Endoscopes and Other Special Equipment

Endoscopic procedures are increasingly used in medicine both diagnostic and therapeutic. Complications and infections are rare, 1 per 1.8 million procedures, but there are no other instruments that are associated with as many infections as endoscopes. This is due to lack of routines, not following routines or lack of competence. An analysis of published exogenous endoscopy-related infections, pseudo-infections and toxic reactions between 1974 and 2004 showed 140 outbreaks where more than 94% of the cases could be prevented by improved decontamination of instruments. Endoscopes are often very complex composed equipment that is difficult to sterilize. They may have combined parts that can be sterilized (high hygienic level) and parts that may only be disinfected (lower hygienic level). In addition, scopes may often have long, narrow lumens, are flexible and may be difficult to clean for organic materials. Still there may be great problems concerning certain endoscopes and other equipment that are difficult to decontaminate. The following chapter is focused on practical measures to disinfect, sterilize and control endoscopes and other special equipment in healthcare institutions.