This article describes a retrospective study by Margery et al in which a flexible endoscope (BF100, Vision Sciences, Natick, MA) with channeled EndoSheath® Technology (BS-F21, Vision-Sciences) was used in 328 elective and emergency bronchoscopic procedures in France. Ninety-two of the patients in the series had a known or suspected infection (with multiresistant bacteria, tuberculosis, hepatitis B or C virus, or human immunodefi ciency virus) or were immunocompromised. The bronchoscope was introduced either nasally, orally, or through a tracheostomy or intubation probe. No data on post-procedure infections were collected because the endoscope and EndoSheath® Technology had already been approved by the US Food and Drug Administration.
Margery et al reported that maneuverability of the bronchoscopy system was initially problematic but that any difficulty had resolved by the time the operator had performed about 10 procedures. No adverse events occurred in the series other than poor visibility due to faulty assembly of the system in five early cases. The authors commented that it was noteworthy that no sheaths tore when inserted through a tracheostomy or intubation probe after lubrication with paraffin oil. They also noted that, in 1998, the cost of the sheaths was nearly twice that of disinfection (84 versus 46 euros), although they acknowledged that their study did not assess the cost of using EndoSheath® Technology in routine conditions.
Margery et al concluded that the bronchoscope/EndoSheath® Technology offers several advantages that can reduce its direct costs: the time otherwise required for disinfection and sterilization procedures is saved; the nursing team’s activity is optimized because the disinfection interval is obviated and training is limited to assembly and removal of the sheath; the nursing team is no longer exposed to noxious disinfectants; and the operating life of the endoscopic equipment is increased because of a reduction in the wear that results from repeated disinfection.