CS CONNECTION MIS procedure types may experience


a product shift, acknowledges Carolyn Klimas, Executive Director, Specialty Products Marketing, Olympus America Inc. “While fully disposable


scopes will find certain niches where their use is clinically and economi- cally acceptable, fully reus- able scopes – and hybrid designs that retain key characteristics of the fully reusable scopes while add-


Carolyn Klimas


ing disposable components in key locations – will continue to be preferred for many important and high-volume procedures where the best clinical performance and strong economic value are crucial,” Klimas told HPN. “An example is the Olympus TJF-Q190V duodenoscope with a dispos- able distal endcap, which offers improved handling and imaging at a low cost per use, along with greater access and visualization of the distal end around the elevator, thus meeting the FDA’s most recent guidance on duodenoscopes.”


Ron Banach, Director, Clinical Train- ing, Ruhof Corp., points to device quality as the reason that hybrids likely won’t overtake reusables completely.


“Performance of the reusable endoscope will be superior,” he predicted.


Ron Banach


Economics and sustainability remain lit- mus tests for any device migration, accord- ing to Gregg Agoston, Vice President, Business Development, SPD Transforma- tion Services, SpecialtyCare. “Cost [and] environmen- tal waste are significant issues that will limit the conversion to disposable flexible endoscopes,” he said. “I believe that there will be a shift to hybrid endoscope technology. We already have disposable


Gregg Agoston


valves, etc. I do not believe that disposable or semi-reusable eible endoscopes are the answer as these will create significant amounts of waste every year, and most likely will be cost-prohibitive. We have to ask ourselves why we would consider disposable products versus reusable. If the answer is that we are concerned about the ability of our technicians to effectively clean and sterilize [or] HLD the endoscopes, we have uncovered the root cause of the problem.”


Agoston stresses that “flexible endo-


scopes are not the only complex instru- ments that are reprocessed in a hospital. There are robotic instruments and countless other complex instruments with multiple parts lumens and electronics. If we can- not reprocess flexible endoscopes then we should be questioning if we can we reprocess any of these other complex instru- ments. Should we move to disposable for all of these instruments as well?” Agoston refers to history – more than


seven decades ago specifically – as a key discussion point. he current symptoms of eible endo- scopes that are not properly cleaned and prepared for surgery stem from a common root founded in the original SPD organiza- tional model that was created in the 1940s and unfortunately has not changed to meet today’s demanding surgical instru- ment needs,” he indicated. “In the 1940s a movement began led by W.B. Underwood, John J. Perkins and the American College of Surgeons (ref. IAHCSMM Central Service Technical Manual) to remove instrument processing from the perioperative area to a centralized location, ‘Central Sterile Depart- ment.’ This change helped to standardize


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