Shine on Flexible Endoscope Reprocessing - ASP Learning Lab
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  2. ASP Summit
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  4. Webinars Series #6
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Web.1 May 28
What's New on Flexible Endoscopes Reprocessing Guidelines?
Speaker: Mr David Bellamy
Learn More
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Web.2 June 26
Endoscope processing effectiveness: A reality check and call to action!
Speaker: Available soon
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Web.3 September 18
Flexible Endoscope Decontamination: The challenge of biofilm.
Speaker: Available soon
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Web.4 October 30
Improving Flexible Endoscope Reprocessing: the importance of dry storage.
Speaker: Available soon
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Web.5 November 20
Reprocessing Flexible Endoscopes : towards sterilization.
Speaker: Available soon
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Dr. Carlos Palos
ASP Summit • Scientific Director
Infection Control & Antimicrobial Stewardship
Lisbon , Portugal

As with previous editions, each webinar will feature a keynote speaker and include opportunities for interaction to address any questions.
We invite you to join us on this journey through the lifecycle of endoscopic reprocessing.
Shine on endoscopic reprocessing!

Web.1 May 28
What's New on Flexible Endoscopes Reprocessing Guidelines?
Mr David Bellamy photo
Mr David Bellamy
Vice President- World Federation of Hospital Sterilization Sciences, Sterilizing Services Department Manager- NSW Health
Experienced Consultant for Decontamination and Sterilisation projects, Protocols and Certifications
Sydney, Australia

SYNOPSIS:

Flexible endoscopes remain among the most challenging reusable medical devices to clean, disinfect, and sterilize. This webinar will explore the most recent updates in international and national guidelines, highlighting critical changes aimed at improving patient safety and infection prevention. Participants will gain practical insights into the rationale behind updated protocols, including enhanced drying procedures, storage conditions, microbiological surveillance, and staff competency. The session is designed for CSSD professionals, endoscopy nurses, infection preventionists, and healthcare managers involved in endoscope handling and reprocessing.

Topics to be covered:

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Enhanced Cleaning and
Pre-Cleaning Protocols
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Drying and
Storage Requirements
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Microbiological Surveillance and
Quality Assurance
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Competency, Documentation, and
Traceability
General Announcement

Modern medicine relies heavily on endoscopic procedures due to their minimal invasiveness and lower costs compared to surgical methods. The development of endoscopes has facilitated the transition from mere visualization to diagnostic and therapeutic procedures that were previously unattainable without invasive techniques. 1,2 

Endoscopic procedures play a crucial role in cancer screening, particularly in the detection of colorectal cancer among other pathologies. 3 

The global volume of endoscopic procedures performed annually varies according to different sources. Some data suggest that approximately 200 million procedures are conducted worldwide, with gastrointestinal procedures accounting for approximately 133 million and respiratory procedures around 10 million. Factors such as an aging population, improvements in preventive healthcare, and advancements in technology are expected to contribute to an increase in these figures. 4 

Infections associated with endoscopic procedures are among the potential complications, which also include bleeding, perforation, and cardiorespiratory events. Unfortunately, the incidence of these infections is not well documented compared to healthcare-associated infections. The type of infection varies according to the endoscopic procedure and the patient’s condition, ranging from mild infections to severe cases such as bacteremia, sepsis, septic shock, or even death. 5-8 

Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures are particularly concerning due to their association with post-procedure cholangitis in 2 to 4% of cases. Additionally, ERCP procedures have been linked to outbreaks caused by multi-drug-resistant bacteria, specifically carbapenem-resistant Enterobacterales, which are challenging to treat and carry high morbidity and mortality rates. Structural modifications to duodenoscopes intended to facilitate physicians’ work have inadvertently complicated the reprocessing of these devices. 5-8 

Endoscopes can harbor microorganisms that may cause infections if not properly reprocessed. Moreover, even with adequate reprocessing, there may still be microorganisms present in the equipment that is ready for use.9 

Biofilms play an important role in the contamination of endoscopic reprocessing. Inadequate removal of biofilms and improper storage of endoscopes can affect the effectiveness of the process.10-12 

Endoscopic reprocessing requires the application of appropriate reprocessing procedures at every stage, including cleaning, disinfection, storage, and documentation for traceability, as regulated by standards.13-16 

Flexible endoscopy encompasses a large variety of heat sensitive, complex and intensively used medical devices with high risk for patients. 

