How to prevent fluid invasion damage to your flexible endoscope: the importance of leakage testing

One of the most common damages to the flexible endoscope is due to fluid & debris invasion. Usually it is due to a cut or a hole in the insertion tube, mainly on the tip, or due to a crack in the endoscope body( next to the handle and the ocular) . Soon after the endoscope sealing is damaged – an increased abnormal wear& tear of the scope is happening. This may lead to breakage or stiffness of the angulation, lighting loss, foggy view, black dots on field of view and stains inside the lens. These are expensive damages to repair, and usually will end in a total loss of the scope, as you can never be sure that all fluids were removed and that there is no inner corrosion or damage to inner parts.

An endoscope with fluid invasion is dangering the patient health as it may transfer infectious agents during the endoscopy procedure. A Leaking scope can not be highly disinfected, as the liquids and debris inside are interfering with the disinfection process.  Hence Leak testing is a critical element in the prevention of scope damage. The sooner you know about the leakage – the smaller the damage will be. Failure to perform a leakage test, and for an adequate length of time, will increase the chance of a fluid-related major scope damage.

There are some precautions to follow to avoid the leakage of the flexible scope:

• Physically check the scope before every use – to make sure there are no cracks, dents or any physical change of the insertion tube. For example, Thickness of the tip may physically hurt the patient. Also make sure the endoscope body is in order, without cracks and that there is no movement in the ocular. Damage to the ocular may be due to the usage of an endoscopy camera or due to putting irregular pressure on it.
• Avoid putting / using sharp and/or warm tools next to the flexible endoscope.
• Avoid overbending the insertion tube during procedure and during the cleaning & disinfecting of the scope.
• Perform a leakage test before every usage of the scope, prefferd with water.
• Make sure you clean and disinfect your scope regularly, and according to the instructions and regulations of the manufacturer and your local ministry of health.
• In case of disinfecting by soaking- Avoid over soaking of the scope and make sure that the soaking disinfectant is recommended to use by the scope manufacturer.