Sustainable endoscopy
It is certain that sustainable practices in healthcare significantly contribute to improving public health by promoting the reduction of environmental pollution and more mindful use of available resources. Furthermore, striving for sustainability can also lead to cost savings. More efficient energy use, waste reduction, and the application of eco-friendly technologies not only have a positive impact on the environment but can also reduce the operational costs of healthcare institutions. This allows them to allocate more resources to patient care, thereby enhancing the quality and accessibility of services.
It is essential to understand that the pursuit of sustainability also expresses social responsibility, contributing to increased equity. When large companies, including those in the healthcare sector, adopt sustainable practices, they ensure a clean environment, resources, and natural balance for society. This approach creates opportunities for improved quality of life accessible to all, including future generations. Thus, sustainable development positively impacts not only our present but also our future and is fundamental to preserving social well- being.
Sustainability is vital not only for
environmental protection but also for technological advancement, as the implementation of sustainable practices encourages research, innovation, and development. In the following sections, I will detail how a new technological innovation can contribute to sustainability, with particular attention to the Khamsin machine. The Khamsin machine has transformed
the cleaning process of flexible endoscopes, significantly contributing to the reduction of clinical waste generated during cleaning. This innovative solution not only minimises the amount of waste but also promotes the development of more sustainable healthcare practices.
The structure and function of flexible endoscopes in healthcare To understand the sustainability role of the Khamsin machine, we first need to be aware of how flexible endoscopes operate and their applications in healthcare. Endoscopy is a medical examination technique that has developed over the past 100 years.5
The flexible
endoscope is one of the key tools in this method, allowing doctors to investigate hard-to-reach internal body parts, such as the stomach, intestines, airways, bladder, and urinary tract. A flexible endoscope consists of three main parts: the distal end, the control section, and the connecting section.6
48
www.clinicalservicesjournal.com I February 2025 The distal end is inserted into the human
body. It is a thin, flexible tube with a light source and a mini-camera at its tip. These devices send high-resolution images to a monitor, assisting doctors during the examination. There is also a valve around the light source and camera that enables the introduction and suction of water and air. Additionally, there is a working channel in this section through which doctors can insert instruments for minor interventions or tissue sampling. The distal end can be manoeuvred, allowing doctors to guide the endoscope precisely to the area to be examined, even if the internal structure is curved. The control section is the middle part of the endoscope that is held in hand, responsible for controlling the device and managing the instruments. This section contains components that regulate the bending of the distal end. Here, small medical instruments can be operated, and the flow of air and water can also be controlled. The final part, the connecting section,
provides the connection of the endoscope to the external monitor, light source, and water and air supply systems. It also enables the device’s power supply and connects the controls to the various components of the instrument. Thus, the flexible endoscope is a complex medical device that essentially consists of a flexible tube with numerous thin channels.
The risks of biofilms One of the biggest contributors to clinical waste associated with the use of flexible endoscopes is their disinfection. The challenge lies in the fact that flexible endoscopes cannot be disassembled, making it impossible to verify the success of the cleaning process, as there is no way to visually inspect the internal components. Inadequate disinfection can lead to severe consequences and even the death of the patient. During a procedure, numerous biological
materials – such as bacteria, viruses, proteins, and tissue remnants – can enter the endoscope. If not properly cleaned, these materials can form biofilms on the internal walls of the device. Biofilms are microbial communities made up of viruses, bacteria, algae, and other harmful microorganisms. Together, these microorganisms can create a well-protected, resilient infectious layer. Clinical studies have shown that infections and outbreaks associated with endoscopic procedures are often initiated by these biofilms.7,8 To prevent cross-contamination, we have two
main options. The first option is to use single- use endoscopes, which is not a sustainable or environmentally friendly solution. This approach generates significant waste, which contradicts sustainability principles.
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