This article comments on the article by Du et al,who conducted a randomized controlled trial aiming at evaluating the effectiveness of a novel spray flushing system in cleaning flexible endoscopes while minimizing dam...This article comments on the article by Du et al,who conducted a randomized controlled trial aiming at evaluating the effectiveness of a novel spray flushing system in cleaning flexible endoscopes while minimizing damage to the working channels.We share our perspective on the importance of improving endoscope reprocessing methods.The findings highlight the spray flushing system's capacity to improve cleaning efficacy while minimizing damage,suggesting that it might be important in enhancing endoscope reprocessing procedures.展开更多
Digestive endoscopy has been widely used in the diagnosis and treatment of digestive diseases.However,the anatomical complexity of specific lesions increases the difficulty of these operations,resulting in complicatio...Digestive endoscopy has been widely used in the diagnosis and treatment of digestive diseases.However,the anatomical complexity of specific lesions increases the difficulty of these operations,resulting in complications or treatment failure.Although various strategies,such as floss traction and the application of transparent caps,have been explored,their effectiveness remains limited due to individual differences in patients’anatomical characteristics.The multibending(MB)endoscope represents a significant innovation as it is a conventional endoscope with an additional bending section and dual channels.Currently,this technology has been applied in gastroscopy,duodenoscopy and peroral cholangioscopy.The bending part of the endoscope facilitates its passage into difficult-to-reach anatomical regions and improves operating angles,thereby enhancing surgical precision and efficiency while reducing complication rates.Furthermore,the dualchannel design accelerates procedural workflows and increases operational versatility.This innovation is poised to transform endoscopic diagnosis and treatment of digestive system diseases.Since the MB endoscope is relatively new,further research is needed to comprehensively explore its benefits for and potential in endoscopic diagnosis and treatment.The aim of this review is to summarize the current research,indications,and future directions of MB endoscope.展开更多
As the cornerstone of sterile instrument maintenance in endoscopy centers,the quality of endoscope cleaning directly impacts hospital infection control effectiveness.The traceability system for endoscopy centers utili...As the cornerstone of sterile instrument maintenance in endoscopy centers,the quality of endoscope cleaning directly impacts hospital infection control effectiveness.The traceability system for endoscopy centers utilizes digital means to document the entire cleaning process,enabling real-time monitoring and precise quality control.This paper analyzes current quality control practices in endoscope cleaning and addresses existing challenges.It explores how traceability systems standardize procedures,enhance monitoring,and improve management efficiency.The study proposes optimization strategies for traceability system implementation,clarifying its core value in endoscope cleaning quality control.These findings provide theoretical foundations and practical guidance for hospitals to refine management of endoscopy centers,ensure diagnostic safety,and reduce infection risks,ultimately advancing endoscope cleaning quality control toward standardized and informatized development.展开更多
The advancement in endoscopic technology and techniques has increased its use in the diagnosis and treatment of gastrointestinal diseases.Reprocessing of reusable endoscopes remains a challenge.Inadequate reprocessing...The advancement in endoscopic technology and techniques has increased its use in the diagnosis and treatment of gastrointestinal diseases.Reprocessing of reusable endoscopes remains a challenge.Inadequate reprocessing leads to bacterial contamination of the endoscope,a significant cause of endoscope-related infections.To thoroughly address the complexities of cleaning a flexible endo-scope,various cleaning methods have been devised and tested across different studies.This letter evaluates one such method,spray flushing for flexible gastro-scopes,developed and tested in a randomized controlled trial by Du et al.Based on the post-processing test results for this method,Du et al conclude that there is improved cleaning efficacy and reduced damage compared to manual brush cleaning.The validity and reliability of the results could be further enhanced by carefully considering the study design and a few underlying concepts that contribute to the reprocessing quality of different types of endoscopes.展开更多
BACKGROUND Current disinfection methods for gastrointestinal endoscopes consume a significant amount of water resources and produce a large volume of waste.AIM To achieve the objectives of efficiency,speed,and cost-ef...BACKGROUND Current disinfection methods for gastrointestinal endoscopes consume a significant amount of water resources and produce a large volume of waste.AIM To achieve the objectives of efficiency,speed,and cost-effectiveness,this study utilized vaporized hydrogen peroxide(VHP)generated from sodium percarbonate granules to conduct an anhydrous disinfection test on gastrointestinal endoscopes.METHODS The experimental device rapidly converts sodium percarbonate granules into VHP,and performs disinfection experiments on gastrointestinal endoscope models,disposable endoscopes,and various types of reusable gastrointestinal endoscopes.Variables such as the intraluminal flow rate(FR),relative humidity(RH),exposure dosage,and organic burden are used to explore the factors influencing the disinfection of long and narrow lumens with VHP.RESULTS The device generates a certain concentration of VHP that can achieve high-level disinfection of endoscope models within 30 minutes.RH,exposure dosage,and organic burden significantly affect the disinfection efficacy of VHP,whereas the intraluminal FR does not significantly impact disinfection efficacy.All ten artificially contaminated disposable endoscopes achieved satisfactory disinfection results.Furthermore,when this device was used to treat various types of reusable endoscopes,the disinfection and sterilization effects were not significantly different from those of automatic endoscope disinfection machines(using peracetic acid disinfectant solution)(P>0.05),and the economic cost of disinfectant required per endoscope was lower(1.5 China Yuan),with a shorter disinfection time(30 minutes).CONCLUSION The methods and results of this study provide a basis for further research on the use of VHP for the disinfection of gastrointestinal endoscopes,as well as for the development of anhydrous disinfection technology for gastrointestinal endoscopes.展开更多
