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Flexible Bronchoscope and Disposable-Sheath Endoscope System: Technological Evaluation

Colt, H.G., Beamis, J.J., Harrell, J.H., & Mathur, P.M. (2000). Chest, 118, 183-7.

The goal of this prospective, multicenter, clinical study by Colt et al was to assess the image clarity, ease of use, and handling performance of an early-generation flexible fiberoptic bronchoscope (B-F 100, Vision Sciences, Natick, MA) with a sterile, single-use, disposable sheath containing a working channel (BS-F21 EndoSheath® Technology, Vision Sciences). The investigation was conducted in three tertiary care referral centers and enrolled 24 patients who underwent bronchoscopy using either a transnasal or transoral approach.

After each examination, the endoscopist used a 5-point scale (with 5 indicating excellent and 1 poor) to evaluate the following 12 aspects of the performance of the bronchoscope system: image clarity, fiberoptic-to-video conversion clarity, illumination, fogging, handling comfort, distal tip angulation, insertion tube handling, ease of passage and patient tolerance, suction valve performance, suction volume, accessory passage, and fluid injection and removal.

For each of the 12 variables assessed, the mean score was at least 3.5. The highest scores were for image clarity and illumination (mean values, 4.5 and 4.63, respectively). Handling comfort was average, a finding that the researchers considered due to the unfamiliar feel of the B-F 100 bronchoscope compared with other bronchoscopes. 

Colt et al noted that their study was a preliminary technological evaluation of a new system that requires more fine tuning. They concluded, however, that their results convincingly demonstrated the effectiveness of the system and cited several possible specific advantages of the single-use EndoSheath® Technology. These benefits are faster endoscope turnaround times; the opportunity to use one endoscope more often and perhaps avoid the need to purchase additional instruments; and an increase in the availability of bronchoscopy in settings in which sophisticated disinfection or sterilization equipment is not readily available, such as primary care clinics, mobile screening programs, and intensive care units.

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