Reprocessing device having variable orifice device

Abstract

A decontamination system suitable for cleaning medical devices having lumens of various diameters that join together can include a variable orifice device (e.g., an air proportional valve). The control system can be configured to adjust the variable orifice device based on a flow characteristic, e.g., flow rate, so that the flow rates in the medical device lumens are similar.

Description

Content of disclosure

[0001] [Field] The subject matter disclosed herein relates to decontaminating instruments having lumens, particularly medical devices such as endoscopes.

[0002] 〔background〕 Endoscopes are reusable medical devices. Endoscopes should be reprocessed, i.e., decontaminated, between medical procedures in which they are used to avoid causing infection or disease in the subject. Endoscopes are difficult to decontaminate, as described in various news articles. See, for example, Chad Terhune, “Superbug outbreak: UCLA will test new scope-cleaning machine,” LA Times, July 22, 2015, http: / / www.latimes.com / business / la-fi-ucla-superbug-scope-testing-20150722-story.html (last visited October 30, 2017). Endoscope reprocessing can be performed by medical personnel or with the aid of machines such as endoscope reprocessing machines, e.g., the EVOTECH® Endoscope Cleaner and Reprocessor by Advanced Sterilization Products, Inc.

[0003] Two endoscope reprocessing methods according to the disclosed subject matter include disinfection or liquid chemical sterilization. Either type of procedure can include the steps of removing foreign matter from the endoscope, cleaning the endoscope, introducing a disinfectant liquid or liquid chemical sterilant into the endoscope, rinsing the endoscope, and drying the endoscope.

[0004] [Disclosure Summary] Disclosed herein is a decontamination system suitable for cleaning medical devices having lumens of various diameters that merge with one another. The disinfection system can include a source of a first decontamination fluid, a gas compressor, a first variable orifice device, and a second variable orifice device. The variable orifice devices can be, for example, air proportional valves, such as closed-loop air proportional valves. The disinfection system can also include a first flush line connected to the gas compressor via the first variable orifice device and further connected to the source of the first decontamination fluid. The disinfection system can also include a second flush line connected to the gas compressor via the second variable orifice device and further connected to the source of the first decontamination fluid. Furthermore, the first flush line can include a first output, and the second flush line can include a second output. The first output and the second output can be connected to the lumens of the endoscope, for example, a suction channel, a biopsy channel, an air channel, and a water channel. In many endoscopes, the suction channel and biopsy channel join to form a joint channel, often referred to as the suction / biopsy channel, and similarly, the air channel and water channel join to form a joint channel, often referred to as the air / water channel.

[0005] The first variable orifice device may include a first orifice having a first size and the second variable orifice device may include a second orifice having a second size different from the first size. A first flow characteristic sensor may be disposed along the first flush line between the first variable orifice device and the first output. A second flow characteristic sensor may be disposed along the second flush line between the first variable orifice device and the second output. These flow characteristic sensors may be, for example, flow sensors.

[0006] The decontamination system may also include a first source for containing the decontamination fluid. The first source may be disposed between the first variable orifice device and the first flush line. The decontamination system may also include a second source for containing the decontamination fluid. The second source may be disposed between the second first variable orifice device and the second flush line.

[0007] The decontamination system may also include a first bypass line connected to the first variable orifice device and the first flush line. The decontamination system may also include a second bypass line connected to the second variable orifice device and the second flush line.

[0008] A first valve may be connected to the first variable orifice device, the first flush line, and the first bypass line. The first valve may direct air from the first variable orifice device to the first source or the bypass line. A second valve may be connected to the second variable orifice device, the second flush line, and the second bypass line. The second valve may direct air from the first variable orifice device to the first source or the bypass line.

[0009] The decontamination system may also include a control system coupled to the first flow characteristic sensor, the first closed-loop air proportional valve, the second flow characteristic sensor, and the second closed-loop air proportional valve. The control system may be configured to adjust a first size of the first orifice or a second size of the second orifice based on a first output from the first flow characteristic sensor, a second output from the second flow characteristic sensor, or both.

[0010] The decontamination system may be operated according to the following steps: A first volume of gas, e.g., air, may flow through a first variable orifice device into a first flush line, containing a decontamination liquid; A second volume of gas may flow through a second variable orifice device into a second flush line, also containing a decontamination liquid; A first channel of the endoscope may be connected to a first output of the first flush line, and a second channel of the endoscope may be connected to a second output of the second flush line. Thus, the first volume of gas may flow through the first channel, the second volume of gas may flow through the second channel, and the first and second volumes of gas may flow through a joining channel. Additionally, flow characteristics (e.g., flow rate) along the first or second flush line may be measured with a flow characteristic sensor. Based on the flow characteristics, a first size of the first orifice, a second size of the second orifice, or both may be altered. Preferably, the first size, the second size, or both are varied to make the first flow rate and the second flow rate approximately equal.

[0011] The first and second sizes can be altered by a controller. Thus, the method may also include receiving the flow characteristic at the controller, determining, by the controller, whether to alter the flow characteristic, sending instructions to the first variable orifice, the second variable orifice device, or both, to alter the size of the first orifice, the second orifice, or both, and altering the size of the first orifice, the second orifice, or both.

[0012] This method may result in purging liquid from the endoscope channels and drying the endoscope channels.

[0013] While the specification concludes with claims particularly pointing out and distinctly claiming the subject matter described herein, it is believed that the subject matter will be better understood from the following description of several embodiments taken in conjunction with the accompanying drawings, in which like reference numerals indicate the same elements and in which: [Brief description of the drawings]

[0014] [Figure 1] FIG. 1 illustrates a front view of an exemplary reprocessing system. [Diagram 2] 2 shows a schematic diagram of a single decontamination tank of the reprocessing system of FIG. 1. [Diagram 3] 2 shows a cross-sectional side view of proximal and distal portions of an endoscope that may be decontaminated using the reprocessing system of FIG. 1. [Figure 4A] 2 shows the top portion of an alternative schematic diagram of a single decontamination tank of the reprocessing system of FIG. 1. [Figure 4B] 1 shows the lower part of an alternative schematic diagram. [Diagram 5] 4B shows a variation of the enlarged portion of FIG. 4A.

[0015] [Mode for carrying out the invention] The following detailed description should be read with reference to the drawings, in which like elements in different drawings are numbered the same. The drawings, which are not necessarily to scale, depict selected embodiments and are not intended to limit the scope of the invention. The detailed description illustrates the principles of the invention by way of example, not by way of limitation. The description describes several embodiments, adaptations, variations, alternatives and uses of the invention, including what is currently believed to be the best mode of carrying out the invention, clearly enabling one skilled in the art to make and use the invention.