Objective:To evaluate the application value of lean management in the management of flexible endoscopes.Methods:From January to December 2023,routine management was implemented,and 200 flexible endoscopes used for exa...Objective:To evaluate the application value of lean management in the management of flexible endoscopes.Methods:From January to December 2023,routine management was implemented,and 200 flexible endoscopes used for examination and treatment were included in the control group;from January to December 2024,lean management was implemented,and 200 flexible endoscopes used for examination and treatment were included in the observation group.The average daily usage frequency,management effectiveness,and failure rate of flexible endoscopes were compared between the two groups.Results:The average daily usage frequency of flexible endoscopes in the observation group was higher than that in the control group(P<0.05);the 3S retrieval rate and spot-check qualification rate of endoscopes in the observation group were higher than those in the control group(P<0.05);the failure rate of flexible endoscopes in the observation group was lower than that in the control group(P<0.05).Conclusion:Implementing lean management during the management of flexible endoscopes can improve the efficiency of endoscope retrieval,increase the average daily usage frequency of flexible endoscopes,and reduce endoscope failures.展开更多
BACKGROUND Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.AIM To develop a spray flushing system to achieving effective cleaning of the working...BACKGROUND Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.AIM To develop a spray flushing system to achieving effective cleaning of the working channels while minimizing damage.METHODS This prospective study included 60 used endoscopes and 60 Teflon tubes randomly divided into a control group(n=30)and an experimental group(n=30).The material of Teflon tubes was the same as that of the endoscope working channel.Endoscopes in the control group were manually cleaned using traditional cleaning brushes,while those in the experimental group were cleaned using the newly developed spray flushing system.ATP levels,cleanliness,and microbiological testing of the working channels were measured.Additionally,Teflon tubes in the control group underwent 500 passes with a cleaning brush,while those in the experimental group were subjected to the spray flushing system,and channel damage was evaluated.RESULTS The ATP levels(RLU)in the two groups were 32.5(13-66)and 26(16-40),respectively(P>0.05).Cleanliness scores were 1.5(1-2)and 1(1-2),respectively(P>0.05).Debris was found in 73.3%of the control group,which was significantly higher than 46.7%in the experimental group(P<0.05).Microbiological tests for both groups yielded negative results.Teflon tube damage in the control group was rated at 4(4-5.25),which was significantly higher than in the experimental group 4(3-4)(P<0.01).CONCLUSION The spray flushing system demonstrated superior efficacy in removing debris and resulted in less damage to the endoscope working channels compared with traditional cleaning brushes.展开更多
AIM To assess the feasibility and safety of a novel enteroscope,negative-pressure suction endoscope in examining the small intestine of a porcine model.METHODS In vitro experiments in small intestinal loops from 20pig...AIM To assess the feasibility and safety of a novel enteroscope,negative-pressure suction endoscope in examining the small intestine of a porcine model.METHODS In vitro experiments in small intestinal loops from 20pigs and in vivo experiments in 20 living pigs were conducted.RESULTS In in vitro experiments,a negative pressure of>0.06MPa was necessary for optimal visualization of the intestine,and this pressure did not cause gross or histological damage to the mucosa.For satisfactory examination of the small intestine in vivo,higher negative pressure(>1.00 MPa)was required.Despite this higher pressure,the small intestine did not show any gross or microscopic damage in the suctioned areas.The average time of examination in the living animals was 60±7.67 min.The animals did not experience any apparent ill effects from the procedure.CONCLUSION Small intestine endoscope was safely performed within a reasonable time period and enabled complete visualization of the intestine in most cases.展开更多
A 2.4GHz ASK transmitter suitable for a low power wireless capsule endoscope system is presented. A mixer-based frequency up-conversion transmitter architecture is employed to achieve a high data rate. A pseudodiffere...A 2.4GHz ASK transmitter suitable for a low power wireless capsule endoscope system is presented. A mixer-based frequency up-conversion transmitter architecture is employed to achieve a high data rate. A pseudodifferential stacked class-A power amplifier using the current reuse technique is proposed to save power. The transmitter mainly includes two parts： a 20MHz ASK modulator based on a constant amplitude phase lock loop （PLL） and a direct up-conversion RF circuit. This design, implemented in a TSMC 0.25μm CMOS process, achieves a - 23. 217dBm output power with a data rate of 1Mbps and dissipates 3.17mA of current with a single 2.5V power supply.展开更多
We recently read with great interest a study by Zhang et al in the World Journal of Gastroenterology.In our practice,we focus specifically on examining appendiceal mucinous neoplasms(AMNs)with endoscopic ultrasound(EU...We recently read with great interest a study by Zhang et al in the World Journal of Gastroenterology.In our practice,we focus specifically on examining appendiceal mucinous neoplasms(AMNs)with endoscopic ultrasound(EUS)using different scopes.AMNs are rare neoplastic lesions characterized by an accumulation of mucin inside a cystic dilatation of the appendix.Clinically,they can present as nonspecific acute appendicitis.AMNs can turn into a life-threatening condition,termed pseudomyxoma peritonei,in which the ruptured appendix causes accumulation of mucin in the abdomen.Therefore,accurate and rapid diagnosis of AMN is essential.EUS is able to confirm and stage AMNs;although,EUS examination was once limited to the rectal and anal regions due to the conven-tional oblique-view scopes.With the emergence of new forward-view linear echoendoscopes and instruments like EUS miniprobes and overtubes,the scope of examination is changing.Herein,we discuss the feasibility of using the curved linear array echoendoscopes to examine cecal and appendiceal orifice lesions.展开更多
AIM: To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoe-mulsification and intraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glauc...AIM: To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoe-mulsification and intraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glaucoma (PACG). ·METHODS: Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation was performed in 32 eyes of 29 patients with PACG. Regular follow-up was performed 1 week and 1 month, 3, and 6 months after surgery to assess complications, intraocular pressure (IOP), anterior chamber depth, visual acuity, and anterior chamber angle. ·RESULTS: Preoperative mean IOP was 24.88±7.22mmHg with pharmacological treatment, and was 13.70 ±4.02, 13.06 ±3.74, 14.29 ±4.70, and 14.33 ±5.01mmHg 1 week, 1 month, 3 months, and 6 months after surgery, respectively. The postoperative decrease in IOP was significant (P 【 0.05). The rate for all eyes with IOP of 21mmHg or less was 93.8% (30 eyes) at the final visit without ocular hypotensive agents. The average preoperative anterior chamber depth was 1.60 ±0.64mm, and this value significantly increased to 2.72±0.62, 2.76±0.70, 2.73±0.68, and 2.74 ±0.71mm at 1 week, 1 month, 3 months, and 6 months, respectively. Visual acuity was improved in 28 eyes (87.5% ) at 6 months postoperatively. The anterior chamber angle had increased in 25 eyes (78.1% ) at the final visit; it was adhesive 90°-180° in 6 eyes, 180°-270° in only 1 eye. Two eyes exhibited minimal hyphema in the early postoperative period, but it could gradually be absorbed. Fibrinous reaction was observed in five eyes and spontaneously disappeared within 7 days. No shallow anterior chamber, iridodialysis, choroidal deta-chment, or malignant glaucoma was found in any eyes.CONCLUSION:Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation to manage PACG has several advantages, including optimized visualization, greater accuracy, and improved safety. Our results suggest that it has certain curative effects and clinical application value.展开更多
