Endoscope Reprocessing Purge-Then-Fill Technique
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Solution Overview
Problem
Endoscopes are difficult to decontaminate effectively, leading to potential infections due to their complex channel structures and the challenges in ensuring thorough disinfection, especially with restrictive channels like elevator channels.
Innovation Solution
The implementation of a 'Purge-Then-Fill' technique in reprocessing units that supply various fluids to endoscope channels, including air, disinfectant, and water, with a focus on repetitive filling and purging cycles to ensure thorough disinfection, particularly in restrictive channels, and the use of high-concentration disinfectants to enhance bioburden reduction.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional submersion disinfection method is used, then the endoscope is exposed to disinfectant, but the restrictive channels are not thoroughly disinfected due to poor fluid circulation
Solution Approach 1:
The patent divides the disinfection process into separate stages: initial filling of all channels, purging of restrictive channels, second filling, and final purging. This segmentation allows targeted treatment of different channel types, ensuring thorough disinfection of restrictive channels while maintaining simplicity in the overall method.
Solution Approach 2:
The patent performs preliminary filling of all channels with disinfectant before addressing the restrictive channels. This preliminary action ensures that non-restrictive channels receive adequate disinfection early in the process, allowing subsequent steps to focus specifically on the challenging restrictive channels.
2Reliability
If repetitive fill and purge cycles are performed on all channels, then thorough disinfection is achieved, but the processing time increases significantly
Solution Approach 1:
The patent applies different disinfection strategies to different channel types based on their specific characteristics. Non-restrictive channels receive standard filling, while restrictive channels undergo additional purging and refilling cycles. This localized approach ensures adequate bioburden reduction in all channels without unnecessarily extending the overall processing time.
Solution Approach 2:
The patent implements periodic fill and purge cycles specifically for restrictive channels, alternating between filling with disinfectant and purging with air or water. This periodic action enhances disinfection efficacy in restrictive channels while maintaining a controlled rhythm that prevents excessive time consumption.
3Reliability
If high-concentration disinfectant is used, then bioburden reduction is enhanced, but the risk of channel damage and material degradation increases
Solution Approach 1:
The patent uses high-concentration disinfectant selectively in the initial filling step and subsequent refilling of restrictive channels, where the disinfectant contact time is controlled. This partial application of excessive concentration ensures adequate bioburden reduction in the most critical areas while limiting overall exposure to prevent material damage.
Solution Approach 2:
The patent changes the concentration parameter of the disinfectant solution, using high concentration (e.g., 5.25% sodium hypochlorite) for enhanced bioburden reduction in restrictive channels, while controlling the duration and frequency of exposure to minimize material degradation risks.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This method improves the efficacy and efficiency of endoscope reprocessing by ensuring thorough disinfection of all channels, including restrictive ones, reducing the time required for bioburden reduction and minimizing the risk of infection transmission.
Implementation Method 1
purging the restrictive channel and the less-restrictive channel of the disinfectant
Implementation Method 2
supplying various fluids, including at least air and disinfectant, and optionally also water
Implementation Method 3
disinfecting the endoscope by, among other things, submerging it in a disinfectant capable of substantially killing microorganisms thereon
Data Source
AI summary
Efficacy and efficiency of reprocessing a medical device having a restrictive channel and at least one less-restrictive channel, e.g., an endoscope, via disinfection may be improved by using a so-called “Purge-Then-Fill” technique in which channels are purged of disinfectant before refilling them with the disinfectant. Preferably, a less-restrictive channel is purged before the restrictive channel is purged, and then the less-restrictive channel or another less-restrictive channel is filled before the restrictive channel is filled.