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Reducing low risk of transmissible infection in duodenoscopes: at what cost to the planet?
  1. Anjan Dhar1,2,
  2. Bu'Hussain Hayee3,
  3. Emma Wesley4,
  4. William Stableforth5,
  5. Shaji Sebastian6,7
  1. 1Gastroenterology, Darlington Memorial Hospital, Darlington, UK
  2. 2School of Health & Life Sciences, Teesside University, Middlesbrough, UK
  3. 3King's Health Partners Institute for Therapeutic Endoscopy, King's College Hospital NHS Foundation Trust, London, UK
  4. 4Departments of Gastroenterology, Taunton and Somerset NHS Foundation Trust, Taunton, UK
  5. 5Departments of Gastroenterology and Endoscopy, Royal Cornwall Hospitals NHS Trust, Truro, UK
  6. 6Hull and East Yorkshire NHS Trust & Hull and York Medical School, Hull Royal Infirmary, Hull, UK
  7. 7School of Health & Life Sciences, Hull York Medical School, Hull, UK
  1. Correspondence to Professor Anjan Dhar, Gastroenterology, Darlington Memorial Hospital, Darlington DL3 6HX, UK; adhar{at}

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We read with interest the paper by Bang et al on the equivalence of single-use duodenoscopes compared with conventional reusable duodenoscopes to prevent transmissible infections.1 We congratulate the authors for their study demonstrating the economic, technical and safety equivalence of single-use duodenoscopes to conventional reusable duodenoscopes for endoscopic retrograde cholangiopancreatography (ERCP).

The drive toward single-use endoscopes was generated by the incidence of duodenoscope-related infections in the USA, prompting the Food and Drug Administration in 2019 to recommend that healthcare providers and manufacturers transition to disposable components in duodenoscopes to reduce transmissible infections. A systematic review and meta-analysis of the rate and impact of duodenoscope infection involved 15 studies with over 13 000 duodenoscope analysis and found a 15.25% rate of contamination from preprocessed patient-ready duodenoscopes.2

It must be stated that the risk …

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  • Contributors AD conceptualised the idea for this letter. BHH, EW, WS and SS contributed equally to the writing and editing of this letter. Green Endoscopy Network members also approved this letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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