BACKGROUND Conventionally, the low luminous intensity, low image resolution, and difficulty in operation have been reported with the ultrathin endoscope. However, it has markedly advanced recently. The improvement of ...BACKGROUND Conventionally, the low luminous intensity, low image resolution, and difficulty in operation have been reported with the ultrathin endoscope. However, it has markedly advanced recently. The improvement of the diagnostic ability is expected.AIM To compare the early gastric cancer diagnostic ability of an ultrathin endoscope loaded with a laser light source and that of the conventional endoscope.METHODS The target subjects were 375 consecutive patients who underwent endoscopy at our hospital for post-endoscopic submucosal dissection follow-up of gastric cancer from January to August 2018. During endoscopy, the ultrathin endoscope was used in 140 patients(37.3%), and the conventional endoscope was used in235 patients(62.7%). Patient background was adjusted using the propensity score matching method, and gastric cancer detection ability was evaluated in the two groups.RESULTS The gastric cancer detection rate was 7.8% in the ultrathin endoscope group and7.0% in the conventional endoscope group, and the mean intragastric observation time was 4.1 ± 1.7 min in the ultrathin endoscope group and 4.1 ± 1.9 min in the conventional endoscope group, showing no significant differences between the groups. Moreover, the biopsy implementation rate was 31.8% in the ultrathin endoscope group and 41.1% in the conventional endoscope group, and the biopsy prediction rate was 17.9% and 13.2%, respectively, showing no significant differences between the groups.CONCLUSION The gastric cancer diagnostic ability of the ultrathin endoscope loaded with a laser light source was comparable to that of the conventional endoscope. The observation time was also comparable. Thus, endoscopy using the ultrathin endoscope loaded with the laser light source would be the first option in screening examinations of gastric cancer due to its low invasion.展开更多
Objectives： This pilot study of employing chlorine dioxide （CD） gas to disinfect gastrointestinal endoscopes was conducted to meet the expectations of many endoscopy units in China for a high-efficiency and low-cos...Objectives： This pilot study of employing chlorine dioxide （CD） gas to disinfect gastrointestinal endoscopes was conducted to meet the expectations of many endoscopy units in China for a high-efficiency and low-cost disin- fectant. Methods： An experimental prototype with an active circulation mode was designed to use CD gas to disinfect gastrointestinal endoscopes. One type of testing device composed of polytetrafluoroethylene （PTFE） tubes （2 m long, inner diameter 1 mm） and bacterial carrier containers was used to simulate the channel of the endoscope. PTFE bacterial carriers inoculated with Bacillus atrophaeus with or without organic burden were used to evaluate the spor- icidal activity of CD gas. Factors including exposure dosage, relative humidity （RH）, and flow rate （FR） influencing the disinfection effect of CD gas were investigated. Moreover, an autoptic disinfecting test on eight real gastrointestinal endoscopes after clinical use was performed using the experimental prototype. Results： IRH, exposure dosage, or- ganic burden, and the FIR through the channel significantly （P〈0.05） affected the disinfection efficacy of CD gas for a long and narrow lumen. The log reduction increased as FR decreased. Treatment with 4 mg/L CD gas for 30 min at 0.8 L/min FR and 75% IRH, resulted in complete inactivation of spores. Furthermore, all eight endoscopes with a maximum colony-forming unit of 915 were completely disinfected. The cost was only 3 CNY （0.46 USD） for each endoscope. Conclusions： The methods and results reported in this study could provide a basis for further studies on using CD gas for the disinfection of endoscopes.展开更多
A robotic endoscope is mainly composed of a tactile array sensor, soft mobilemechanism for earthworm locomotion and turning mechanism based on shape memory effect. The tactilearray sensor can provide the information a...A robotic endoscope is mainly composed of a tactile array sensor, soft mobilemechanism for earthworm locomotion and turning mechanism based on shape memory effect. The tactilearray sensor can provide the information about magnitude and orientation of interacting forcesbetween the robotic endoscope and the wall of gastrointestinal tracts. The soft mobile mechanismcontacts gastrointestinal tracts with air-in inflatable balloons, so it has better soft andnon-invasive properties. The turning mechanism can be actively bent by shape memory alloy componentsand conform to the complex shape of gastrointestinal tracts. The working principle of roboticendoscope is dealt with.展开更多
Airborne transmission is among the most frequent types of nosocomial infection.Recent years have witnessed frequent outbreaks of airborne diseases,such as severe acute respiratory syndrome(SARS)in 2002,Middle East res...Airborne transmission is among the most frequent types of nosocomial infection.Recent years have witnessed frequent outbreaks of airborne diseases,such as severe acute respiratory syndrome(SARS)in 2002,Middle East respiratory syndrome(MERS)in 2012,and coronavirus disease 2019(COVID-19),with the latter being on the rampage since the end of 2019 and bringing the effect of aerosols on health back to the fore(Gralton et al.,2011;Wang et al.,2021).An increasing number of studies have shown that certain highly transmissible pathogens can maintain long-term stability and efficiently spread through aerosols(Leung,2021;Lv et al.,2021).As reported previously,influenza viruses that can spread efficiently through aerosols remain stable for a longer period compared to those that cannot.The World Health Organization(WHO)has stated that aerosol-generating procedures(AGPs)play an important role in aerosol transmission in hospitals(Calderwood et al.,2021).AGPs,referring to medical procedures that produce aerosols,including dental procedures,endotracheal intubation,sputum aspiration,and laparoscopic surgeries,have been reported to be significantly associated with an increased risk of nosocomial infection among medical personnel(Hamilton,2021).展开更多
