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Coming clean on reuse of endoscopic equipment
  1. Section Head,
  2. Section of Gastroenterology,
  3. Virginia Mason Medical Center,
  4. 1100 Ninth Avenue, PO Box 900 (C3-GAS),
  5. Seattle, WA 98111, USA

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Over the past decade, endoscopic accessories have evolved from reusable to disposable in many parts of the world. The impetus for this has been multifactorial and includes concerns of cross-contamination between patients because of inability to assure proper cleaning and the inevitable equipment deterioration that occurs with reuse.1 A contrasting and more cynical view has been espoused, however, that marketing items as “one-time-use” precludes the need for manufacturers to undertake microbiological studies after reprocessing. Moreover, its implementation has been associated with a dramatic increase in the purchase of accessories such as needle injectors, sphincterotomes, and even biopsy forceps.2Within the United States, several factors came together to reinforce this “use and dispose” mentality. On the one hand are the known personnel costs needed to store and reprocess an instrument. On the other are medicolegal concerns regarding both cross-contamination between patients and use of an accessory that failed to maintain optimal form and function. Couple the former with an insurance system that routinely reimbursed for the use and disposal of such devices and the fact that many such accessories were only available in a disposable version (for example, …

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