Brian Newton, president of The Scope Exchange, an endoscopy repair companybased in Greensboro, NC, explains the latest information for keeping delicateequipment functioning effectively.
Q: How often should endoscopes be checked for maintenance? Are thereblatant signs when a scope is not working properly and should be checked?
A: Scopes should be leak tested after every procedure/beforedisinfection. The most effective leak test is to submerse the entire scope andfollow OEM instructions. If a leak is detected, the scope needs to be sent infor repair immediately. Scopes should be checked for maintenance on a weekly,monthly, or quarterly basis depending on the number of scopes used andprocedures performed.
There are blatant signs that a scope should be checked. One of the mostcommon is when a video scope starts taking pictures by itself, or when it willnot take pictures. Usually this is a sign of fluid invasion. The fluid hasentered the video switch block controls, and the scope needs to be sent in forrepair immediately. Another sign is a cloudy picture. If a picture is cloudy ona video scope, users should look for buildup of gluteraldehyde on the distallens. If buildup on the lens is detected, clean the lens with an alcohol wipe.If there is no buildup or debris on the lenses, the video scope probably hasfluid in the distal end. The scope needs to be sent in for repair immediately.
If a fiber optic scope is cloudy, look for a buildup of gluteraldehyde ordebris on the distal lenses. If there is no buildup or debris, look for fluid inthe eyepiece and distal lenses. If there is any sign of fluid, send the scope infor repair immediately.
Other signs are clicking and/or sluggishness in the angulation controls,significant movement of the insertion tube when angulating the distal end, poorlight transmission, color fluctuations in the video image, blockage or frictionwhen passing a brush through the biopsy and/or suction channel, poor waterand/or air flow, poor suction and tears or significant dents in the insertion orlight guide tube. Users should call their repair company and/or salesrepresentative for inspection and/or advice.
Another sign is fluid in the water-resistant cap when it is removed after thedisinfection process. If fluid is present, redo the leak test. If the leak testis negative, more than likely the water-resistant cap is not so water resistant.
Scopes should also be checked for rough edges, sharp nozzles andcracking/deteriorating glue as all of the above can pose a significant risk topatient safety.
Q: What are the most common repairs made to endoscopes?
A:Air/water nozzle unclog and/or replace; bending rubber replacement; angulationadjustment; biopsy channel replacement; suction channel replacement; minor andmajor fluid invasion.
Q: What services should endosuite managers be looking for in a companythat offers scope repair services?
A: Honesty, quality, and customer service! Scope repair companiesshould be able to tell you why a repair is necessary. Test your repair company.Tell them you suspect a scope has major fluid invasion, send it in for repairand see what they quote. If you are going to experience the cost savings ofusing an independent service organization, they must be honest. Quality is equalto honesty. Check out the quality of their replacement parts. Without quality,pricing and turnaround time mean nothing. Last but of equal importance iscustomer service. Everybody makes a mistake once in a while. How do they honor awarranty? Do they continually look for reasons to charge more money for theirmistakes? The following are a couple of good questions to ask:
Q: Are some scopes more fragile than others? Are there any brandsknown within the industry that generally require more repair than others?
A: Small diameter fiber optic scopes are more fragile than otherscopes. Special protection should be used during storage and transport. Eachbrand of scopes has advantages and disadvantages. Unfortunately, I cannotmention a particular OEM, but managers should look into the warranty and whatkind of support they will receive after the purchase. If they are buying usedequipment, make sure the company has their own repair facility capable ofdelivering high quality repair, service, and loaners. Some scopes are made tolast and others are what we call resposable scopes. They are not made to beworked on. Once they break they typically require a major overhaul by the OEM.This defeats the purpose of buying a less expensive scope.
Q: If a scope is treated ideally, how long is the expected lifespan?How long should endonurses and technicians expect to be able to trust a scopethat has been repaired before worrying about sending it in again?
A: Ideally a scope can last quite a long time but the lifespan dependsupon the number of procedures and the number of scopes used to perform thoseprocedures. Obviously an account with a sufficient number of scopes to meet theprocedure volume will experience a greater life span. The lifespan also dependsupon proper handling, use, care, and maintenance.
A scope is typically not sent in for repair until it develops a problem.Obviously a scope repaired with quality parts and workmanship will last muchlonger than a scope repaired with low quality parts and/or poor workmanship.
Q: How should scopes be treated to prevent excessive repair bills?
A: Scopes should be treated according to OEM specifications. Mostnurses and technicians do an excellent job in the handling of endoscopes. Irecommend having dedicated cleaning personnel. This reduces the number of peopleinvolved in the handling process. Fewer people involved can reduce excessiverepair expenses. Dedicated cleaning personnel can reduce repair bills byroutinely performing proper cleaning and disinfection procedures as prescribedby the OEM. Familiarity with the scopes can prevent damage before it occurs. Atechnician familiar with the scopes can usually notice buckles or kinks in thechannels and other signs as listed above that if detected would be a minorrepair charge. Leak testing is by far the most important step in reducing repairexpenses.
Brian Newton is the president of The Scope Exchange, a leader in therefurbishing of endoscopes and support equipment.