I recently completed a fascinating one-hour course offered by Ofstead & associates that discussed insoluble substances inside endoscope after use. Infant gas relief drops, Gas-X, Mylanta Gas and other products tha contain simethicone are inserted in the biopsy channel when there is trouble seeing due to bubbles or foam.
The problem for reprocessing endoscopes with simethicone is that it is insoluble in water, detergent and alcohol. Simethicone will actually repel water, making removal from biopsy or water channels very difficult. It is possible to remove the droplets of simethicone by locating the droplets and using swabs. The borescope can then be used to verify the removal of the substance.
The course also discusses how Tissue glue may also be found inside the channels of colonoscopes. If tissue glue is allowed to harden in the working channel it may not able to be removed. The working channel may become blocked and require repair of the instrument. I was also surprised to learn that the use of cooking spray has a lubricant inside working channels is another source of simethicone (silicone) residue. The oils residue can be cleaned using hot water and detergent the simethicone still remains a problem.
This was a very revealing course that exposes many of the issues faced when reprocessing endoscopes. It also reinforces the need to use a borescope to inspect the lumens and channels of endoscopes. I recommend that anyone involved in the reprocessing of endoscopes take the time to learn from this webinar.