Optimizing the reprocessing of flexible endoscopes presents various challenges. To address these, it is important to enhance the expertise of professionals, improve endoscopic reprocessing units, reconsider the classification of flexible endoscopes within the Spaulding system, and consider implementing sterilization.17-21 

In this new webinar series, Shine on Flexible Endoscope Reprocessing, we are proud to announce: 

Webinar#1 – What’s New on Flexible Endoscopes Reprocessing Guidelines?

Webinar#2 – Endoscope processing effectiveness: A reality check and call to action!

Webinar#3 – Flexible Endoscope Decontamination: The challenge of biofilm 

Webinar#4 – Improving Flexible Endoscope Reprocessing: the importance of dry storage. 

Webinar#5 – Reprocessing Flexible Endoscopes: towards sterilization 

Webinar#6 – Round table– Shine on Flexible Endoscope Reprocessing

As with previous editions, each webinar will feature a keynote speaker and include opportunities for interaction to address any questions.  

We invite you to join us on this journey through the lifecycle of endoscopic reprocessing.  

Shine on endoscopic reprocessing! 

 Carlos Palos, MD 

Consultant in Internal Medicine. Specialist in Intensive Care Medicine. Certified in Infection Prevention and Rational Use of Antimicrobials by the Portuguese Medical Association. Fellow of the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). 

Scientific Director of the ASP SUMMIT 2025 SERIES – Shine on Flexible Endoscope Reprocessing

References :