[0016] As used herein, the term "about" or "approximately" with respect to any numerical value or range indicates an appropriate dimensional tolerance that allows a portion or collection of components to function for its intended purpose as described herein. More specifically, "about" or "approximately" can refer to a range of values ​​of ±10% of the stated value, e.g., "about 90%" can refer to a range of values ​​of 81% to 99%. Additionally, as used herein, the terms "patient," "host," "user," and "subject" refer to any human or animal subject, and are not intended to limit the system or method to human use, although use of the invention in human patients represents a preferred embodiment.

[0017] 1-2 illustrate an exemplary reprocessing system 2 that may be used to decontaminate endoscopes and other medical devices that include channels or lumens formed therethrough. The system 2 of this example generally includes a first station 10 and a second station 12. The stations 10, 12 are at least substantially similar in all respects for simultaneously or sequentially decontaminating two different medical devices. A first decontamination tank 14a and a second decontamination tank 14b receive the contaminated device. Each tank 14a, 14b is selectively sealed by a respective lid 16a, 16b. In this example, the lids 16a, 16b cooperate with the respective tanks 14a, 14b to provide a microbial blocking relationship to prevent environmental microorganisms from entering the tanks 14a, 14b during the decontamination operation. By way of example only, the lids 16a, 16b may include a microbial removal or HEPA air filter formed therein for ventilation. The lids 16a, 16b may also house reprocessing fluids (eg, cleaning or decontamination fluids) and delivery conduits for these fluids.

[0018] A control system 20 includes one or more microcontrollers, such as a programmable logic controller PLC, for controlling the decontamination and user interface operations. Although one control system 20 is shown herein as controlling both decontamination stations 10, 12, those skilled in the art will recognize that each station 10, 12 may include a dedicated control system. A visual display 22 displays the decontamination parameters and machine status for the operator, and at least one printer 24 prints a hard copy output of the decontamination parameters for records to be filed or attached to the decontaminated equipment or its storage package. It should be understood that the printer 24 is merely optional. In some versions, the visual display 22 is combined with a touch screen input device. Additionally or alternatively, a keypad and / or other user input features are provided for input of decontamination process parameters and machine control. Other visual gauges 26, such as pressure gauges, provide digital or analog output of decontamination or medical device leak test data.

[0019] 2 shows only one decontamination station 10 of the reprocessing system 2 in a schematic manner, those skilled in the art will recognize that the decontamination station 12 may be configured and operable similarly to the decontamination station 10. It should also be understood that the reprocessing system 2 may include only a single decontamination station 10, 12, or three or more decontamination stations 10, 12.

[0020] The decontamination tank 14a receives an instrument having at least one lumen or channel therein for decontamination, such as an endoscope 200 (FIG. 3). Any internal channel of the endoscope 200 is connected with a flush conduit, such as a flush line 30. Each flush line 30 is connected to the outlet of a corresponding pump 32, each of which in this embodiment has a dedicated pump 32. The pump 32 in this embodiment includes a peristaltic pump that pumps fluids, such as liquid and air, through the flush lines 30 and any internal channels of the endoscope 200. Alternatively, any other suitable type of pump may be used. In this embodiment, the pump 32 may draw liquid from the tank 14a through a filtered drain and valve S1; or draw decontaminated air from an air supply system 36 through valve S2. The air supply system 36 in this embodiment includes a pump 38 and a microorganism-removing air filter 40 that filters microorganisms from the incoming air stream. Typically, a single endoscope 200 can be received in the tank 14a, however, in some embodiments, sufficient flush lines 30 are provided in the tank 14a such that two endoscopes 200 can be received therein and connected to the flush lines 30.

[0021] A pressure switch or sensor 42 is in fluid communication with each flush line 30 to sense excessive pressure in the flush line. Any excessive pressure or lack of flow sensed may indicate partial or complete blockage, for example, by body tissue or dried body fluids, in the channel of the endoscope 200 to which the associated flush line 30 is connected. Isolation of each flush line 30 relative to the other flush lines 30 allows for easy identification and isolation of the particular blocked channel depending on which sensor 42 senses the excessive pressure or lack of flow. The pressure sensor 42 may also help protect the endoscope 200 from damage due to excessive fluid pressurization, since the pump 32 may be shut off if excessive pressure is detected.

[0022] The basin 14a is in fluid communication with a water source 50, such as a utility or city water connection including hot and cold water inlets, and a mixing valve 52 which flows into a break tank 56. A microbial removal filter 54, such as a 0.2 μm or less absolute pore size filter, decontaminates the incoming water, which is delivered into the break tank 56 through an air gap to prevent backflow. A sensor 59 monitors the liquid level in the basin 14a. An optional water heater 53 can be provided if a suitable hot water source is not available. The condition of the filter 54 can be monitored directly by monitoring the flow rate of water therethrough, or indirectly by monitoring the basin fill time using a float switch or the like. If the flow rate falls below a selected threshold, this indicates a partially clogged filter element requiring replacement.

[0023] A bath drain 62 drains liquid from the bath 14a through an enlarged helical tube 64 into which an elongated portion of the endoscope 200 can be inserted. The drain 62 is in fluid communication with a recirculation pump 70 and a drain pump 72. The recirculation pump 70 recirculates liquid from the bath drain 62 to the spray nozzle assembly 60, which sprays the liquid into the bath 14a and onto the endoscope 200. A coarse screen 71 and a fine screen 73 filter out particles in the recirculating fluid. The drain pump 72 pumps liquid from the bath drain 62 to a utility drain 74. A level sensor 76 monitors the flow of liquid from the pump 72 to the utility drain 74. The pumps 70, 72 can be operated simultaneously such that liquid is sprayed into the bath 14a while the bath 14a is being drained to encourage a flow of residue out of the bath 14a and away from the endoscope 200. Of course, a single pump and valve assembly could replace the dual pumps 70,72.

[0024] An in-line heater 80 with a temperature sensor 82, upstream of the recirculation pump 70, heats the liquid to an optimal temperature for cleaning and / or disinfection. A pressure switch or sensor 84 measures the pressure downstream of the circulation pump 70. In some variations, a flow sensor is used instead of the pressure sensor 84 to measure the fluid flow downstream of the circulation pump 70. Detergent solution 86 is metered into the flow downstream of the circulation pump 70 via a metering pump 88. A float switch 90 indicates the level of detergent 86 available. Decontaminant solution 92 is metered into the flow upstream of the circulation pump 70 via a metering pump 94. To more accurately meter the decontaminant solution 92, the pump 94 fills a metering reserve chamber 96 under the control of a fluid level switch 98 and the control system 20. By way of example only, the decontaminant solution 92 may include a disinfectant or liquid chemical sterilant. Exemplary disinfectants may include activated glutaraldehyde solution, such as CIDEX® Activated Glutaraldehyde Solution by Advanced Sterilization Products of Irvine, Calif., or ortho-phthalaldehyde OPA, such as CIDEX® Ortho-phthalaldehyde Solution by Advanced Sterilization Products of Irvine, Calif. Exemplary liquid chemical sterilants may include peracetic acid ("PAA") or hydrogen peroxide.

