Every Step Matters!

Endocscopes must be cleaned and disinfected correctly to ensure patient and healthcare worker safety. Pre-cleaning, manual washing, disinfection, rinsing, visual inspection, and storage are all basic steps recommended by multi-scoiety standards.  Olive Endoscopy provides personalised solutions that will assist you at every step of the process as- EVERY STEP COUNTS!
Listed down are the steps for reprocessing flexible GI endoscopes. Please note that these steps are common practices that are required to be followed as per standard guidelines; for details specific to your device model, refer the manufacturer's IFU (Instructions for use)

1. Precleaning the endoscope and accessories

Precleaning is the first step of reprocessing, and should be conducted at the bedside immediately after completing the endoscopic procedure. 

• Wipe the insertion tube with a moist towel or sponge soaked in the freshly made detergent solution immediately after removing the endoscope from the patient.

• Dip the endoscope's distal end into the suitable detergent solution and suction a significant volume of detergent solution through it.

• Follow the endoscope manufacturer's recommendations for flushing the air and water channels.

• Follow the manufacturer's recommendations for flushing the auxiliary water channel.

• Attach the water-resistant cap.

• Transport the soiled endoscope to the reprocessing area in a closed container to avoid potentially infectious organisms being exposed to workers, patients, or the environment.

2. Leak testing the endoscope

Leak testing detects damage to the interior or exterior of the endoscope. The leak test is done before immersion of the endoscope in reprocessing solutions to minimize damage to parts of the endoscope not designed for fluid exposure.

• Suction valves, air water valves, and biopsy valves should all be removed. It should be noted that the endoscope must be entirely dismantled in order to reach all surfaces for thorough cleaning.

• Before immersing the scope in clear water, attach the leak tester and pressurise the scope.

• Fully submerge the pressurised endoscope and bend the distal portion of the scope in all directions, looking for bubbles. Look for bubbles emanating from the scope's interior in the insertion tube and distal bending portion, as well as the universal cord.

• Take the endoscope out of the sink or basin. Turn the leak detector off. 

•Remove the leak tester from the video cap. Allow for depressurization of the endoscope.

3.  Manual Cleaning

Manual cleaning of endoscopes is necessary prior to automated or manual disinfection. This is the most important step in removing the microbial burden from an endoscope.

• Fill a sink with water and submerge the endoscope. Before immersing the endoscope, make sure the water-resistant cap is secure.

• Remove all debris from the endoscope's exterior by brushing and wiping it while submerged in water.

• Clean all removable parts, including inside and under the suction valve, air/water valve, and biopsy port cover and openings, with a small, soft brush.

• Brush all endoscope channels that are accessible, including the body, insertion tube, and endoscope umbilicus.

• After each passage, rinse the brush in the detergent solution to remove any visible debris before retracting and reinserting it.

• Connect the suction, biopsy, air, and water cleaning adapters to the endoscope and flush water through the channels.

• Drain the water. In a second sink, fill water and pour detergent solution to the water (10 ml to 1 litre of water)

• Repeat wiping down the exterior and brushing of all accessible parts of the endoscope in the detergent solution 

• Flush water through the internal channels and drain the solution

4.  Manual High-Level Disinfection 

       Note: For Automated High-level disinfection, refer guide for your automated reprocessor)

      •Completely immerse the endoscope and all removable parts in a sink of high-level disinfectant/sterilant such as glutaraldehyde, orthophthalaldehyde, peracetic acid, etc. to avoid damage to the endoscope.

      •Completely immerse the endoscope and all removable parts in a sink of high-level disinfectant/sterilant such as glutaraldehyde, orthophthalaldehyde, peracetic acid, etc. to avoid damage to the endoscope.

     •Soak the endoscope for the time/temperature required to produce HLD in the high-level disinfectant/sterilant. To ensure that the soaking time is accurate, set a timer. 

      20 minutes Glutaraldehyde

      5 min OPA (Orthophthalaldehyde)

     •Pour disinfectant into all of the endoscope's channels until it can be seen exiting the opposite end of each one. Make sure the chemical is completely absorbed into all channels and that there are no air pockets

       5. Rinsing with RO water

     •Thoroughly rinse all surfaces and removable parts, and flush all channels of the endoscope and its removable parts with clean water according to disinfectant and endoscope manufacturer’s recommendation

     •Use a lint-free cloth/sponge to pat dry the endoscope

     6. Visual Inspection

 Visually inspection ensures endoscope and its accessories are thoroughly cleaned and free from visible debris

 •Place the endoscope on the inspection table & switch on illumination

 •Visually inspect endoscope for debris with 10x lens

 •Use air gun to dry the external surface and internal channels of the endoscope

 •In the instance that visual inspection detects dirt, the reprocessing procedure needs to repeated once againn

7. Storage

 Correct storage of the GI endoscope will prevent damage to the exterior of the instrument by protecting it from physical impact. Endoscopes should be stored in a manner that will protect it from contamination

 •Hang the endoscope in a vertical position to facilitate drying (with caps, valves, and other detachable components removed per manufacturer’s instructions)

 •Use acrylic support provided to ensure stable storage of endoscope