  1. Jensen DM, Machicado GA. The advantages and disadvantages of endoscopy. Gastrointest Endosc. 2003;57(6):S3-S6. Available at: https://www.sciencedirect.com/science/article/pii/S1096286703000719 
  2. Bisschops R, East JE, Hassan C, et al. Endoscopy Around the World: Perspectives. Gastrointest Endosc. 1998;48(6):S1-S10 
  3. European Society of Gastrointestinal Endoscopy. Role of gastrointestinal endoscopy in the screening of digestive tract cancers. Endoscopy. 2020;52(3):217-225. Available at: https://www.esge.com/assets/downloads/pdfs/guidelines/2020_a_1104_5245.pdf 
  4. Grand View Research. Endoscopy Procedures Estimates Market Size Report, 2030. Published 2024. Accessed April 7, 2025. https://www.grandviewresearch.com/industry-analysis/endoscopy-procedures-estimates-market-report. 
  5. Hearnshaw SA, Rutter MD, Bevan P, et al. Infection after endoscopic procedures: A large population-based study. Gastroenterology. 2019;157(3):684-693. doi:10.1053/j.gastro.2019.06.053. 
  6. Sethi S, Kassem E, El-Serag H. Gastrointestinal endoscopy and risk of infection. Clin Gastroenterol Hepatol. 2021;19(8):1562-1574.e1. doi:10.1016/j.cgh.2020.09.038. 
  7. Spach, D. H., Silverstein, F. E., & Stamm, W. E. (1993). Transmission of infection by gastrointestinal endoscopy and bronchoscopy. Annals of internal medicine, 118(2), 117–128. https://doi.org/10.7326/0003-4819-118-2-199301150-00008  
  8. Ofstead CL, Dirlam Langlay AM, Mueller NJ, Tosh PK, Wetzler HP. Re-evaluating endoscopy-associated infection risk estimates and their implications. Am J Infect Control. 2013;41(8):734-736. doi:10.1016/j.ajic.2012.10.008 
  9. Epstein, L., Hunter, J. C., Arwady, M. A., Tsai, V., Stein, L., Gribogiannis, M., Frias, M., Guh, A. Y., Laufer, A. S., Black, S., Pacilli, M., Moulton-Meissner, H., Rasheed, J. K., Avillan, J. J., Kitchel, B., Limbago, B. M., MacCannell, D., Lonsway, D., Noble-Wang, J., Conway, J., … Kallen, A. J. (2014). New Delhi metallo-β-lactamase-producing carbapenem-resistant Escherichia coli associated with exposure to duodenoscopes. JAMA, 312(14), 1447–1455. https://doi.org/10.1001/jama.2014.12720 
  10. Larsen, S., Russell, R. V., Ockert, L. K., Spanos, S., Travis, H. S., Ehlers, L. H., & Mærkedahl, A. (2020). Rate and impact of duodenoscope contamination: A systematic review and meta-analysis. EClinicalMedicine, 25, 100451. https://doi.org/10.1016/j.eclinm.2020.100451  
  11. Alfa MJ, Sewell DL, Olson N, et al. The role of biofilms in reprocessing medical devices. Am J Infect Control. 2013;41(5):S76-S80. doi:10.1016/j.ajic.2013.01.001 
  12. Zong Z, Li M, Li J, et al. A study of the efficacy of bacterial biofilm cleanout methods for endoscope reprocessing. J Clin Microbiol. 2010;48(6):1898-1903. doi:10.1128/JCM.06221-11. ​ASM Journals+2PMC+2giejournal.org+2 
  13. Alfa MJ, Singh H. Impact of wet storage and other factors on biofilm formation and contamination of patient-ready endoscopes: a narrative review. Gastrointest Endosc. 2020;91(2):236-247. doi:10.1016/j.gie.2019.08.043. 
  14. Association for the Advancement of Medical Instrumentation. ANSI/AAMI ST91:2021. Flexible and semi-rigid endoscope processing in health care facilities. Arlington, VA: Association for the Advancement of Medical Instrumentation; 2021. 
  15. Day LW, Muthusamy VR, Collins J, et al. Multisociety guideline on reprocessing flexible GI endoscopes and accessories [published correction appears in Gastrointest Endosc. 2021 Nov;94(5):1019. doi: 10.1016/j.gie.2021.09.026.]. Gastrointest Endosc. 2021;93(1):11-33.e6. doi:10.1016/j.gie.2020.09.048 
  16. Beilenhoff U, Biering H, Blum R, et al. Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA) – Update 2018. Endoscopy. 2018;50(12):1201-1219. 
  17. Ofstead CL, Hopkins KM, Buro BL, Eiland JE, Wetzler HP. Challenges in achieving effective high-level disinfection in endoscope reprocessing. Am J Infect Control. 2020;48(3):309-315. doi:10.1016/j.ajic.2019.09.013 
  18. Varghese MM, Memic S, Torres-Teran MM, Cadnum JL, Rutala WA, Donskey CJ. Evaluation of a new technology for terminal sterilization of flexible endoscopes using hydrogen peroxide gas plasma. Infect Control Hosp Epidemiol. Published online January 27, 2025. doi:10.1017/ice.2024.236 
  19. Patel A, Jain N. Flexible Endoscopes: Terminal Sterilization and Impact to Patient Safety. Biomed Instrum Technol. 2020;54(s1):80-83. doi:10.2345/0899-8205-54.s3.80 
  20. Omidbakhsh N, Manohar S, Vu R, Nowruzi K. Flexible gastrointestinal endoscope processing challenges, current issues and future perspectives. J Hosp Infect. 2021;110:133-138. doi:10.1016/j.jhin.2021.01.021 
  21. World Federation for Hospital Sterilization Sciences: WFHSS Guidelines (Chapter 9) – Flexible Endoscopy Reprocessing Principles – https://guidelines.wfhss.com/frontpage/flexible-endoscopy/, accessed on 8/4/2025