Methods for preventing endoscope contamination and endoscope storage and transport equipment

Abstract

This disclosure relates to a method for preventing endoscope contamination and an endoscope storage and / or transport device. The method for preventing endoscope contamination involves using blue light to prevent contamination of surfaces in a compartment of an endoscope storage and / or transport device that may or will come into contact with an inserted endoscope, wherein such blue light has, in particular, a wavelength between 400 nm and 470 nm, and especially 405 nm.

Description

[0001] The present disclosure relates to a method for preventing endoscope contamination and an endoscope storage and / or transport device.

[0002] The latest standards and local guidelines emphasize that it is of utmost importance to dry and store flexible endoscopes safely.

[0003] The most common method for reprocessing flexible endoscopes is to subject them to a high-level disinfection (HLD) process. Afterward, the flexible endoscope is either used immediately or must be dried and stored. The endoscopes are dried and stored in special facilities called drying and storage cabinets. The flexible endoscope can remain in the drying and storage cabinet for extended periods, typically ranging from 1 to 4 weeks.

[0004] It is common for different endoscopes to be stored within the same compartment of a drying and storage cabinet, which poses the risk of cross-contamination or recontamination of the endoscopes stored together. The main sources of recontamination are misuse, such as inserting a dirty endoscope into the drying and storage cabinet, technical defects, or bacterial regrowth when endoscopes are reprocessed using HLD methods rather than sterilized, resulting in a certain residual total bacterial count.The risk of recontamination also exists with transport systems used to move the flexible endoscope from a reprocessing area to a drying and storage cabinet or to a patient, such as mobile endoscopy carts with compartments used to transport endoscopes from a drying and storage cabinet to an operating room (OR) and back, or to and from reprocessing or disinfection stations.

[0005] The most important method to prevent endoscope contamination during transportation, drying, and storage is to perform regular manual cleaning and disinfection of the affected products. However, manual cleaning and disinfection of surfaces in contact with the flexible endoscope is a time-consuming process that has at least the following disadvantages. It can incur significant labor costs due to its labor-intensive nature; the use of chemicals poses a health risk to personnel; such chemicals can be aggressive and degrade the material of the affected products; and misuse can occur, leading to inadequate cleaning and disinfection—i.e., chemicals are not used correctly or are not distributed over the entire surface that may come into contact with an endoscope.

[0006] It is a task to provide means to prevent cross-contamination or recontamination of endoscopes after they have been cleaned and disinfected and before they are reused.

[0007] Such a problem can be solved by a method for preventing endoscope contamination, the method comprising inserting at least one endoscope into a compartment of an endoscope storage and / or transport device, the compartment having one or more inner surfaces that can or will come into contact with an inserted endoscope, closing the compartment and / or the endoscope storage and / or transport device for storing and / or transporting the at least one inserted endoscope, starting the application of blue light to the inner surfaces that can or are in contact with the at least one inserted endoscope, opening the compartment and / or the endoscope storage and / or transport device for removing the at least one inserted endoscope,after opening the compartment and / or the endoscope storage and / or transport device to remove the at least one inserted endoscope, stopping the application of blue light to the inner surfaces that may be or are in contact with the at least one inserted endoscope and removing the at least one inserted endoscope from the compartment.

[0008] The method for preventing endoscope contamination is based on the recognition that the surfaces of products that come into contact with clean flexible endoscopes should be exposed to light of a specific wavelength that deactivates and destroys microorganisms, thus eliminating the need for manual disinfection.

[0009] Flexible endoscopes themselves are already disinfected using UV light. However, one disadvantage of UV light, especially UVA or UVB light, is that it causes severe material deterioration over time, particularly due to induced cross-linking of plastics, which leads to embrittlement. Furthermore, UV light is hazardous to the user, meaning special precautions must be taken to prevent the emission of UV radiation.

[0010] In contrast, the present proposal proposes using blue light in the visible spectrum, specifically wavelengths from 400 nm to 470 nm, to disinfect surfaces that may come into contact with endoscopes. This wavelength is much less harmful and can be used continuously within the drying and storage cabinet or the endoscope transport system.

