing, transportation, and storage can help reduce repair costs while maximizing endoscope uptime. "An endoscope is a complex instrument with intricate components," says Mariani. "Regular checks for damage and functionality are very important."

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