High level disinfection(HLD) of the gastrointestinal(GI)endoscope is not simply a slogan, but rather is a form of experimental monitoring-based medicine. By definition,GI endoscopy is a semicritical medical device. He...High level disinfection(HLD) of the gastrointestinal(GI)endoscope is not simply a slogan, but rather is a form of experimental monitoring-based medicine. By definition,GI endoscopy is a semicritical medical device. Hence,such medical devices require major quality assurance for disinfection. And because many of these items are temperature sensitive, low-temperature chemical methods, such as liquid chemical germicide, must be used rather than steam sterilization. In summarizing guidelines for infection prevention and control for GI endoscopy, there are three important steps that must be highlighted: manual washing, HLD with automated endoscope reprocessor, and drying. Strict adherence to current guidelines is required because compared to any other medical device, the GI endoscope is associated with more outbreaks linked to inadequate cleaning or disinfecting during HLD. Both experimental evaluation on the surveillance bacterial cultures and in-use clinical results have shown that, the monitoring of the stringent processes to prevent and control infection is an essential component of the broader strategy to ensure the delivery of safe endoscopy services, because endoscope reprocessing is a multistep procedure involving numerous factors that can interfere with its efficacy. Based on our years of experience in the surveillance of culture monitoring of endoscopic reprocessing, we aim in this study to carefully describe what details require attention in the GI endoscopy disinfection and to share our experience so that patients can be provided with high quality and safe medical practices. Quality management encompasses all aspects of pre- and postprocedural care including the efficiency of the endoscopy unit and reprocessing area, as well as the endoscopic procedure itself.展开更多
A novel non-cable whole tectorial membrane micro-robot for an endoscope is developed. The micro-robot we have fabricated and tested can propel itself in the intestine tract of a pig in an autonomous manner by earthwor...A novel non-cable whole tectorial membrane micro-robot for an endoscope is developed. The micro-robot we have fabricated and tested can propel itself in the intestine tract of a pig in an autonomous manner by earthworm-like locomotion. The silicone of bellow shape is laid over the outer surface of the micro-robot to reduce the affection of the viscoelastic properties of the intestine. Wireless power transfer and communication systems are employed to realize the non-cable locomotion of the mi-cro-robot. The prototype of the micro-robot is 13.5 mm in diameter and 108 mm in length. The experimental results show that the towing force for the micro-robot is about 0.8 N, which is much smaller than the maximum driving force 2.55 N of the linear actuator. The supplying power of the wireless power transfer system fulfills the needs of the micro-robot system and the mi-cro-robot can creep reliably in the large intestine of a pig and other contact environments.展开更多
Recently,peroral direct cholangioscopy(PDCS) using an ultra-slim endoscope has come into the spotlight.However,the working channel is too small to use various devices for lithotripsy.We report a case of endoscopic lit...Recently,peroral direct cholangioscopy(PDCS) using an ultra-slim endoscope has come into the spotlight.However,the working channel is too small to use various devices for lithotripsy.We report a case of endoscopic lithotripsy with PDCS using a conventional endoscope as a cholangioscope.Computed tomography scan on an 80-year-old female who was admitted with acute cholangitis showed two large stones in the bile duct.Endoscopic retrograde cholangiopancreatography was attempted first.However,mechanical lithotripsy failed because the stone was too large for the basket catheter.Finally,electric hydraulic lithotripsy with PDCS using a conventional endoscope was performed allowed the stones to be cleared completely.In conclusion,PDCS using a conventional endoscope can be an alternative solution for endoscopic lithotripsy for patients with large stones in the dilated bile duct.展开更多
AIM:To investigate the safety and efficacy of phacoemulsification with capsular-tension-ring implantation and posterior chamber intraocular lens implantation combined with ophthalmic endoscope-controlled goniosynechia...AIM:To investigate the safety and efficacy of phacoemulsification with capsular-tension-ring implantation and posterior chamber intraocular lens implantation combined with ophthalmic endoscope-controlled goniosynechialysis(Phaco-CTR-IOL-OE-GSL)for treating secondary angle-closure glaucoma induced by traumatic lens subluxation.METHODS:A retrospective and descriptive study was performed on patients with lens subluxation,angle closure,goniosynechia,and evaluated intraocular pressure(IOP)that cannot be controlled with medication,who underwent Phaco-CTR-IOL-OE-GSL.The postoperative best-corrected visual acuity(BCVA),IOP,range of goniosynechia and complications were retrospectively observed.RESULTS:Nine patients with secondary angle-closure glaucoma induced by traumatic lens subluxation were included.The follow-up period was 51.1±8.6 mo.The preoperative range of zonule rupture was 158.2°±33.0°,and the range of goniosynechia was 220.0°±92.5°.The baseline BCVA was 0.9±1.0 logMAR,IOP was 30.7±17.3 mm Hg and number of anti-glaucoma medication was 3.2±1.1.Mild intraoperative hyphaemia with 8 eyes(88.8%)in the anterior chamber,and was absorbed two days postoperatively.One eye(11.1%)had postoperative ciliary body detachment and was recovered after five days of topical drug treatment.BCVA was 0.2±0.2 logMAR at 3 mo postoperatively.The average IOP at the last follow-up was 16.7±2.0 mm Hg,and no anti-glaucoma medications were used.The average range of recurrent goniosynechia was 54.9°±33°at the final postoperative gonioscopic examination.CONCLUSION:Phaco-CTR-IOL-OE-GSL is safe and effective in the treatment of secondary angle-closure glaucoma induced by traumatic lens subluxation.The use of an endoscope provides a more direct and clear examination for GSL,and 360°dissection is easily achieved.展开更多
The diagnosis and treatment of the lacrimal passage obstruction with lacrimal endoscope was investigated and its subsidiary surgical procedures were evaluated. Ninety-three patients （109 eyes） with lacrimal passage ...The diagnosis and treatment of the lacrimal passage obstruction with lacrimal endoscope was investigated and its subsidiary surgical procedures were evaluated. Ninety-three patients （109 eyes） with lacrimal passage obstruction, including presaccal canalicular obstruction （PSCO） and nasolacrimal duct obstruction （NLDO）, were examined under a lacrimal endoscope, and the obstruc- tions were treated with laser or micro-drill. All patients were followed up after the operation for 3--6 months. The difference between the laser and the micro-drill treatment was observed. During the period of follow-up, the curative rate was 82.57%. The healing rate in PSCO group and NLDO was 80.36% and 84.91% respectively （P〉0.05）. Alter treatment with the laser, the healing rate was 93.33% in the PSCO group and 66.67% in the NLDO group respectively （P〈0.05）. After treatment with the micro-drill, the healing rate in PSCO and NLDO groups was 65.39% and 94.28% respec- tively （P〈0.01）. The lacrimal passage obstruction can be observed and treated directly through the lacrimal endoscope. Choosing different surgical procedures in operation according to the locations of the obstruction is helpful to improve the effectiveness.展开更多
文摘This article comments on the article by Du et al,who conducted a randomized controlled trial aiming at evaluating the effectiveness of a novel spray flushing system in cleaning flexible endoscopes while minimizing damage to the working channels.We share our perspective on the importance of improving endoscope reprocessing methods.The findings highlight the spray flushing system's capacity to improve cleaning efficacy while minimizing damage,suggesting that it might be important in enhancing endoscope reprocessing procedures.