[0011] Blue light is highly effective in destroying germs (bacteria, viruses, fungi, and parasites), biofilm, and even multidrug-resistant organisms, as demonstrated in clinical studies, such as Cabral, J. and Rodrigues AG, "Blue light Disinfection in Hospital Infection Control: Advantages, Drawbacks, and Pitfalls," Antibiotics (2019), 8, 58. This solution does not require an exogenous photosensitizer, as it utilizes endogenous photosensitizers from microorganisms. The effect of blue light can be enhanced by incorporating additional photosensitizers, such as tetrapyrrole derivatives or synthetic analogues, such as meso-tetraarylporphyrins, phthalocyanines, porphycans, texaphyrins, and safirins, into the surface. However, compared to other types of photodynamic disinfection methods, blue light does not require additional photosensitizers to be effective.

[0012] Light sources that emit blue light can be easily integrated into the drying and storage cabinet chamber. This allows all parts of the device to be disinfected. Furthermore, integration into door handles, touchscreens, and other parts of the device that come into contact with the user is possible and inexpensive, as contamination is transferred to and from these surfaces, increasing the risk of contamination to the flexible endoscope. Additionally, blue light prevents recontamination of flexible endoscopes that are being dried, stored, or transported.

[0013] The use of blue light for disinfection according to the method described above entails no additional costs or manufacturing steps for material coating, requires low maintenance, and places low material stress on the user compared to other light disinfection methods. It is harmless to the user, is effective against a wide range of pathogens, and does not induce microorganism resistance. It is useful for the continuous disinfection of air and surfaces. This leads to improved safety against recontamination of reprocessed flexible endoscopes, promotes personnel safety, and reduces overall costs.

[0014] In embodiments, the blue light has a wavelength between 400 nm and 470 nm, in particular 405 nm. Blue light in this wavelength range has been shown to be effective in disinfecting endoscopes without the harmful effects of ultraviolet light on materials and humans.

[0015] In embodiments, the insertion and / or removal of the at least one endoscope into and / or from the compartment is carried out manually or by automated means, wherein the automated means in particular comprise a robot arm and / or an automated carriage.

[0016] In embodiments, starting and stopping the application of blue light can be triggered manually or automatically in response to a sensor signal from one or more mechanical and / or optical sensors detecting the closing and opening of the compartment and / or the endoscope storage and / or transport device and / or the presence of at least one inserted endoscope. Illumination with blue light can also be performed when a compartment is open. However, illuminating the compartment in a closed state will protect users from having to look into bright blue light.

[0017] In embodiments, closing the compartment and / or the endoscope storage and / or transport device comprises closing a door and / or sliding a compartment tray into the endoscope storage and / or transport device.

[0018] Blue light may be used continuously or intermittently; in the case of intermittent use of blue light, the duration of alternating use and non-use of blue light is set to predetermined values ​​that have been shown to provide satisfactory disinfection of the affected surfaces for the purpose of preventing contamination of disinfected and cleaned endoscopes.

[0019] The object is also achieved with a method for preventing endoscope contamination, the method comprising using blue light to prevent contamination of surfaces of a compartment of an endoscope storage and / or transport device that can or will come into contact with an inserted endoscope, wherein such blue light in particular has a wavelength between 400 nm and 470 nm, in particular of 405 nm.

[0020] Furthermore, the object is achieved with an endoscope storage and / or transport device with at least one compartment for at least one endoscope to be inserted, wherein the at least one compartment has one or more inner surfaces that can or will come into contact with an inserted endoscope, characterized in that the endoscope storage and / or transport device has one or more blue light illumination sources, wherein the blue light illumination sources are arranged and aligned to emit blue light onto one or more inner surfaces of the at least one compartment that can or will come into contact with an inserted endoscope.Since the endoscope storage and / or transport device is equipped with blue light illumination sources directed at the internal surfaces to be disinfected or protected from infection, it serves the same purpose and embodies the same features and advantages as the method described above.

[0021] In embodiments, the device may be a drying and storage cabinet and / or a mobile endoscopy cart. Other devices used for storing or transporting endoscopes, or for cleaning and disinfecting endoscopes, may similarly be equipped with blue light illumination sources directed at surfaces that may come into contact with endoscopes.

[0022] The blue light emission sources are configured in embodiments to emit light having a wavelength or wavelengths between 400 nm and 470 nm, in particular 405 nm, thereby providing good disinfection properties while avoiding the disadvantages of UV illumination.

[0023] In embodiments, the endoscope storage and / or transport device may further comprise a door and / or a sliding tray. In this case, the endoscope storage and / or transport device may further comprise a switch connecting a power source to the blue light illumination sources, wherein the switch is switchably connected to the door or the sliding tray in such a way as to turn on the blue light illumination sources when the door is closed or the tray is inserted into the endoscope storage and / or transport device. The benefit of the switch is that blue light is only applied when the device is closed, thus protecting the user's eyes from being irritated by intense blue light.