[0025] Some endoscopes 200 include a flexible outer housing or sheath that surrounds the individual tubular members and the like that form the internal channel and other components of the endoscope 200. This housing defines a closed interior space that is isolated from the patient's tissues and fluids during a medical procedure. It can be important that the sheath remains intact, without any nicks or other holes that would allow contamination of the interior space below the sheath. Thus, the reprocessing system 2 of this embodiment includes a means for testing the integrity of such a sheath. In particular, an air pump, such as pump 38 or another pump 110, pressurizes the interior space defined by the sheath of the endoscope 200 through a conduit 112 and a valve S5. In this embodiment, a HEPA or other microorganism removing filter 113 removes microorganisms from the pressurized air. A pressure regulator 114 prevents accidental overpressurization of the sheath. Once fully pressurized, the valve S5 is closed and a pressure sensor 116 looks for a drop in pressure in the conduit 112, indicating the escape of air through the sheath of the endoscope 200. Valve S6 selectively vents conduit 112 and the sheath of endoscope 200 through optional filter 118 once the testing procedure is complete. An air buffer 120 smoothes out pressure pulsations from air pump 110. During reprocessing, endoscope 200 may be maintained under pressure to prevent undesired ingress of reprocessing fluid into the body of the endoscope.

[0026] In this embodiment, each station 10, 12 also houses a drip reservoir 130 and a spill sensor 132 to alert the operator to potential leaks. An alcohol source 134, controlled by valve S3, can supply alcohol to the channel pumps 32 after the rinse step to assist in removing water from the channels 210, 212, 213, 214, 217, 218 of the endoscope 200.

[0027] The flow rates in the lines 30 may be monitored via the channel pumps 32 and pressure sensors 42. If one of the pressure sensors 42 detects too high a pressure, the associated pump 32 is stopped. The flow rates of the pumps 32 and their on duration provide a reasonable indication of the flow rates in the associated lines 30. These flow rates are monitored during the process of checking for occlusions in any of the channels of the endoscope 200. Alternatively, the decay of pressure from the time the pumps 32 cycle off may be used to estimate the flow rate, with a faster decay rate being associated with a higher flow rate.

[0028] More accurate measurement of flow rates in individual channels may be desirable to detect more subtle blockages or failures (e.g., pump failure) to ensure that the correct flow rate through each channel is achieved. To that end, a metering tube 136 having multiple level-indicating sensors 138 is fluidly connected to the input of the channel pump 32. In some versions, a reference connection is provided at a low point of the metering tube 136, and multiple sensors 138 are positioned vertically above the reference connection. By passing a current from the reference point through the fluid to the sensors 138, it can be determined which sensor 138 is immersed, and therefore the level in the metering tube 136. Additionally or alternatively, any other suitable components and techniques can be used to sense the fluid level. By closing valve S1 and opening vent valve S7, the channel pump 32 aspirates only from the metering tube 136. The amount of fluid being drawn can be very accurately determined based on the sensors 138. By operating each channel pump 32 in isolation, the flow through the channel pumps can be accurately determined based on time and the volume of fluid discharged from the metering tube 136 .

[0029] In addition to the input and output devices mentioned above, all of the illustrated electrical and electromechanical devices are operatively connected to and controlled by the control system 20. Specifically, but not by way of limitation, the switches and sensors 42, 59, 76, 84, 90, 98, 114, 116, 132, 136 provide inputs I to the microcontroller 28, which controls cleaning and / or sanitizing cycles and other machine operations accordingly. For example, the microcontroller 28 includes outputs O operatively connected to the pumps 32, 38, 70, 72, 88, 94, 100, 110, valves S1, S2, S3, S5, S6, S7, and heater 80 to control these devices for effective cleaning and / or sanitizing cycles and other operations.

[0030] As shown in FIG. 3, the endoscope 200 has a head portion (control body) 202. The head portion 202 is formed with openings 204, 206. During normal use of the endoscope 200, an air / water valve (not shown) and a suction valve (not shown) are disposed within the openings 204, 206. A flexible shaft (umbilical tube) 208 is attached to the head portion 202. A combined air / water channel 210 and a combined suction / biopsy channel 212 are housed in the shaft 208. Separate air channels 213 and water channels 214 are also disposed in the head portion 202 and merge into the air / water channel 210 at a junction 216. It will be understood that the term "junction" as used herein is not limited to a geometric point, but rather refers to an intersecting junction, and that these terms may be used interchangeably. Additionally, separate suction channel 217 and biopsy channel 218 are housed in head portion 202 and merge into suction / biopsy channel 212 at junction 220. Although endoscope 200 is shown with four separate channels (i.e., air channel 213, water channel 214, suction channel 217, and biopsy channel 218) that overlap into two combined channels (i.e., air / water channel 210 and suction / biopsy channel 212), commercially available endoscopes may have fewer or more channels, e.g., one to eight channels. These channels may be used for different purposes. Typically, in a given endoscope, these channels each have a uniform diameter along its length. The length depends on the overall length of the endoscope and whether the channel exists throughout the entire endoscope so that the length of the channel is equal to or substantially equal to the length of the endoscope, or whether it exists only in a portion of the channel (e.g., between the control body and the distal end of the umbilical tube so that the length of the channel is equal to or substantially equal to the length of the umbilical tube).