基金Supported by the National Natural Science Foundation of China,No.81602056 and No.82273393the Young Talents Promotion Project of Shandong Medical Association in 2023,No.2023_GJ_0087.
文摘Digestive endoscopy has been widely used in the diagnosis and treatment of digestive diseases.However,the anatomical complexity of specific lesions increases the difficulty of these operations,resulting in complications or treatment failure.Although various strategies,such as floss traction and the application of transparent caps,have been explored,their effectiveness remains limited due to individual differences in patients’anatomical characteristics.The multibending(MB)endoscope represents a significant innovation as it is a conventional endoscope with an additional bending section and dual channels.Currently,this technology has been applied in gastroscopy,duodenoscopy and peroral cholangioscopy.The bending part of the endoscope facilitates its passage into difficult-to-reach anatomical regions and improves operating angles,thereby enhancing surgical precision and efficiency while reducing complication rates.Furthermore,the dualchannel design accelerates procedural workflows and increases operational versatility.This innovation is poised to transform endoscopic diagnosis and treatment of digestive system diseases.Since the MB endoscope is relatively new,further research is needed to comprehensively explore its benefits for and potential in endoscopic diagnosis and treatment.The aim of this review is to summarize the current research,indications,and future directions of MB endoscope.
文摘As the cornerstone of sterile instrument maintenance in endoscopy centers,the quality of endoscope cleaning directly impacts hospital infection control effectiveness.The traceability system for endoscopy centers utilizes digital means to document the entire cleaning process,enabling real-time monitoring and precise quality control.This paper analyzes current quality control practices in endoscope cleaning and addresses existing challenges.It explores how traceability systems standardize procedures,enhance monitoring,and improve management efficiency.The study proposes optimization strategies for traceability system implementation,clarifying its core value in endoscope cleaning quality control.These findings provide theoretical foundations and practical guidance for hospitals to refine management of endoscopy centers,ensure diagnostic safety,and reduce infection risks,ultimately advancing endoscope cleaning quality control toward standardized and informatized development.
文摘The advancement in endoscopic technology and techniques has increased its use in the diagnosis and treatment of gastrointestinal diseases.Reprocessing of reusable endoscopes remains a challenge.Inadequate reprocessing leads to bacterial contamination of the endoscope,a significant cause of endoscope-related infections.To thoroughly address the complexities of cleaning a flexible endo-scope,various cleaning methods have been devised and tested across different studies.This letter evaluates one such method,spray flushing for flexible gastro-scopes,developed and tested in a randomized controlled trial by Du et al.Based on the post-processing test results for this method,Du et al conclude that there is improved cleaning efficacy and reduced damage compared to manual brush cleaning.The validity and reliability of the results could be further enhanced by carefully considering the study design and a few underlying concepts that contribute to the reprocessing quality of different types of endoscopes.
基金Supported by the Joint Logistics Support Force Comprehensive Equipment Research Project,No.LB2023B010100-09.
文摘BACKGROUND Current disinfection methods for gastrointestinal endoscopes consume a significant amount of water resources and produce a large volume of waste.AIM To achieve the objectives of efficiency,speed,and cost-effectiveness,this study utilized vaporized hydrogen peroxide(VHP)generated from sodium percarbonate granules to conduct an anhydrous disinfection test on gastrointestinal endoscopes.METHODS The experimental device rapidly converts sodium percarbonate granules into VHP,and performs disinfection experiments on gastrointestinal endoscope models,disposable endoscopes,and various types of reusable gastrointestinal endoscopes.Variables such as the intraluminal flow rate(FR),relative humidity(RH),exposure dosage,and organic burden are used to explore the factors influencing the disinfection of long and narrow lumens with VHP.RESULTS The device generates a certain concentration of VHP that can achieve high-level disinfection of endoscope models within 30 minutes.RH,exposure dosage,and organic burden significantly affect the disinfection efficacy of VHP,whereas the intraluminal FR does not significantly impact disinfection efficacy.All ten artificially contaminated disposable endoscopes achieved satisfactory disinfection results.Furthermore,when this device was used to treat various types of reusable endoscopes,the disinfection and sterilization effects were not significantly different from those of automatic endoscope disinfection machines(using peracetic acid disinfectant solution)(P>0.05),and the economic cost of disinfectant required per endoscope was lower(1.5 China Yuan),with a shorter disinfection time(30 minutes).CONCLUSION The methods and results of this study provide a basis for further research on the use of VHP for the disinfection of gastrointestinal endoscopes,as well as for the development of anhydrous disinfection technology for gastrointestinal endoscopes.
