1. Endoscope Reprocessing: Problem and trends

2. Difficulty of cleaning and disinfecting endoscopes
Due to the endoscope material the endoscope is build with :
no heat sterilization
Due to the hospital practice and habits
Due to the endoscope design

5. BIOFILM AND ENDOSCOPES
Internal surface of a brand new endoscope biopsy channel (Teflon )
4µm

6. BIOFILM AND ENDOSCOPES
Internal surface of an endoscope biopsy channel after 300 exams (Teflon)
20µm

7. BIOFILM AND ENDOSCOPES
Internal surface of an endoscope biopsy channel after 300 exams (Teflon)
4µm

8. BIOFILM AND ENDOSCOPES
Internal surface of an endoscope biopsy channel after 600 exams (Teflon)
4µm

9. Where do we come from ? Cleaning only the distal part of the endoscope
because endoscopes were not waterproof
because the contamination risk was ignored
The only thing the doctors cared about was :
the reprocessing time between two patients
not to damage their endoscopes

10. New awareness of the contamination risk
Changes in the types of germs
Changes in the legal responsibility
Changes in the types of patients
Hepatitis, Aids, multi resistant mycobacteria, SARS, Creutzfeld Jacob (mad cow)….
Elderly people, Immunodepressed patients….
The doctor and the hospital can be sued

11. New awareness of the chemical risk
Skin, eyes and respiratory toxicity: allergy, asthma
For the nurse
For the patient
For the environment
Colitis due to improper rinse of the endoscope
Non biodegradable disinfectant kills the bacteria used in sewage plants

12. New risk management for the hospital
Need for :
More endoscopes
Writing and implementation of protocols
Evaluation, improvement of these protocols
Respect of protocols
Traceability
In one word : Quality and safety for the patient

13. New risk management in general
New Chemistry
New Guidelines & Regulatory
New Technologies
Need for :