Care and Handling of the Flexible Endoscope

The Flexible Endoscope

You may be surprised to learn that the writings of Hippocrates referenced examination of the gastrointestinal tract around 300 BC. He describes examination of the rectum, assisted by candlelight! A thousand years later, Adolph Kussmaul visualized the stomach using a metal tube. Harold Hopkins made the next major leap around the turn of the 20th century, developing the rod lens system still used in rigid endoscopes today. Rudolph Schindler modified the Hopkins laparoscope to make it semi-flexible in the 1930’s and in the late 1950’s, a team led by Basil Hirschowitz added fiber optic technology, allowing the endoscope to become completely flexible. You may still see these fiber optic flexible endoscopes in use today.
Thinking Cap

Flexible endoscopes permit minimally invasive visualization of the interior of many body cavities and lumens of tubular organs and the number of endoscopic procedures increases each year. The basic design and concept has remained the same but technical advancements have brought about improvements in size, imaging, light transmission and the instrument’s ability to be cleaned and reprocessed. Models may differ slightly in their capabilities, as well as in length and diameter.

The cost of new equipment continues to rise as the technology advances and most facilities are examining ways to extend the life spans of their flexible scopes. Fortunately, proper care-and-handling practices within a facility can greatly influence an instrument’s life expectancy. These practices start with understanding the scope’s construction and recognizing the actions that can cause damage. Further, those who reprocess the scopes must understand the reason for each step of reprocessing, not just follow the instructions. Finally, dramatic savings can occur when facility staff are educated to recognize potential problem areas within each stage of scope use: pre- and intra-procedure, transportation, leak testing, cleaning and reprocessing, and storage.

And now for a Pop Quiz to test your knowledge. Try to answer each question before clicking on the bar to reveal the answer:

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It took over 1000 years to advance from using candlelight to today's state-of-the-art fiber optic technology.