文摘Objective:To evaluate the application value of lean management in the management of flexible endoscopes.Methods:From January to December 2023,routine management was implemented,and 200 flexible endoscopes used for examination and treatment were included in the control group;from January to December 2024,lean management was implemented,and 200 flexible endoscopes used for examination and treatment were included in the observation group.The average daily usage frequency,management effectiveness,and failure rate of flexible endoscopes were compared between the two groups.Results:The average daily usage frequency of flexible endoscopes in the observation group was higher than that in the control group(P<0.05);the 3S retrieval rate and spot-check qualification rate of endoscopes in the observation group were higher than those in the control group(P<0.05);the failure rate of flexible endoscopes in the observation group was lower than that in the control group(P<0.05).Conclusion:Implementing lean management during the management of flexible endoscopes can improve the efficiency of endoscope retrieval,increase the average daily usage frequency of flexible endoscopes,and reduce endoscope failures.
基金West China Nursing Discipline Development Special Fund Project,No.HXHL21029。
文摘BACKGROUND Commonly used cleaning brushes in the reprocessing of flexible endoscopes often cause damage within the working channels.AIM To develop a spray flushing system to achieving effective cleaning of the working channels while minimizing damage.METHODS This prospective study included 60 used endoscopes and 60 Teflon tubes randomly divided into a control group(n=30)and an experimental group(n=30).The material of Teflon tubes was the same as that of the endoscope working channel.Endoscopes in the control group were manually cleaned using traditional cleaning brushes,while those in the experimental group were cleaned using the newly developed spray flushing system.ATP levels,cleanliness,and microbiological testing of the working channels were measured.Additionally,Teflon tubes in the control group underwent 500 passes with a cleaning brush,while those in the experimental group were subjected to the spray flushing system,and channel damage was evaluated.RESULTS The ATP levels(RLU)in the two groups were 32.5(13-66)and 26(16-40),respectively(P>0.05).Cleanliness scores were 1.5(1-2)and 1(1-2),respectively(P>0.05).Debris was found in 73.3%of the control group,which was significantly higher than 46.7%in the experimental group(P<0.05).Microbiological tests for both groups yielded negative results.Teflon tube damage in the control group was rated at 4(4-5.25),which was significantly higher than in the experimental group 4(3-4)(P<0.01).CONCLUSION The spray flushing system demonstrated superior efficacy in removing debris and resulted in less damage to the endoscope working channels compared with traditional cleaning brushes.
文摘AIM To assess the feasibility and safety of a novel enteroscope,negative-pressure suction endoscope in examining the small intestine of a porcine model.METHODS In vitro experiments in small intestinal loops from 20pigs and in vivo experiments in 20 living pigs were conducted.RESULTS In in vitro experiments,a negative pressure of>0.06MPa was necessary for optimal visualization of the intestine,and this pressure did not cause gross or histological damage to the mucosa.For satisfactory examination of the small intestine in vivo,higher negative pressure(>1.00 MPa)was required.Despite this higher pressure,the small intestine did not show any gross or microscopic damage in the suctioned areas.The average time of examination in the living animals was 60±7.67 min.The animals did not experience any apparent ill effects from the procedure.CONCLUSION Small intestine endoscope was safely performed within a reasonable time period and enabled complete visualization of the intestine in most cases.
文摘A 2.4GHz ASK transmitter suitable for a low power wireless capsule endoscope system is presented. A mixer-based frequency up-conversion transmitter architecture is employed to achieve a high data rate. A pseudodifferential stacked class-A power amplifier using the current reuse technique is proposed to save power. The transmitter mainly includes two parts： a 20MHz ASK modulator based on a constant amplitude phase lock loop （PLL） and a direct up-conversion RF circuit. This design, implemented in a TSMC 0.25μm CMOS process, achieves a - 23. 217dBm output power with a data rate of 1Mbps and dissipates 3.17mA of current with a single 2.5V power supply.
文摘We recently read with great interest a study by Zhang et al in the World Journal of Gastroenterology.In our practice,we focus specifically on examining appendiceal mucinous neoplasms(AMNs)with endoscopic ultrasound(EUS)using different scopes.AMNs are rare neoplastic lesions characterized by an accumulation of mucin inside a cystic dilatation of the appendix.Clinically,they can present as nonspecific acute appendicitis.AMNs can turn into a life-threatening condition,termed pseudomyxoma peritonei,in which the ruptured appendix causes accumulation of mucin in the abdomen.Therefore,accurate and rapid diagnosis of AMN is essential.EUS is able to confirm and stage AMNs;although,EUS examination was once limited to the rectal and anal regions due to the conven-tional oblique-view scopes.With the emergence of new forward-view linear echoendoscopes and instruments like EUS miniprobes and overtubes,the scope of examination is changing.Herein,we discuss the feasibility of using the curved linear array echoendoscopes to examine cecal and appendiceal orifice lesions.
文摘AIM: To describe and evaluate a new ophthalmic endoscope surgical technique combined with phacoe-mulsification and intraocular lens (IOL) implantation to treat goniosynechialysis and manage primary angle-closure glaucoma (PACG). ·METHODS: Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation was performed in 32 eyes of 29 patients with PACG. Regular follow-up was performed 1 week and 1 month, 3, and 6 months after surgery to assess complications, intraocular pressure (IOP), anterior chamber depth, visual acuity, and anterior chamber angle. ·RESULTS: Preoperative mean IOP was 24.88±7.22mmHg with pharmacological treatment, and was 13.70 ±4.02, 13.06 ±3.74, 14.29 ±4.70, and 14.33 ±5.01mmHg 1 week, 1 month, 3 months, and 6 months after surgery, respectively. The postoperative decrease in IOP was significant (P 【 0.05). The rate for all eyes with IOP of 21mmHg or less was 93.8% (30 eyes) at the final visit without ocular hypotensive agents. The average preoperative anterior chamber depth was 1.60 ±0.64mm, and this value significantly increased to 2.72±0.62, 2.76±0.70, 2.73±0.68, and 2.74 ±0.71mm at 1 week, 1 month, 3 months, and 6 months, respectively. Visual acuity was improved in 28 eyes (87.5% ) at 6 months postoperatively. The anterior chamber angle had increased in 25 eyes (78.1% ) at the final visit; it was adhesive 90°-180° in 6 eyes, 180°-270° in only 1 eye. Two eyes exhibited minimal hyphema in the early postoperative period, but it could gradually be absorbed. Fibrinous reaction was observed in five eyes and spontaneously disappeared within 7 days. No shallow anterior chamber, iridodialysis, choroidal deta-chment, or malignant glaucoma was found in any eyes.CONCLUSION:Endoscope-assisted goniosynechialysis combined with phacoemulsification and IOL implantation to manage PACG has several advantages, including optimized visualization, greater accuracy, and improved safety. Our results suggest that it has certain curative effects and clinical application value.