[0031] The endoscope may include various channels. The diameters and lengths of these channels are also provided based on an exemplary endoscope having a length of about 3.5 m. However, it should be understood that these dimensions, particularly the length, may vary based on the length of the endoscope. The air channel may be used to deliver air to remove debris from the endoscope, for example, the lens of the endoscope. An exemplary air channel may include a first segment having a diameter of about 1.2 mm and a length of about 1700 mm, and a second segment having a length of about 1400 mm. The suction channel may be used to aspirate fluids and debris directly connected thereto. An exemplary suction channel may include a first segment having a diameter of about 1.2 mm and a length of about 1700 mm, and a second segment having a length of about 1400 mm. The biopsy channel may be used to provide an entry point and passageway to the instrument channel of the endoscope. An exemplary biopsy channel may have a diameter of about 4.2 mm and a length of about 50 mm. The instrument channel may be used to provide a passage from the biopsy channel to the distal end of the endoscope for a forceps or another instrument to collect a biopsy tissue sample. An exemplary instrument channel may have a diameter of about 3.8 mm, and a length of about 1700 mm. In general, the instrument channel and the biopsy channel may be collectively referred to as the biopsy channel, for example, in this application. The water jet channel or auxiliary water channel may be used to deliver a jet stream of sterile fluid to flush away debris on the tissue or blood that may be blocking the view of the treatment site. An exemplary water jet channel may have a diameter of about 1.0 mm and include a length of about 3500 mm. The balloon channel may be used to aspirate air fluid to fill a balloon cover placed over the insertion tube of the endoscope near the distal tip of the endoscope, keeping the view intact within the lumen of the GI tract. An exemplary balloon channel may have a diameter of about 0.8 mm and a length of about 2400 mm, as well as a second segment having a length of about 1400 mm. Finally, the endoscope may also include an elevator channel that houses the wires connected to the elevator mechanism.The wire can be manipulated to redirect the elevator mechanism, which can be used to angle a forceps or other instrument at the distal tip, for example, for purposes of endoscopic retrograde cholangiopancreatography biopsy. An exemplary suction channel can have a diameter of about 0.8 mm and a length of about 1660 mm, as well as a second segment having a length of about 1400 mm. Additionally, as discussed above, some of these channels can be joined with other channels. In general, a water channel can be joined with an air channel, and a biopsy channel can be joined with an suction channel.

[0032] In the head 202, the air channel 213 and the water channel 214 lead to an opening 204 for an air / water valve, not shown. The suction channel 217 leads to an opening 206 for a suction valve, not shown. Furthermore, a flexible supply hose 222 is connected to the head 202 and houses the channels 213', 214', 217' connected to the air channel 213, the water channel 214 and the suction channel 217 via the respective openings 204, 206. In practice, the supply hose 222 is also referred to as a photoconductor casing. The interconnected air channels 213, 213' are hereinafter collectively referred to as the air channel 213. The interconnected water channels 214, 214' are hereinafter collectively referred to as the water channel 214. The interconnected suction channels 217, 217' are hereinafter collectively referred to as the suction channel 217. A connection 226 for the air channel 213, connections 228, 228a for the water channel 214 and a connection 230 for the suction channel 217 are arranged on the end section 224, also called the light conductor connector, of the flexible hose 222. When the connection 226 is in use, the connection 228a is closed. A connection 232 for the biopsy channel 218 is arranged on the head part 202.

[0033] A channel separator 240 is shown inserted into the openings 204, 206. The channel separator 240 includes a body 242 and plug members 244, 246 that plug the respective openings 204, 206. A coaxial insert 248 on the plug member 244 extends inside the opening 204 and terminates in an annular flange 250 that blocks a portion of the opening 204 to separate the channel 213 from the channel 214. By connecting the lines 30 to the openings 226, 228, 228a, 230, 232, liquids for cleaning and disinfecting can flow through the endoscope channels 213, 214, 217, 218 and exit the distal tip 252 of the endoscope 200 via the channels 210, 212. The channel separator 240 ensures that such liquids flow all the way through the endoscope 200 without leaking out of the openings 204, 206; and separates the channels 213, 214 from one another so that each channel 213, 214 has its own independent flow path. Those skilled in the art will appreciate that various endoscopes having different arrangements of channels and openings may require modifications to the channel separator 240 to accommodate such differences while blocking the ports in the head 202 and keeping the channels separated from one another so that each channel may be flushed independently from the other channels. Otherwise, if one channel becomes blocked, flow may simply be redirected to a connected, unblocked channel.

[0034] A leak port 254 on the end section 224 leads to an interior portion 256 of the endoscope 200 and is used to check its physical integrity, i.e., to ensure that no leaks have formed between any of the channels and the interior 256 or from the outside to the interior 256.

[0035] Successful decontamination of an endoscope such as endoscope 200 requires the supply of various decontamination liquids, or decontamination fluids, such as water, detergents, disinfectants, and sterilants (including decontamination liquids, and various gases, e.g., air or nitrogen), in sufficient volumes for sufficient time to all surfaces, including the interior surfaces of all endoscope channels, i.e., air channel 213, water channel 214, suction channel 217, biopsy channel 218, air / water channel 210, and suction / biopsy channel 212. A particular challenge in endoscope reprocessing arises because endoscopes typically contain two to eight channels or lumens having small but different diameters (e.g., about 0.5 mm to about 10 mm), which may be about 3 m to 6 m long, and which may merge with each other (e.g., channels 210 and 212) or separate from each other depending on the direction of flow.

[0036] For a single uniform channel with a thin circular cross section, the laminar fluid flow can be theoretically described according to the Hagen-Poiseuille equation:

[0037]

number

[0038] Due to the difference in diameter and length of each channel, as well as the complexity of their geometry, including certain channels joining or merging with each other to form a combined channel, challenges exist in providing each of the decontamination fluids simultaneously to all of the internal surfaces of the channels in sufficient volume and for sufficient time to achieve the desired decontamination goal, such as cleaning, rinsing, disinfecting, sterilizing or drying. For example, if fluid is provided to one large diameter channel and one small diameter channel, the fluid may not flow easily through the small diameter channel because the resistance to flow is greater in the smaller channel than in the larger channel. Additional challenges arise from certain channels joining each other. For example, consider aspiration channel 217, biopsy channel 218, and combined aspiration / biopsy channel 212. Reliable delivery of fluid to the inner surfaces of these three channels can be aided by simultaneously introducing fluids through connections 230 and 232 under pressure such that all fluids introduced through both connections flow easily toward distal end 252 at the desired volumetric flow rate. Thus, undesirable stagnation or backflow should be avoided. For example, if the inlet pressure at junction 220 is equal to or greater than the pressure anywhere in suction channel 217 between connection 230 and junction 220, stagnation or backflow toward junction 230 may occur.

[0039] Conventional systems typically supply decontamination fluid to each of the channels separately, e.g., one or two channels at a time, from a single source operating at a single pressure, perhaps with the aid of a device such as a channel separator 240. Thus, the overall time required to clean, decontaminate, and dry an endoscope may be reduced by overcoming the above-mentioned challenges in a manner that allows fluid to be delivered simultaneously to a greater number of channels of an endoscope, e.g., three or more, including all of the channels, without compromising the volume of fluid to be delivered to each channel, the volumetric flow rate of each fluid in each channel, and the overall delivery time for delivering fluid to each channel. Thus, for example, in an endoscope that includes eight channels, substantial time savings may be achieved if decontamination fluid could be delivered to all eight channels simultaneously while supplying the decontamination fluid in sufficient volume and at sufficient volumetric flow rate to achieve the cleaning, decontamination, and drying goals of each channel.

