The Evolution of ERCP

Tools in the Suite

Highlighting products that increase efficiency, support patient care and safety, and enhance productivity. The presence of these key components of the endoscopy suite may be second nature, but you’d be lost without them.

Scope Cleaning

Endoscopes have changed the way surgery is performed. While the use of endoscopic procedures greatly reduces the amount of trauma to the patients when physicians perform surgery, their complex design and numerous construction materials complicate the cleaning and sterilization process. The endoscope is a potential nightmare for infection control and is much more difficult to reprocess than many smaller, more delicate instruments. Endoscopes have long, dark, narrow channels that can be contaminated with body fluids and can create a perfect breeding place for microorganisms. Serious nosocomial infections can occur, and very expensive equipment can be damaged if diligent and careful reprocessing is not consistently practiced.

Spectrum Flexscope brushes

Spectrum Surgical Instruments offers a variety of reusable and disposable cleaning brushes for flexible endoscopes.

Long-lasting bristles made of antimicrobial nylon resist bacterial growth.

Alex Vrancich, operations manager for Spectrum, cautions against using an improperly sized brush when cleaning the endoscope. “The risk is getting that brush stuck in the channel and not being able to get it out,” he says.

“Then you’re looking at massive repair costs. It’s crucial to use the proper sized brush for the channel.

“Using a brush that’s too small obviously isn’t going to clean,” he continues.

Spectrum Surgical Instruments

“Using a brush that’s too big doesn’t clean as well either. When you’re brushing your teeth, you use the ends of the bristles — that’s how you clean. When you use too big of a brush in an endoscope, you flatten out those bristles. Basically, you’re not brushing those inner walls; you’re just kind of smearing, like you would with the sides of a toothbrush.”

The Caterpillar Brush by Cygnus Medical, designed to be pulled through the endoscope channels, is more than a foot in length and features 80,000 scrubbing bristles — compared to some brushes with a bristle section of one half of an inch and a bristle count of 600 or less. Higher bristle count means more effective cleaning, says Shaun Sweeney, manager of Cygnus.

The Cygnus Endo Pack

The Cygnus Endo Pack — everything needed for scope cleaning in one convenient, cost-effective kit — includes a caterpillar brush, hand pad and enzymatic detergent concentrate. “You fill the sink with water, open the kit, and you have everything you need to brush out the channels and clean the exterior,” says Sweeney.

First Step, a ‘spin-off’ of Endo Pack, was created to be used bedside to clean the insertion tube and channels before sending the scope to processing. Often the ERCP scope cart is traveling to the nursing floors, where detergents by the gallon are not readily available.

“They’re filling up a little basin of water, putting it on top of the cart, and rolling it through the hospital,” says Sweeney. “As you go through elevators and around hallways, it just spills.

Keeping First Step packets inside the cart for use when needed increases efficiency and protects the scopes by getting a head start on bioburden.”

The Double Header by U.S. Endoscopy

The Double Header by U.S. Endoscopy features a channel cleaning brush at one end and a control head cleaning brush at the other. “The nice thing is you only need to use one device,” says Allison Hanson, marketing manager for U.S. Endoscopy. The Double Header also features a fluorescent tip on the channel end, which is clearly visible in water. “A lot of times you want to submerge the endoscope into the cleaning solution, but you can’t see head or tail of the brush because the endoscope is black, the water is dirty and sudsy. This brush has a fluorescent yellow ball at the tip.

It’s very bright, and you can see what you’re doing.”

The Endo Gator is a disposable irrigation system manufactured by Byrne Medical. Endo Gator carries water from the source, through the pump via tubing, to assist with the probe that would go down into a channel or to assist with irrigation flushing. A built-in backflow device prevents the possibility of cross-contamination.

The Endo Gator by Byrne

Encompas Unlimited manufactures products for safe storage of costly endoscopes. Wall-mounted, key-lock, vented cabinets can accommodate 18 scopes. A new wall-mounted rack can hold three scopes in the amount of space normally required for one. Cushioned vinyl padding, sold with wall racks or separately, protects delicate scope heads from damage sustained hitting hard walls.

Medical InterMetro Mobile Workcenter

“We’re always listening to our customers,” says Don Byrne, president of Byrne Medical. “We’ve had several hospitals ask us, can you find this? Can you help us with that? We’re always trying to keep an attentive ear to the customer, which ultimately is the nurse or the technician.

I travel around the country, and my last question is always, What’s a pain for you today? What’s a nuisance? Maybe I’m not the answer guy, but at least we can come back and discuss that and see whether there is an opportunity.”

Ergo Express Drive System

Storage solutions within the suite are as significant as the endoscopy equipment itself. An efficiently run suite is the result of smart planning. Patient prep, procedure rooms, recovery, equipment/supply storage, and linen holding are all areas with storage space needs. While each environment is unique, there are cart, cabinet and shelving solutions available to meet any need.

The Starsys Mobile/Movable WorkCenter is virtually casework on wheels, says Dave Salus, marketing manager for InterMetro. Starsys is a mobile, modular system that offers the convenience and adaptability of being mobile.

“If the customer moves workspace, they wheel the unit down the hall,” says Salus. “If they need to create a temporary suite because they’re doing major renovation, or if new equipment is being installed, they can actually set up temporary suites by moving all of the equipment and supplies on wheels into the temporary rooms while the main room is being renovated or upgraded.” A variety of shelving, carts and workstations are available in wire, solid metal and polymer, and are adaptable to all departments.

PHS West specializes in the production and custom design of motorized carts powered by the Ergo Express™ Drive System, and offer the potential of more than 2,000 different designs. “It’s basically like dropping a box of Legos on the floor and building the cart to the exact needs of the department,” says Dan Cummings, president of PHS West.

“We can start out with a simple platform cart that can be retrofitted onto an existing cart, all the way up to a very elaborate work station.”

Ergo Express carts feature a self-contained battery charger, 24-volt electronics and drive motor, and non-marking tires and casters. Carts can be designed motorized or non-motorized — which can easily be converted with power should the need arise. Motorization enables transport of heavy loads over long distances, up ramps and over uneven thresholds.

InnerSpace/Datel Corporation’s Space 3000 Series maximizes space limitations with either mobile or stationary storage. A variety of upper, lower, and full-size cabinets provide versatility, and interchangeable accessories such as shelves, baskets, and divided trays can be combined as needed.

The Harmony cart, also from InnerSpace, provides customizable designs to meet specific procedural or departmental needs. A variety of accessories — including sidemounting wire baskets, glove box holders wastebasket and cord wrap — can complement standard pull-out writing surface, central locking system with key and 4-inch swivel casters (two with locks).

U.S. Endoscopy

The bite block is another essential element of endoscopy, protecting endoscopes from damage that can occur during upper endoscopic procedures. Aware of the possible complications associated with latex, manufacturers are offering non-latex choices.

The U.S. Endoscopy family of latex-free bite blocks is available in pediatric, intermediate and adult sizes, colorcoded by size, available with no strap, non-latex or Velcro strap. An internal mechanism on the bite block has been removed from the intermediate size to make it easier for small children, elderly patients or anyone who has had a stroke or similar problems opening their mouths.

Encompas Unlimited

Encompas Unlimited offers a variety of bite blocks in adult and pediatric sizes, which accommodate up to a 60 FR dilator. The wider opening enables easy passage of the dilator without having to remove the bite block from the patient’s mouth. Six different color-coded disposable models are available latex-free.

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