Shine on Flexible Endoscope Reprocessing

With approximately 200 million endoscopic procedures performed worldwide each year, flexible endoscopes are among the most complex reusable medical devices in healthcare — and among the most challenging to reprocess safely.

Endoscope-transmitted infections (ETIs), though underreported, can range from mild illness to life-threatening sepsis, prolonged hospitalisation, increased morbidity and mortality, and substantial healthcare costs. Outbreaks linked to contaminated endoscopes can trigger regulatory scrutiny, legal liability, and reputational damage.

Real-world evidence — from outbreak investigations, regulatory inspection reports, and peer-reviewed studies — consistently shows that high-level disinfection (HLD) alone may not eliminate microbial contamination. Persistent gaps in cleaning, drying, surveillance, and staff competency continue to put patients at risk despite apparent guideline adherence.

Shine On Flexible Endoscope Reprocessing is the ASP Summit Continuous Education eBook consolidating insights from five world-class expert-led webinars. It covers the full reprocessing lifecycle: from updated international guidelines and enhanced cleaning protocols, to the challenge of biofilms, validated drying methods, AI-assisted inspection, and the evidence for sterilization as the standard of care.

Access the eBook for these essential learnings

1. What’s new in flexible endoscope reprocessing guidelines Explore the latest updates from AAMI ST91:2021, ESGE/ESGENA, AS 5369:2023, and GENCA 2025 on pre-cleaning at point of use, drying standards, microbiological surveillance, staff competency requirements, and scope traceability. Practical guidance designed for CSSD professionals, endoscopy nurses, infection preventionists, and healthcare managers.
2. Endoscope processing effectiveness: a reality check and call to action Understand why reprocessing failures persist despite apparent guideline adherence — drawing on real-world outbreak data, CMS inspection reports, and peer-reviewed studies documenting deficiencies across pre-treatment, manual cleaning, HLD, and drying. Learn why negative surveillance cultures alone are dangerously misleading, and what a safety-first approach demands from clinical teams and healthcare leaders.
3. Flexible endoscope decontamination: the challenge of biofilms Learn how biofilm formation within endoscope channels resists HLD, harbours microbial loads exceeding 10⁸ CFU per device, and persists despite brushing and manual cleaning. Understand the five stages of the biofilm lifecycle, the limitations of current water surveillance methods, and which enhanced decontamination strategies can meaningfully reduce patient infection risk.
4. The importance of drying and a role for AI Discover why inadequate drying is a leading — and frequently underestimated — driver of ETIs, with residual fluid detected in up to 95% of GI scopes after standard reprocessing. Compare air drying, manual compressed-air, and automated drying cabinet approaches; review why high-concentration alcohol flush may hinder drying; and explore how AI-assisted borescope inspection offers a promising, scalable solution for detecting working-channel damage at scale.
5. Why accept imperfection when utopia is possible? Examine the full decontamination life cycle — from enhanced manual cleaning, semi-automated pre-cleaning technologies, and validated drying to controlled-environment storage — and the compelling case for reclassifying flexible endoscopes as “critical” devices. Explore the evidence for vaporised hydrogen peroxide (VHP) plasma sterilization as the highest-assurance standard of care for high-risk procedures, including ERCP.