[0040] Applicant has determined that each inlet pressure, i.e., the pressure at the location where fluid is introduced or first enters the channels (e.g., connections 226, 228, 230 and 232, and junctions 216 and 220), can be adjusted to allow decontamination fluid to flow simultaneously, within a desired flow rate, through each channel and ultimately toward distal end 252. That is, the pressure at some or all of connections 226, 228, 230 and 232 should be different, taking into account the pressure drop as a function of length and diameter, as well as the pressure at each junction.

[0041] For example, assume that decontamination fluid is simultaneously supplied at equal pressure to aspiration channel 217 via connection 230 and to biopsy channel 218 via connection 232. Since biopsy channel 218 is of a larger diameter and shorter length than aspiration channel 217, the pressure drop between connection 230 and junction 220 should be greater than the pressure drop from connection 232 to junction 220. Thus, the pressure at junction 220 may be greater than the pressure in aspiration channel 217 at a location between connection 230 and junction 220. Such may cause the flow in aspiration channel 217 to stagnate or to shift in aspiration channel 217 toward connection 230. However, these pitfalls may be avoided by supplying fluid at a lower pressure at connection 232 than at connection 230. Preferably, the pressure at connections 232 and 230 is selected so that the pressure in channel 218 just before junction 220 is equal to the pressure in channel 217 just before junction 220, and fluid in both channels can proceed at that pressure past junction 220 into biopsy / aspiration channel 212 without slowing the flow through either of channels 217 and 218. Additionally, the pressure at junction 220 should be sufficient to push fluid through biopsy / aspiration channel 212 and out distal end 252.

[0042] Both Figures 4A and 4B reflect an alternative schematic diagram of the functionality of the reprocessing system 2 for a single decontamination station 10. An important difference between the schematic diagrams of Figures 4A and 4B and that of Figure 2 is that the schematic diagrams of Figures 4A and 4B include at least one variable orifice device, such as variable orifice device 410, which can help regulate the input pressure of the decontamination fluid for reasons discussed above. As shown, the system includes eight variable orifice devices 410, 412, 414, 416, 418, 420, 422, 424, and the system can be used to reprocess endoscopes having up to eight channels. At least one sensor for measuring a flow characteristic, e.g., flow rate, pressure, or shear stress, can be disposed on each flush line. For example, a flow sensor, e.g., flow sensor 426, can be disposed on a flush line, e.g., 458, between one of the variable orifice devices and a corresponding output from the system, e.g., output 442, that connects to a corresponding channel of the endoscope. As shown, eight flush lines are provided, namely, 458, 460, 462, 464, 466, 468, 470, and 472; eight flow sensors are provided, namely, 426, 428, 430, 432, 434, 436, 438, 440; and eight outputs are provided, namely, 442, 444, 446, 448, 450, 452, 454, 456. These outputs may be provided in a wash chamber 492, which may include a nozzle 494 for spraying decontamination fluid into the chamber.

[0043] The system may also include eight reservoirs or sources R1-R8, one upstream of each flush line. These sources may be filled with decontamination fluid, particularly decontamination liquid, and when full, the liquid may be evacuated therefrom via gas provided by compressed gas source 474, which may optionally flow through air filter 475. Thus, each reservoir may include a level sensor, for example a minimum height level sensor and a maximum height level sensor, which may be used to activate and deactivate a corresponding air proportional valve so that the compressed gas may begin to push the liquid out when the reservoir is full, and the compressed gas flow may be stopped when the reservoir is empty. For example, the minimum height and maximum height level sensors of R1 are labeled 502 and 504, respectively. Valves, such as valve 506 immediately downstream of R1, may also be provided to prevent backflow through the reservoirs. An in-line heater 508 may also be provided to heat the liquid entering the reservoir to a desired temperature appropriate for the liquid and the procedure being performed. A manifold 510 may optionally be included to facilitate mounting of various flow characteristic sensors within the system, such as, for example, pressure sensors.

[0044] The system may also include one or more sources 512, 514, and 516 of decontamination fluids, e.g., peracetic acid, detergent, and alcohol, that may be refilled by a user. Pumps 518, 520, and 522 may pump these decontamination fluids through the system, e.g., R1 through R8, when corresponding solenoids 524, 526, and 528 are in an open state. An optional gas purge line 530, with structures such as a pressurized source of gas (e.g., air), a filter, and a solenoid, may also be provided to purge decontamination fluids from at least a portion of the system. Water may be supplied to the system via water source 540 and filtered by filter 542. Other components and features of the system that may be useful in a commercial version of the reprocessing system, but are not the focus of the claimed subject matter, include, e.g., a drain sump 532 and other heaters, pumps, solenoids, flow characteristic sensors, valves, etc., which are reflected in Figures 4A and 4B but are not numbered.

[0045] As described herein, a gas, e.g., air, can be used to introduce, propel, and purge liquid from the flush lines (e.g., 458) and the channels of the endoscope connected to the flush lines. When a gas, e.g., air, is used to purge flushing liquid from the flush lines and endoscope channels, the gas can flow through a source (e.g., R1) that contains little or no flushing liquid, such as a volume having a height lower than a height that would be detected by a minimum height level sensor, such as sensor 504 at R1. Alternatively, as reflected in FIG. 5, the gas may flow through bypass lines, e.g., 480, 482, and 484, so as not to flow through sources, e.g., R1, R2, and R3, which may contain residual liquid. As shown, the bypass lines (e.g., 480), as well as the sources (e.g., R1), can be connected to corresponding variable orifice devices (e.g., 410) and flush lines (e.g., 458) through which a fluid, typically a gas, e.g., air, can flow from the corresponding variable orifice devices to the corresponding flush lines. Thus, valves 486, 488, 490 may be disposed between a corresponding variable orifice device, e.g., 410, 412, 414, on one side, and a source, e.g., R1, R2, R3, and bypass lines 480, 482, 484, on the other side, to direct gas from the variable orifice device toward the source or toward the bypass line to bypass the source before the gas reaches the corresponding flush line. While the example provided in FIG. 5 reflects components corresponding to only flush lines 458, 460, 462, further iterations of the components described in this section may be included on the remaining flush lines 464, 466, 468, 470, 472. Thus, for example, a bypass line may be disposed between each flush line and each corresponding variable orifice device shown in FIGS. 4A and 4B.