文摘BACKGROUND Conventionally, the low luminous intensity, low image resolution, and difficulty in operation have been reported with the ultrathin endoscope. However, it has markedly advanced recently. The improvement of the diagnostic ability is expected.AIM To compare the early gastric cancer diagnostic ability of an ultrathin endoscope loaded with a laser light source and that of the conventional endoscope.METHODS The target subjects were 375 consecutive patients who underwent endoscopy at our hospital for post-endoscopic submucosal dissection follow-up of gastric cancer from January to August 2018. During endoscopy, the ultrathin endoscope was used in 140 patients(37.3%), and the conventional endoscope was used in235 patients(62.7%). Patient background was adjusted using the propensity score matching method, and gastric cancer detection ability was evaluated in the two groups.RESULTS The gastric cancer detection rate was 7.8% in the ultrathin endoscope group and7.0% in the conventional endoscope group, and the mean intragastric observation time was 4.1 ± 1.7 min in the ultrathin endoscope group and 4.1 ± 1.9 min in the conventional endoscope group, showing no significant differences between the groups. Moreover, the biopsy implementation rate was 31.8% in the ultrathin endoscope group and 41.1% in the conventional endoscope group, and the biopsy prediction rate was 17.9% and 13.2%, respectively, showing no significant differences between the groups.CONCLUSION The gastric cancer diagnostic ability of the ultrathin endoscope loaded with a laser light source was comparable to that of the conventional endoscope. The observation time was also comparable. Thus, endoscopy using the ultrathin endoscope loaded with the laser light source would be the first option in screening examinations of gastric cancer due to its low invasion.
基金Project supported by the National High-Tech R&D Program(863)of China(No.2014AA021405)
文摘Objectives： This pilot study of employing chlorine dioxide （CD） gas to disinfect gastrointestinal endoscopes was conducted to meet the expectations of many endoscopy units in China for a high-efficiency and low-cost disin- fectant. Methods： An experimental prototype with an active circulation mode was designed to use CD gas to disinfect gastrointestinal endoscopes. One type of testing device composed of polytetrafluoroethylene （PTFE） tubes （2 m long, inner diameter 1 mm） and bacterial carrier containers was used to simulate the channel of the endoscope. PTFE bacterial carriers inoculated with Bacillus atrophaeus with or without organic burden were used to evaluate the spor- icidal activity of CD gas. Factors including exposure dosage, relative humidity （RH）, and flow rate （FR） influencing the disinfection effect of CD gas were investigated. Moreover, an autoptic disinfecting test on eight real gastrointestinal endoscopes after clinical use was performed using the experimental prototype. Results： IRH, exposure dosage, or- ganic burden, and the FIR through the channel significantly （P〈0.05） affected the disinfection efficacy of CD gas for a long and narrow lumen. The log reduction increased as FR decreased. Treatment with 4 mg/L CD gas for 30 min at 0.8 L/min FR and 75% IRH, resulted in complete inactivation of spores. Furthermore, all eight endoscopes with a maximum colony-forming unit of 915 were completely disinfected. The cost was only 3 CNY （0.46 USD） for each endoscope. Conclusions： The methods and results reported in this study could provide a basis for further studies on using CD gas for the disinfection of endoscopes.
基金This project is supported by Sn angnai Eaucation Committee.
文摘A robotic endoscope is mainly composed of a tactile array sensor, soft mobilemechanism for earthworm locomotion and turning mechanism based on shape memory effect. The tactilearray sensor can provide the information about magnitude and orientation of interacting forcesbetween the robotic endoscope and the wall of gastrointestinal tracts. The soft mobile mechanismcontacts gastrointestinal tracts with air-in inflatable balloons, so it has better soft andnon-invasive properties. The turning mechanism can be actively bent by shape memory alloy componentsand conform to the complex shape of gastrointestinal tracts. The working principle of roboticendoscope is dealt with.
基金supported by the Medicine and Health Care in Zhejiang Province Science and Technology Plan Projects(Nos.2020KY552 and 2021PY006)the Commonweal Project of Science and Technology Department of Zhejiang Province(No.LGF21H030007),China.
文摘Airborne transmission is among the most frequent types of nosocomial infection.Recent years have witnessed frequent outbreaks of airborne diseases,such as severe acute respiratory syndrome(SARS)in 2002,Middle East respiratory syndrome(MERS)in 2012,and coronavirus disease 2019(COVID-19),with the latter being on the rampage since the end of 2019 and bringing the effect of aerosols on health back to the fore(Gralton et al.,2011;Wang et al.,2021).An increasing number of studies have shown that certain highly transmissible pathogens can maintain long-term stability and efficiently spread through aerosols(Leung,2021;Lv et al.,2021).As reported previously,influenza viruses that can spread efficiently through aerosols remain stable for a longer period compared to those that cannot.The World Health Organization(WHO)has stated that aerosol-generating procedures(AGPs)play an important role in aerosol transmission in hospitals(Calderwood et al.,2021).AGPs,referring to medical procedures that produce aerosols,including dental procedures,endotracheal intubation,sputum aspiration,and laparoscopic surgeries,have been reported to be significantly associated with an increased risk of nosocomial infection among medical personnel(Hamilton,2021).