[0024] In embodiments, the endoscope storage and / or transport device further comprises automated means for inserting and / or removing the at least one endoscope into or from the compartment, in particular a robot arm and / or an automated carriage.

[0025] In embodiments, the endoscope storage and / or transport device may further comprise one or more mechanical and / or optical sensors adapted and configured to detect the closing and opening of the compartment and / or the endoscope storage and / or transport device and / or the presence of at least one inserted endoscope. In this case, the endoscope storage and / or transport device may further comprise a controller adapted and configured to activate and deactivate the blue light illumination of the at least one cabinet in response to sensor signals from the one or more mechanical and / or optical sensors.

[0026] In further embodiments, the endoscope storage and / or transport device further comprises a controller adapted and configured to control the application of blue light to be continuous or intermittent. In the case of intermittent application of blue light, the duration of alternating application and non-application of blue light is set to predetermined values. Intermittent application of light can reduce the power requirement for blue light disinfection. The controller may be the same controller adapted and configured to activate and deactivate the blue light illumination in response to sensor signals in the previously described embodiment, or a separate controller.

[0027] In embodiments, the endoscope storage and / or transport device may further comprise additional photosensitizers embedded in at least one inner surface that can or will come into contact with an inserted endoscope, in particular tetrapyrrole derivatives and / or synthetic analogues, in particular meso-tetraarylporphyrins, phthalocyanines, porphycans, texaphyrins and / or safirins.

[0028] Further features will become apparent from the description of embodiments together with the claims and the accompanying drawings. Embodiments may fulfill individual features or a combination of several features.

[0029] The embodiments are described below without limiting the general inventive concept, whereby express reference is made to the drawings for the disclosure of all details not explained in detail in the text.

[0030] In the drawings: Fig. 1 schematically illustrates a typical endoscope use and maintenance cycle, Fig. Figure 2 schematically illustrates an embodiment of a drying and storage cabinet and Fig. 3 schematically illustrates an embodiment of a method for preventing endoscope contamination.

[0031] In the drawings, identical or similar elements or corresponding parts are provided with the same reference numbers, so that a corresponding repetition is omitted.

[0032] Fig. Figure 1 schematically illustrates a typical endoscope use and care cycle. In the center, an endoscope 2 is positioned in a receptacle 4 commonly used for disinfecting and reprocessing endoscopes. Cables 6 are also depicted at the center of the care cycle. The care cycle itself is a closed cycle, divided by a dashed line into a reprocessing section and an operating room (OR) section. Starting in the operating room section, the endoscope 2 can be transported to the operating room by means of a mobile endoscopy cart 12 with one or more receptacles or compartments for use in an operation (OR), which may be a surgical or diagnostic procedure.

[0033] After completion of the operation (OP), the inserted endoscope is placed back into a compartment of the mobile endoscopy cart 12 to be transported from the operating room (OR) to a first reprocessing station, in this case a pre-cleaning station 14, such as the EPW 100 S system from Steelco, where a semi-automated pre-cleaning of the flexible endoscopes is carried out before automatic reprocessing in a washer-disinfector.

[0034] The inserted endoscope is then transported by the mobile endoscopy cart 12 to the reprocessing unit 16, where it is thoroughly cleaned and disinfected before being transported by the mobile endoscopy cart 12 back to a drying and storage cabinet 10. The endoscope is dried and stored there until it is removed for its next use and transported back to the operating room.

[0035] Fig. 2 schematically illustrates one embodiment of a drying and storage cabinet 10 according to the present disclosure. The drying and storage cabinet 10 includes a compartment 21 for storing reprocessed endoscopes 2. The compartment 21 has interior surfaces 22 with which the endoscopes 2 stored in the compartment 21 can come into contact. To prevent contamination of the endoscope 2, which may be contamination 30 introduced by a user, blue light illumination sources 20 are located within the compartment 21 such that they illuminate the interior surfaces 22 with intense blue light having wavelengths between 400 nm and 470 nm. The wavelength may be a narrower range, for example, centered around or located at 405 nm. Instead of a plurality of blue light illumination sources 20, one or two blue light illumination sources 20 may be used for the most important surfaces 22.