[0046] Because gas is compressible and sensitive to pressure differentials across an endoscope, it presents particular challenges in delivering gas at a given flow rate for a sufficient time to purge disinfectant from an endoscope or to dry all of the internal surfaces of each of the endoscope's channels. The system described herein can overcome these challenges as it can be used to simultaneously deliver gas to at least two channels of an endoscope in a manner that facilitates and reduces the time required to purge or dry these channels. Furthermore, because each channel of an endoscope should be dried after introducing one or more liquids and before introducing another liquid, substantial time savings can be achieved by purging or drying these channels simultaneously rather than sequentially. For example, in an exemplary decontamination procedure, an endoscope can be decontaminated by providing decontamination fluid to each channel according to the following order: water to rinse, air to dry, detergent to wash, water to rinse, air to dry, disinfectant to decontaminate, water to rinse, air to dry, alcohol to wash, and air to dry. In an exemplary sterilization procedure, an endoscope may be sterilized by providing a decontamination fluid to each channel following a similar sequence, but instead of providing a disinfectant, a liquid chemical sterilant may be provided followed by a neutralizing agent.

[0047] Thus, the variable orifice devices, such as device 410, may be closed-loop or open-loop air proportional valves. A variety of acceptable air proportional valves are manufactured and sold by companies such as ASCO, a division of Emerson, an SMC corporation. Air may be simultaneously supplied to the endoscope channels from a centralized compressed gas source, such as compressor 474. In this manner, the variable orifice devices can adjust the pressure of gas received at each inlet of each endoscope channel to an inlet pressure that has been previously determined (or predetermined) to correspond to a predetermined flow rate through each channel of the endoscope, and additionally or alternatively corresponds to a shear stress along the interior surfaces of those channels. Alternatively, each of the variable orifice devices may be configured to receive input from a flow sensor connected to the other channel, such that each of the variable orifice devices maintains equal or nearly equal flow rates (e.g., each flow rate is within 10% of the other flow rates) through each of the channels. For example, in an endoscope such as endoscope 200 having converging air and water channels, and converging biopsy and suction channels, supplying air having a temperature near room temperature to each of connections 226, 228, 230, and 232 (FIG. 3) at a pressure of about 10 psi to 30 psi, e.g., 20 psi, for about 10 seconds to 10 minutes, e.g., 30 seconds, 1 minute, 2 minutes, or 5 minutes, should provide a flow rate that should dry the entire interior surface of the channels of the endoscope by the dual mechanism of purging liquid from the distal end of the endoscope while evaporating any droplets remaining in the channels. As used herein, the term dry means that the residual liquid on the surfaces has a thickness of less than about 0.06 mm. Thus, each variable orifice of the variable orifice device can be sized to reduce the pressure from the pressure output by compressor 474 (which may be about 344.74 kPa to 482.63 kPa (about 50 psi to about 70 psi), for example, about 413.69 kPa (about 60 psi)) to the desired input pressure at each of connections 226, 228, 230 and 232.Additionally, a pressure regulator 476 can be included between the compressor 474 and the variable orifice device to regulate the pressure to between about 68.95 kPa and about 241.32 kPa (about 10 psi to about 35 psi), such as between about 96.53 kPa and about 193.05 kPa (about 14 psi to about 28 psi), which can assist the variable orifice device in further regulating the pressure.

[0048] Ideally, the size of each variable orifice can be changed before and during a decontamination procedure. For example, by using a user input device, such as a keyboard or touch screen, connected to the control system 20 (FIG. 2), a user can set a desired orifice size based on a predetermined input pressure for any endoscope to be reprocessed by the system. Furthermore, by comparing the flow rate measured at each of the flow sensors to a predetermined flow rate desired to dry the channel, the pressure at each of the outputs, such as output 442, can be automatically modified by the control system 20 when the flow rate measured by a flow sensor (e.g., 426) differs from the predetermined flow rate of the corresponding endoscope channel. For example, if the flow rate at the flow sensor is less than the predetermined flow rate, the variable orifice of the variable orifice device may be expanded. Conversely, if the flow rate at the flow sensor is greater than the predetermined flow rate, one or more of the variable orifices of the variable orifice device may be contracted. Additionally or alternatively, and as described above, each of the variable orifice devices may be configured to receive input from a flow sensor connected to the other channel, such that each of the variable orifice devices maintains equal or nearly equal flow rates through each of the channels (e.g., the flow rates being within about 10% or about 20% of each of the other flow rates). The flow rates within each of the channels may vary based on the location and size of any droplets within the channel that have not yet dried or been expelled from the distal end of the endoscope.

[0049] A computational fluid dynamics simulation was performed on a gastrointestinal endoscope with an aspiration channel and a biopsy channel that are combined into an aspiration / biopsy channel. In this simulation, the aspiration channel was specified as having a length of 1.7 m and a diameter of 4 mm, the biopsy channel was specified as having a length of 0.022 m and a diameter of 6 mm, and the aspiration / biopsy channel was specified as having a length of 2.178 m and a diameter of 6 mm. Additional inputs of inlet air pressure to the aspiration and biopsy channels, as well as outputs of shear stress, flow rates, and flow regimes are shown in Table 1. The simulation assumed simultaneous and steady-state flow of air through each channel. As reflected in Table 1, when the inlet pressure to the suction channel is 28 psi, the flow rate in the suction channel can be increased by over 300% from 1.21 m / s to 3.83 m / s and the shear stress in the suction channel can be increased by nearly 600% from 9 Pascals to 53 Pascals by decreasing the inlet pressure to the biopsy channel from 28 psi to 14 psi. Furthermore, since the flow rate and shear stress in the channels are functions of the inlet pressure to the channels, the flow rate and shear stress in the channels can be adjusted to approximate each other. For example, in Table 1, when the biopsy channel inlet is 14 psi and the suction channel inlet pressure is 28 psi, the flow rate is 4.4 m / s and 3.83 m / s, respectively, and the shear stress is 59 Pascals and 53 Pascals, respectively. Thus, the inlet pressures to the biopsy and aspiration channels can be selected to optimize treatment time for the flow rates and corresponding shear stresses in each channel.

[0050] [Table 1]

[0051] In accordance with the embodiments shown and described herein, applicant has devised a method and variations thereof for using a decontamination system to drive a gas, e.g., air, to advance liquid through a channel of an endoscope, purge liquid from the channel, and dry the channel. A first volume of gas, e.g., air, can flow through a first variable orifice device (e.g., 410) into a first flush line (e.g., 458) that may contain a decontamination liquid or gas. A second volume of gas can also flow through a second variable orifice device (e.g., 412) into a second flush line (e.g., 460) that may also contain a decontamination liquid or gas. An endoscope can be connected to the flush line. For example, a first channel of the endoscope can be connected to a first output of the first flush line, and a second channel of the endoscope can be connected to a second output of the second flush line. Thus, the method also includes flowing a first volume of air through the first channel and flowing a second volume of air through the second channel. In preferred applications of this method, a first channel of the endoscope and a second channel of the endoscope merge into a first junction channel, and in these applications, both the first volume of gas and the second volume of gas can be flowed through the first junction channel.

