Novel single-use duodenoscope compared with 3 models of reusable duodenoscopes for ERCP: a randomized bench-model comparison

Andrew S. Ross, Marco J. Bruno, Richard A. Kozarek, Bret T. Petersen, Douglas K. Pleskow, Divyesh V. Sejpal, Adam Slivka, Dale Moore, Karina Panduro, Joyce A. Peetermans, Jeffrey Insull, Matthew J. Rousseau, Gregory P. Tirrell, V. Raman Muthusamy

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Abstract

Background and Aims: Multidrug-resistant infectious outbreaks associated with duodenoscope reuse have been documented internationally. A single-use endoscope could eliminate exogenous patient-to-patient infection associated with ERCP. Methods: We conducted a comparative bench simulation study of a new single-use and 3 models of reusable duodenoscopes on a synthetic anatomic bench model. Four ERCP tasks were performed: guidewire locking (single-use and 1 reusable duodenoscope only), plastic stent placement and removal, metal stent placement and removal, and basket sweeping. The study schedule included block randomization by 4 duodenoscopes, 4 tasks, and 2 anatomic model ERCP stations. Ability to complete tasks, task completion times, and subjective ratings of overall performance, navigation/pushability, tip control, and image quality on a scale of 1 (worst) to 10 (best) were compared among duodenoscopes. Results: All 4 ERCP tasks (total 14 subtasks) were completed by 6 expert endoscopists using all 4 duodenoscopes, with similar task completion times (median, 1.5-8.0 minutes per task) and overall performance ratings by task (median, 8.0-10.0). Navigation/pushability ratings were lower for the single-use duodenoscope than for the 3 reusable duodenoscopes (median, 8.0, 10.0, 9.0, and 9.0, respectively; P <.01). Tip control ratings were similar among all the duodenoscopes (median, 9.0-10.0; P =.77). Image quality ratings were lower for 1 reusable duodenoscope compared with the single-use and other 2 reusable duodenoscopes (median, 8.0, 9.0, 9.0, and 9.0, respectively; P <.01). Conclusions: A new single-use duodenoscope was used to simulate 4 ERCP tasks in an anatomic model, with performance ratings and completion times comparable with 3 models of reusable duodenoscopes.

Original languageEnglish (US)
JournalGastrointestinal endoscopy
DOIs
StateAccepted/In press - Jan 1 2019

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Ross, A. S., Bruno, M. J., Kozarek, R. A., Petersen, B. T., Pleskow, D. K., Sejpal, D. V., Slivka, A., Moore, D., Panduro, K., Peetermans, J. A., Insull, J., Rousseau, M. J., Tirrell, G. P., & Muthusamy, V. R. (Accepted/In press). Novel single-use duodenoscope compared with 3 models of reusable duodenoscopes for ERCP: a randomized bench-model comparison. Gastrointestinal endoscopy. https://doi.org/10.1016/j.gie.2019.08.032