基金The gastrointestinal endoscopy unit of Kaohsiung Chang Gung Memorial Hospital,Taiwan
文摘High level disinfection(HLD) of the gastrointestinal(GI)endoscope is not simply a slogan, but rather is a form of experimental monitoring-based medicine. By definition,GI endoscopy is a semicritical medical device. Hence,such medical devices require major quality assurance for disinfection. And because many of these items are temperature sensitive, low-temperature chemical methods, such as liquid chemical germicide, must be used rather than steam sterilization. In summarizing guidelines for infection prevention and control for GI endoscopy, there are three important steps that must be highlighted: manual washing, HLD with automated endoscope reprocessor, and drying. Strict adherence to current guidelines is required because compared to any other medical device, the GI endoscope is associated with more outbreaks linked to inadequate cleaning or disinfecting during HLD. Both experimental evaluation on the surveillance bacterial cultures and in-use clinical results have shown that, the monitoring of the stringent processes to prevent and control infection is an essential component of the broader strategy to ensure the delivery of safe endoscopy services, because endoscope reprocessing is a multistep procedure involving numerous factors that can interfere with its efficacy. Based on our years of experience in the surveillance of culture monitoring of endoscopic reprocessing, we aim in this study to carefully describe what details require attention in the GI endoscopy disinfection and to share our experience so that patients can be provided with high quality and safe medical practices. Quality management encompasses all aspects of pre- and postprocedural care including the efficiency of the endoscopy unit and reprocessing area, as well as the endoscopic procedure itself.
基金Project (No. 2007AA04Z234) supported by the Hi-Tech Researchand Development Program (863) of China
文摘A novel non-cable whole tectorial membrane micro-robot for an endoscope is developed. The micro-robot we have fabricated and tested can propel itself in the intestine tract of a pig in an autonomous manner by earthworm-like locomotion. The silicone of bellow shape is laid over the outer surface of the micro-robot to reduce the affection of the viscoelastic properties of the intestine. Wireless power transfer and communication systems are employed to realize the non-cable locomotion of the mi-cro-robot. The prototype of the micro-robot is 13.5 mm in diameter and 108 mm in length. The experimental results show that the towing force for the micro-robot is about 0.8 N, which is much smaller than the maximum driving force 2.55 N of the linear actuator. The supplying power of the wireless power transfer system fulfills the needs of the micro-robot system and the mi-cro-robot can creep reliably in the large intestine of a pig and other contact environments.
文摘Recently,peroral direct cholangioscopy(PDCS) using an ultra-slim endoscope has come into the spotlight.However,the working channel is too small to use various devices for lithotripsy.We report a case of endoscopic lithotripsy with PDCS using a conventional endoscope as a cholangioscope.Computed tomography scan on an 80-year-old female who was admitted with acute cholangitis showed two large stones in the bile duct.Endoscopic retrograde cholangiopancreatography was attempted first.However,mechanical lithotripsy failed because the stone was too large for the basket catheter.Finally,electric hydraulic lithotripsy with PDCS using a conventional endoscope was performed allowed the stones to be cleared completely.In conclusion,PDCS using a conventional endoscope can be an alternative solution for endoscopic lithotripsy for patients with large stones in the dilated bile duct.
基金Wenzhou Municipal Science and Technology Bureau(No.Y20180712)。
文摘AIM:To investigate the safety and efficacy of phacoemulsification with capsular-tension-ring implantation and posterior chamber intraocular lens implantation combined with ophthalmic endoscope-controlled goniosynechialysis(Phaco-CTR-IOL-OE-GSL)for treating secondary angle-closure glaucoma induced by traumatic lens subluxation.METHODS:A retrospective and descriptive study was performed on patients with lens subluxation,angle closure,goniosynechia,and evaluated intraocular pressure(IOP)that cannot be controlled with medication,who underwent Phaco-CTR-IOL-OE-GSL.The postoperative best-corrected visual acuity(BCVA),IOP,range of goniosynechia and complications were retrospectively observed.RESULTS:Nine patients with secondary angle-closure glaucoma induced by traumatic lens subluxation were included.The follow-up period was 51.1±8.6 mo.The preoperative range of zonule rupture was 158.2°±33.0°,and the range of goniosynechia was 220.0°±92.5°.The baseline BCVA was 0.9±1.0 logMAR,IOP was 30.7±17.3 mm Hg and number of anti-glaucoma medication was 3.2±1.1.Mild intraoperative hyphaemia with 8 eyes(88.8%)in the anterior chamber,and was absorbed two days postoperatively.One eye(11.1%)had postoperative ciliary body detachment and was recovered after five days of topical drug treatment.BCVA was 0.2±0.2 logMAR at 3 mo postoperatively.The average IOP at the last follow-up was 16.7±2.0 mm Hg,and no anti-glaucoma medications were used.The average range of recurrent goniosynechia was 54.9°±33°at the final postoperative gonioscopic examination.CONCLUSION:Phaco-CTR-IOL-OE-GSL is safe and effective in the treatment of secondary angle-closure glaucoma induced by traumatic lens subluxation.The use of an endoscope provides a more direct and clear examination for GSL,and 360°dissection is easily achieved.
文摘The diagnosis and treatment of the lacrimal passage obstruction with lacrimal endoscope was investigated and its subsidiary surgical procedures were evaluated. Ninety-three patients （109 eyes） with lacrimal passage obstruction, including presaccal canalicular obstruction （PSCO） and nasolacrimal duct obstruction （NLDO）, were examined under a lacrimal endoscope, and the obstruc- tions were treated with laser or micro-drill. All patients were followed up after the operation for 3--6 months. The difference between the laser and the micro-drill treatment was observed. During the period of follow-up, the curative rate was 82.57%. The healing rate in PSCO group and NLDO was 80.36% and 84.91% respectively （P〉0.05）. Alter treatment with the laser, the healing rate was 93.33% in the PSCO group and 66.67% in the NLDO group respectively （P〈0.05）. After treatment with the micro-drill, the healing rate in PSCO and NLDO groups was 65.39% and 94.28% respec- tively （P〈0.01）. The lacrimal passage obstruction can be observed and treated directly through the lacrimal endoscope. Choosing different surgical procedures in operation according to the locations of the obstruction is helpful to improve the effectiveness.