[0036] Blue light illumination sources 20 can be selected from available light sources, such as blue LEDs, laser sources, or incandescent lamps, such as halogen lamps, designed to emit high-intensity blue light with or without blue light filters. Such blue light sources can be supplied, for example, by Heraeus Noblelight from the BlueLight ® product family or other sources.

[0037] A compartment 21 of the drying and storage cabinet 10 can be a housing in which the endoscopes are hung, or a compartment as shown in Fig. 1 or a receptacle of a mobile endoscopy cart 12. The inner surfaces 22 can be the inner surfaces of such receptacles or housings, but also surfaces of hooks within a housing on which an endoscope 2 can be suspended.

[0038] The drying and storage cabinet may have mechanical and optical sensors 24 and / or a switch 28 that can detect the opening and closing of the compartment 21 and thereby control the activation and deactivation of the blue light illumination by the blue light illumination sources 20. The simplest means would be a switch 28 that can open and close the electrical current path for the blue light illumination sources 20. The switch 28 and / or the sensor(s) 24 can also generate electrical signals that are fed to a controller 26, which controls the blue light illumination sources 20 and activates the illumination when the signal from the switch 28 or sensor 24 indicates that the compartment 21 is closed and possibly an endoscope is present within the compartment 21.

[0039] The compartment can be opened and closed by means of a door. Alternatively, with sliding fixtures, opening and closing the compartment may involve sliding a fixture into an open or closed position, for example, within the mobile endoscopy cart 12, which may be equipped with its own blue light illumination sources 20 and its own power supply and switches or controls.

[0040] The controller 26 may also be designed to activate the blue light illumination intermittently to save power, which may be particularly advantageous when mobile endoscopy carts 12 have their own power supply.

[0041] Fig.3 schematically illustrates an embodiment of a method for preventing endoscope contamination, including steps S100 to S105. In step S100, an endoscope 2 is placed in a compartment 21 of a mobile endoscopy cart 12 or a drying and storage cabinet 10. The compartment 21 and / or the mobile endoscopy cart 12 or drying and storage cabinet 10 is closed in step S101. In step S102, the blue light illumination of the inner surfaces 22 of the compartment 21 is activated to eliminate possible contamination on surfaces that may come into contact with an endoscope 2. The blue light illumination can be used continuously or intermittently, depending on the respective requirements, as long as efficient prevention of contamination of the endoscopes 2 in the compartment 21 is ensured.

[0042] Before a diagnostic or surgical procedure, the compartment 21 or the device 10, 12 is opened in step S103, the blue light illumination is stopped (step S104), and the endoscope 2 required for the procedure is removed from the compartment 21 (step S105). The process is repeated after the endoscope 2 has been inserted into the operating room and reprocessed and disinfected after use.

[0043] Additionally, even in the absence of endoscopes 2, blue light illumination can be applied to the inner surfaces 22 of the compartment 21 as a further means of preventing contamination. Furthermore, it is conceivable that the blue light illumination could be active even when the compartment 21 is open. In this case, however, either the intensity of the blue light illumination should be reduced to prevent the user's vision from being impaired by the high-intensity blue light illumination, or physical means should be installed to block the blue light from reaching the user.

[0044] The most common use would be to apply blue light to maintain a disinfected endoscope in this state, i.e., to turn on the blue light when an endoscope is present. The chamber is then typically closed to maintain positive pressure within the chamber.

[0045] While there have been shown and described what are considered embodiments of the invention, it should be understood that various modifications and changes in form or detail may readily be made without departing from the spirit of the invention. It is therefore intended that the invention not be limited to the precise forms described and illustrated, but should be constructed to cover all modifications which may come within the scope of the appended claims. List of reference symbols 2 endoscope 4 Recording 6 cables 10 Drying and storage cabinet 12 mobile endoscopy carts 14 Pre-cleaning station 16 remanufacturers 20 Blue light illumination source 21 compartments 22 inner surface 24 mechanical and optical sensors 26 Control 28 switches 30 Contamination QUOTES CONTAINED IN THE DESCRIPTION

[0000] This list of documents submitted by the applicant was generated automatically and is included solely for the convenience of the reader. This list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions. Cited non-patent literature

[0000] Cabral, J. and Rodrigues AG, “Blue light Disinfection in Hospital Infection Control: Advantages, Drawbacks, and Pitfalls”, Antibiotics (2019), 8, 58

[0011]

