At first impression, the idea of using a surgical instrument to inspect surgical instruments might sound silly. After all, aren’t there better tools for maintaining endoscopes and lumened instruments than…other scopes? Well, perhaps not. That’s at least according to a team of researchers who recently determined that borescopes are well-suited to visually inspect the tubes that transport liquids or gasses during a medical procedure.
To be clear, the use of borescopes to inspect the nooks and crannies of devices like endoscopes is nothing new. After all, what tool would be better suited to inspect the narrow channels of an endoscope – a kind of borescope specialized for inspecting the insides of a patient – than the kind designed for getting a camera into a tight space? However, the study, titled “Beyond Endoscopes: Pilot Study of Surgical Instrument Lumen Inspection,” aims to address a noted lack in information about using borescopes to inspect lumened instruments other than endoscopes, ensuring they’ve been properly cleaned and maintained before being sterilized for patient use. A lumen is a cavity or channel within a tubular device specifically designed to transport liquids, gasses, or even small surgical implants into a patient’s body.
“Our goal with this research was really to explore if borescope inspections can bring the same kind of value to inspection of surgical instrument lumen as they have with inspecting endoscope channels,” said Krystina Hopkins, research manager at Ofstead & Associates, who helped lead the study.
She emphasized the importance of examining whether borescope inspections could provide beneficial information for reprocessing professionals. Borescope inspections were systematically conducted on arthroscopic shaver handpieces and suction tubes that are regularly cleaned and sterilized.
Results from the study revealed unexpected complexity within instrument lumens, including common architectural features in devices that can lead to debris accumulation. Despite efforts to clean the instruments thoroughly, debris remained persistent in some devices, leading to the replacement of those instruments. This underscores the challenges in cleaning instrument lumens and highlights the need for improved inspection and maintenance protocols, the authors noted.
Hopkins emphasized the importance of having a comprehensive plan in place to address findings from inspections, as unexpected issues are likely to arise. She also highlighted the need for industry-wide standards and guidelines to guide frontline personnel in conducting effective inspections and responding to findings.
Looking ahead, Hopkins mentioned plans for the “Lumens 2.0” study to expand on their findings and encouraged further research in the field. She emphasized the role of standards organizations like AAMI in developing guidance that can supplement current manufacturer instructions, ultimately enhancing patient safety and instrument reliability.
The study, launched by Cori L. Ofstead, MSPH, president and CEO of Ofstead & Associates, marks a significant step toward improving the quality and safety of surgical instrument processing through innovative inspection techniques and collaborative industry efforts.