[0052] One or more flow characteristic sensors (e.g., flow rate sensors 426, 428) may be positioned along the first flush line, the second flush line, or both. Thus, the method may also include measuring flow characteristics, e.g., flow rates, along the first flush line, the second flush line, or both. Based on this or these measurements, a first size of the first orifice of the first variable orifice device may be altered. Additionally or alternatively, based on this or these measurements, a second size of the second orifice of the second variable orifice device may be altered. The reason for altering the first and second sizes is to make the flow characteristics measured in the first and second flush channels at least approximately equal, e.g., equal. Thus, after the first or second size is altered, the method may include measuring a first subsequent flow characteristic in the first flush line and measuring a second subsequent flow characteristic in the second line and comparing them to each other to determine whether they are at least approximately equal to each other.

[0053] To aid in the implementation of the above, the decontamination system may include a controller configured to receive the flow characteristics from the flow characteristic sensor and send instructions based on the flow characteristics. Thus, further steps of the method may include receiving the flow characteristics at the controller, determining by the controller whether the flow characteristics should be changed, and sending instructions to the first variable orifice, the second variable orifice device, or both, to change the size of the first orifice, the second orifice, or both. Thus, the steps of changing the first size and the second size may occur after the controller sends instructions to change the size of the first orifice, the second orifice, or both.

[0054] Any of the examples or embodiments described herein may include various other features in addition to or in place of those described above. The teachings, representations, embodiments, examples, etc. described herein should not be viewed in isolation from one another. Various suitable ways in which the teachings herein can be combined should be apparent to those of skill in the art in light of the teachings herein.

[0055] Having shown and described exemplary embodiments of the subject matter contained herein, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications without departing from the scope of the claims. Moreover, where the methods and steps described above show certain events occurring in a particular order, it is intended that the specific steps need not be performed in the order described, but may be performed in any order so long as the steps enable the embodiments to function for their intended purpose. Thus, to the extent there are variations of the invention that are within the spirit of the disclosure or equivalent to the invention found in the claims, this patent is intended to cover those variations as well. Some of such variations should be apparent to those skilled in the art. For example, the examples, embodiments, geometries, materials, dimensions, proportions, steps, etc. described above are exemplary. Thus, the claims should not be limited to the specific details of structure and operation set forth in the specification and drawings.

[0056] [Embodiment] (1) A decontamination system comprising: a first source of a first decontamination fluid; A gas compressor; a first variable orifice device; a second variable orifice device; and a first flush line connected to the gas compressor through the first variable orifice device and further connected to the first source of the first decontamination fluid, the first flush line including a first output; a second flush line connected to the gas compressor through the second variable orifice device and further connected to the first source of the first decontamination fluid, the second flush line including a second output; , a decontamination system. (2) A decontamination system as described in embodiment 1, wherein the first variable orifice device includes a first orifice having a first size and the second variable orifice device includes a second orifice having a second size different from the first size. (3) a first flow characteristic sensor disposed along the first flush line between the first variable orifice device and the first output; and a second flow characteristic sensor disposed along the second flush line between the first variable orifice device and the second output; 3. The decontamination system of claim 2, further comprising: (4) A decontamination system as described in embodiment 3, wherein the first flow characteristic sensor includes a first flow sensor. (5) A decontamination system as described in embodiment 3, wherein the first supply source is disposed between the first variable orifice device and the first flush line.

[0057] (6) A decontamination system as described in embodiment 4, further comprising a second supply source for containing a second decontamination fluid, the second supply source being disposed between the second first variable orifice device and the second flush line. (7) A decontamination system as described in embodiment 6, wherein the second decontamination fluid is the same as the first decontamination fluid. (8) A decontamination system as described in embodiment 6, further comprising a first bypass line connected to the first variable orifice device and the first flush line. (9) The decontamination system of embodiment 8, further comprising a second bypass line connected to the second variable orifice device and the second flush line. (10) A decontamination system as described in embodiment 9, further comprising a first valve connected to the first variable orifice device, the first flush line, and the first bypass line, the first valve being configured to direct air from the first variable orifice device to the first source or the bypass line.

[0058] (11) The decontamination system of embodiment 10, further comprising a second valve connected to the second variable orifice device, the second flush line, and the second bypass line, the second valve configured to direct air from the first variable orifice device to the first source or the bypass line. (12) A decontamination system as described in embodiment 11, wherein the first variable orifice device includes a first air proportional valve. (13) A decontamination system as described in embodiment 12, wherein the second variable orifice device includes a second air proportional valve. (14) A decontamination system as described in embodiment 13, wherein the first air proportional valve includes a first closed loop air proportional valve. (15) A decontamination system as described in embodiment 14, wherein the second air proportional valve includes a second closed loop air proportional valve.

[0059] (16) A decontamination system as described in embodiment 15, further comprising a control system, the control system being connected to the first flow characteristic sensor and the first closed loop air proportional valve. (17) A decontamination system as described in embodiment 16, wherein the control system is further connected to the second flow characteristic sensor and the second closed loop air proportional valve. (18) A decontamination system as described in embodiment 17, wherein the control system is configured to adjust the first size or the second size based on a first output from the first flow characteristic sensor. (19) A decontamination system as described in embodiment 18, wherein the control system is configured to adjust the first size or the second size based on a second output from the second flow characteristic sensor. (20) A decontamination system as described in embodiment 3 or 19, further comprising a third flush line connected to the gas compressor via a third variable orifice device and further connected to a third source of a third decontamination fluid, the third flush line including a third output.

[0060] (21) A decontamination system as described in embodiment 20, wherein the third decontamination fluid is the same as the first decontamination fluid. (22) The decontamination system of claim 20, further comprising a fourth flush line connected to the gas compressor via a fourth variable orifice device and further connected to a fourth source of a fourth decontamination fluid, the fourth flush line including a fourth output. (23) A decontamination system as described in embodiment 22, wherein the third decontamination fluid is the same as the first decontamination fluid. (24) A decontamination system as described in embodiment 22, wherein the first output is connected to a first channel of an endoscope. (25) A decontamination system as described in embodiment 24, wherein the second output is connected to a second channel of the endoscope.

[0061] (26) A decontamination system as described in embodiment 25, wherein the third output is connected to a third channel of the endoscope. (27) A decontamination system as described in embodiment 26, wherein the fourth output is connected to a fourth channel of the endoscope. (28) A decontamination system as described in embodiment 27, wherein the first channel includes a biopsy channel. (29) A decontamination system as described in embodiment 28, wherein the second channel includes a suction channel. (30) A decontamination system as described in embodiment 29, wherein the first channel and the second channel merge into a first junction channel at a junction point.

