Care of Endoscopic Instrumentation
By Eileen Young,
Endoscopic devices evolve constantly. Physicians, nurses, and reprocessing personnel should be familiar with the use of and recommendations for the care and maintenance of all endoscopes and accessories. Many costly repairs can be reduced significantly or eliminated by mandating attendance at comprehensive in-service programs for all personnel involved in handling and reprocessing endoscopes.
Figure 1: A Rigid Scope
Care and Handling of Telescopes
- Examine tips of reusable sheaths and cannulae prior to insertion to avoid inadvertent patient injury.
- Ensure the channel is free of blood and debris before insertion of the endoscope.
- Be aware of possible electrosurgical hazards that may result from radio-frequency current seeking alternative paths to ground through structures outside the viewing area of the endoscope.
- Disassemble stopcocks and valves on reusable sheaths for cleaning, disinfecting, and sterilizing.
Bridges and Adapters
Cleaning, Disinfecting, and Sterilizing of Endoscopic Instruments
- Do not allow instruments to dry prior to cleaning. If it is not possible to clean immediately, immerse instruments in distilled water. An enzymatic detergent should be added in accordance with the manufacturer's written instructions for use.
- Most endoscopic instruments must be manually cleaned. Do not use ultrasonic or other mechanical devices unless this modality is specifically cited as appropriate in the instructions for use or operating and maintenance manual. These processes can damage adhesives, remove lubricants, and scratch or dent surfaces.
- Only informed personnel should handle endoscopic instruments.
- Do not stack instruments during cleaning, disinfection, sterilization, or storage.
- Do not bend or drop instruments.
- Avoid abrasives.
- Loosely coil all cables including those attached to cameras and power sources.
- Reduce intensity of light sources to low and allow them to cool before turning off the power. This will prolong the life of the bulbs.
- Some flexible endoscopes have venting mechanisms for sterilization and/or disinfection purposes. Closely follow the manufacturer's written guidelines to prevent expensive and frequent repairs.
- Do not reuse or reprocess any devices labeled "single-use."
Eileen Young, RN, is a gynecology clinical specialist at Circon Corporation in Stamford, Conn.