New single-use duodenoscope well-liked by endoscopists

Expert endoscopists reported good overall performance of a new single-use duodenoscope in an initial case series of patients scheduled for endoscopic retrograde cholangiopancreatography (ERCP).

Dr Andrew Ross (Virginia Mason Medical Center, Washington, USA) presented the study which aimed to assess overall satisfaction of the performance of new EXALT single-use Model D disposable duodenoscope in a series of human cases [1]. Because inadequate reprocessing of reusable duodenoscopes can lead to infection transmission, a new single-use duodenoscope was recently developed (see Figure).

Figure. The new EXALT single-use Model D disposable duodenoscope.



It had comparable performance to reusable duodenoscopes when tested by expert endoscopists in a comparative bench model for ERCP. In total, 60 consecutive adult patients in 6 academic medical centres had an ERCP using the first-generation single-use duodenoscope in April and May 2019. Seven ERCP experts rated the new EXALT single-use Model D duodenoscope in ERCP procedures for overall satisfaction on a scale of 1 (unsatisfied) to 10 (very satisfied); preference (Not preferred/Neutral/Preferred) compared with reusable duodenoscopes on 23 ERCP manoeuvres; and qualitative comparison of 17 performance characteristics on a scale of 1 to 5 (again, compared with reusable duodenoscopes). All 60 ERCP procedures were successfully performed, 58 (96.7%) with the single-use duodenoscope alone and 2 (3.3%) with crossover to a reusable duodenoscope.

Median overall satisfaction with the single-use duodenoscope was rated 9.0 (range 1-10). The overall satisfaction rating was ≥7 in 56 (93.3%) ERCPs. All three ratings were at or above midpoint (overall satisfaction ≥5, comparative ERCP manoeuvre “Neutral/Preferred”, and qualitative comparative rating of performance characteristic ≥3 in 47 (78.3%) cases. Low (≤4) overall satisfaction ratings in 4 ERCPs were attributed to suboptimal positioning of the duodenoscope in front of the papilla; these ERCPs were a subset in which biliary or pancreatic duct strictures were dilated and/or stented.

The investigators concluded that the 7 endoscopists in this study were highly satisfied with the single-use duodenoscope in ERCP procedures.

1. Ross A et al. UEG Week 2019, Abstract LB12.

Posted on 23 October 201918 March 2021