Claims

[1] A method for preventing endoscope contamination, the method comprising Inserting at least one endoscope into a compartment of an endoscope storage and / or transport device, wherein the compartment has one or more inner surfaces that can or will come into contact with an inserted endoscope, Closing the compartment and / or the endoscope storage and / or transport device for storing and / or transporting the at least one inserted endoscope, Starting the application of blue light to the internal surfaces that may or are in contact with the at least one inserted endoscope, Opening the compartment and / or the endoscope storage and / or transport device to remove the at least one inserted endoscope, after opening the compartment and / or the endoscope storage and / or transport device to remove the at least one inserted endoscope, stopping the application of blue light to the internal surfaces that may be or are in contact with the at least one inserted endoscope, and Removing at least one inserted endoscope from the compartment. [2] A method for preventing endoscope contamination according to claim 1, wherein the blue light has a wavelength between 400 nm and 470 nm, in particular 405 nm. [3] A method for preventing endoscope contamination according to claim 1, wherein the insertion and / or removal of the at least one endoscope into and / or from the compartment is carried out manually or by automated means, the automated means comprising in particular a robot arm and / or an automated carriage. [4] A method for preventing endoscope contamination according to claim 1, wherein the starting and stopping of the application of blue light is triggered manually or automatically in response to a sensor signal from one or more mechanical and / or optical sensors detecting the closing and opening of the compartment and / or the endoscope storage and / or transport device and / or the presence of at least one inserted endoscope. [5] The method for preventing endoscope contamination according to claim 1, wherein closing the compartment and / or the endoscope storage and / or transport device comprises closing a door and / or inserting a compartment tray into the endoscope storage and / or transport device. [6] A method for preventing endoscope contamination according to claim 1, wherein the application of blue light is either continuous or intermittent, and in the case of intermittent application of blue light, the duration of alternating application and non-application of blue light is set to predetermined values. [7] A method for preventing endoscope contamination, the method comprising using blue light to prevent contamination of surfaces of a compartment of an endoscope storage and / or transport device that may or will come into contact with an inserted endoscope. [8] A method for preventing endoscope contamination according to claim 7, wherein the blue light has a wavelength between 400 nm and 470 nm, in particular 405 nm. [9] Endoscope storage and / or transport device with at least one compartment for at least one endoscope to be inserted, wherein the at least one compartment has one or more inner surfaces which can or will come into contact with an inserted endoscope, characterized by that the endoscope storage and / or transport device has one or more blue light illumination sources, wherein the blue light illumination sources are arranged and aligned to emit blue light onto one or more interior surfaces of the at least one compartment that can or will come into contact with an inserted endoscope. [10] Endoscope storage and / or transport device according to claim 9, wherein the device is a drying and storage cabinet or a mobile endoscopy cart. [11] Endoscope storage and / or transport device according to claim 9, wherein the blue light emission sources are designed to emit light having a wavelength or wavelengths between 400 nm and 470 nm, in particular 405 nm. [12] Endoscope storage and / or transport device according to claim 9, further comprising a door and / or a sliding shelf. [13] The endoscope storage and / or transport device according to claim 12, further comprising a switch connecting a power source to the blue light illumination sources, the switch being switchably connected to the door or the sliding tray so as to turn on the blue light illumination sources when the door is closed or the tray is inserted into the endoscope storage and / or transport device. [14] Endoscope storage and / or transport device according to claim 9, further comprising automated means for inserting and / or removing the at least one endoscope into and / or from the compartment, in particular a robot arm and / or an automated carriage. [15] Endoscope storage and / or transport device according to claim 9, further comprising one or more mechanical and / or optical sensors adapted and arranged to detect the closing and opening of the compartment and / or the endoscope storage and / or transport device and / or the presence of at least one inserted endoscope. [16] The endoscope storage and / or transport device of claim 15, further comprising a controller adapted and configured to activate and deactivate the blue light illumination of the at least one cabinet in response to sensor signals from the one or more mechanical and / or optical sensors. [17] The endoscope storage and / or transport device according to claim 9, further comprising a controller adapted and arranged to control the application of blue light to be either continuous or intermittent, wherein in the case of intermittent application of blue light, the duration of alternating application and non-application of blue light is set to predetermined values. [18] Endoscope storage and / or transport device according to claim 9, further comprising additional photosensitizers incorporated into at least one inner surface which can or will come into contact with an inserted endoscope, in particular tetrapyrrole derivatives and / or synthetic analogues, in particular meso-tetraarylporphyrins, phthalocyanines, porphycans, texaphyrins and / or safirins.

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