[0062] (31) A decontamination system as described in embodiment 30, wherein the third channel includes an air channel. (32) A decontamination system as described in embodiment 31, wherein the fourth channel includes a water channel. (33) A decontamination system as described in embodiment 32, wherein the third channel and the fourth channel merge into a second junction channel at a second junction point. (34) A method of operating a decontamination system, comprising: flowing a first volume of gas through a first variable orifice device; flowing the first volume of the gas into a first flush line containing a decontamination liquid, the first flush line including a first output; flowing a second volume of the gas through a second variable orifice device; flowing the second volume of the gas into a second flush line containing the decontamination liquid, the second flush line including a second output; A method comprising: 35. The method of claim 34, wherein the gas comprises air.

[0063] (36) connecting a first channel of an endoscope to the first output; connecting a second channel of the endoscope to the second output; flowing the first volume of the gas through the first channel; flowing the second volume of the gas through the second channel; 35. The method of embodiment 34, further comprising: (37) The method of embodiment 36, wherein the first channel and the second channel merge into a first junction channel. (38) flowing the first volume of the gas through the first interface channel; flowing the second volume of the gas through the first interface channel; 38. The method of embodiment 37, further comprising: 39. The method of claim 38, wherein the first variable orifice device includes a first orifice having a first size and the second variable orifice device includes a second orifice having a second size. (40) The method of embodiment 39, further comprising measuring flow characteristics along the first flush line or the second flush line with a flow characteristic sensor.

[0064] 41. The method of claim 40, further comprising varying the first size, the second size, or both the first size and the second size based on the flow characteristics. (42) The method of claim 40, wherein the flow characteristics include a flow rate measured by a flow sensor. (43) The method of embodiment 42, further comprising varying the first size, the second size, or both the first size and the second size based on the flow rates such that a first subsequent flow rate in the first channel and a second subsequent flow rate in the second channel are approximately equal. (44) The method of embodiment 43, wherein the first subsequent flow rate is equal to the second subsequent flow rate. 45. The method of claim 41, wherein the decontamination system further includes a controller configured to receive the flow characteristics from the flow characteristic sensor and to send instructions based on the flow characteristics.

[0065] (46) receiving the flow characteristics at the controller; and determining, with the controller, whether the flow characteristics should be changed; sending instructions to the first variable orifice device, the second variable orifice device, or both, to change a size of the first orifice, the second orifice, or both; Varying the size of the first orifice, the second orifice, or both; 46. ​​The method of embodiment 45, further comprising: 47. The method of claim 46, further comprising measuring the flow characteristics a second time after varying the size of the first orifice, the second orifice, or both. (48) The method of embodiment 47, further comprising determining that a first subsequent flow characteristic in the first channel is at least approximately equal to a second subsequent flow characteristic in the second channel. (49) The method of embodiment 48, further comprising determining that the first subsequent flow characteristic is equal to the second subsequent flow characteristic. (50) The method of embodiment 36 or 49, further comprising purging liquid from the endoscope.

[0066] (51) The method of embodiment 36 or 49, further comprising drying the first channel, the second channel, and the first junction channel of the endoscope.

Claims

1. 1. A decontamination system comprising: a first source of a first decontamination fluid; A gas compressor; a first variable orifice device; a second variable orifice device; and a first flush line connected to the gas compressor through the first variable orifice device and further connected to the first source of the first decontamination fluid, the first flush line including a first output, the first source being disposed between the first variable orifice device and the first flush line; a first bypass line connected to the first variable orifice device and the first flush line, the first bypass line allowing air to flow through the first bypass line from the first variable orifice device, bypassing the first source of the first decontamination fluid, to the first flush line; a first valve connected to the first variable orifice device, the first flush line, and the first bypass line, the first valve configured to direct air from the first variable orifice device to the first source or the first bypass line; a second flush line connected to the gas compressor through the second variable orifice device and further connected to the first source of the first decontamination fluid, the second flush line including a second output; , a decontamination system.

2. 2. The decontamination system of claim 1, wherein the first variable orifice device includes a first orifice having a first size and the second variable orifice device includes a second orifice having a second size different from the first size.

3. a first flow characteristic sensor disposed along the first flush line between the first variable orifice device and the first output; a second flow characteristic sensor disposed along the second flush line between the second variable orifice device and the second output; The decontamination system of claim 2 , further comprising:

4. The decontamination system of claim 3 , wherein the first flow characteristic sensor comprises a first flow sensor.

5. 5. The decontamination system of claim 4, further comprising a second source for containing a second decontamination fluid, said second source being disposed between said second variable orifice device and said second flush line.

6. The decontamination system of claim 5 , wherein the second decontamination fluid is the same as the first decontamination fluid.

7. The decontamination system of claim 5 , further comprising a second bypass line connected to said second variable orifice device and said second flush line.

8. The decontamination system of claim 7 , wherein the first output is connected to a first channel of an endoscope.

9. The decontamination system of claim 8 , wherein the second output is connected to a second channel of the endoscope.

10. The decontamination system of claim 9 , wherein the first channel and the second channel merge into a junction channel at a junction point.

11. 1. A method of operating a decontamination system, comprising: flowing a first volume of gas through a first variable orifice device; flowing the first volume of the gas through a source containing a decontamination liquid and into a first flush line, the first flush line including a first output; flowing a second volume of the gas through a second variable orifice device; flowing the second volume of the gas into a second flush line containing the decontamination liquid, the second flush line including a second output; flowing a third volume of the gas through the first variable orifice device; flowing the third volume of the gas through a bypass line that bypasses the source and into the first flush line containing the decontamination liquid; A method comprising:

12. The method of claim 11 , wherein the gas comprises air.

13. connecting a first channel of an endoscope to the first output; connecting a second channel of the endoscope to the second output; flowing the first volume of the gas through the first channel; flowing the second volume of the gas through the second channel; The method of claim 11 further comprising:

14. The method of claim 13 , wherein the first channel and the second channel merge into a junction channel.

15. 14. The method of claim 13, wherein the first variable orifice device includes a first orifice having a first size and the second variable orifice device includes a second orifice having a second size.

16. The method of claim 15, further comprising measuring a flow rate along the first flush line or the second flush line with a flow sensor.

17. 17. The method of claim 16, further comprising: varying the first size, the second size, or both the first size and the second size based on the flow rates such that a first subsequent flow rate in the first channel and a second subsequent flow rate in the second channel are equal or approximately equal.

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