ENDOSHEATH - A DISPOSABLE, SHEATHED, FLEX IBLE GASTROSCOPY - A PROSPECTIVE RANDOMIZED TRIAL

The reprocessing of flexible gastrointestinal endoscopes is time-consu ming and expensive. Endoscopically transmitted infections due to insuf ficient disinfection are already of clinical importance. A new develop ed prototype of a flexible, fiberoptic gastroscope was tested in a pro spective open randomized trial to evaluate the function. reprocessing and hygienical safety of this disposable, sheathed endoscopic system a nd was compared with a standard gastroscope. This new endoscopical sys tem utilizes a disposable sheath to cover and protect all working surf aces of the endoscope from contamination. A prospective, randomized tr ial was performed in our unit to compare the disposable gastroscope (G -F100) with a standard-gastroscope of the newest Generation (GIF-Q 30) . Visual analog rating scales were used to record evaluations of endos cope performance and reprocessing by endoscopists and reprocessing per sonnel. We recorded the time of reprocessing, the time to perform the procedures, depth of insertion, total instrument downtime and any prob lems which occurred during the procedure. Microbiological swabs were t aken from each endoscope. 40 procedures (20 standard, 20 sheathed) wer e performed. The sheathed gastroscope 8,9 min versus 7,1 min. The over all instrument downtime was significantly shortened by the endosheath (9,8 min versus 47,5 min with the standard gastroscope). The disposabl e gastroscope-system permits an increase of procedure-frequency up to a factor of 2,9. The standard gastroscope was preferred by the endosco pists and the reprocessing personnel. No microbiological contamination s of the sheathed or the standard gastroscopes could be demonstrated, and no leak of the sheaths was recorded after gastroscopy. The disposa ble gastroscope has important advantages of decreased instrument turn- around time and potentially increased staff and patient safety.