In vitro evaluation of wire integrity and ability to reprocess single-use sphincterotomes.

BACKGROUND: Sphincterotomes are currently marketed as one-time-use items and constitute considerable cumulative expense in a busy endoscopy unit. It is uncertain whether these accessories can be safely reprocessed without loss of form and function. METHODS: We studied disposable sphincterotomes (five 5F, five 6F) in vitro as to their durability, electrical integrity, and ability to be adequately cleaned both manually and with ethylene oxide after contamination with 10(5) to 10(6) Mycobacterium chelonei. RESULTS: Seven of the 10 sphincterotomes withstood the rigors of reuse; three 6F sphincterotomes developed wire fracture between four and eight uses. Electrical integrity, as measured by an electrosurgical analyzer, remained intact up to time of breakage in all sphincterotomes. Manual cleaning followed by glutaraldehyde soak resulted in residual mycobacterial colonies in five 6F sphincterotomes and a single 5F sphincterotome. No instrument had residual organisms cultured following manual cleaning and ethylene oxide sterilization. CONCLUSIONS: The authors conclude that one-time-use sphincterotomes have the potential for safe reuse.

Disposable versus reusable biopsy forceps: a prospective evaluation of costs.

BACKGROUND: Disposable biopsy forceps have been heavily marketed as cost-effective, convenient, and safer to use than conventional forceps. METHODS: In an attempt to define whether disposable or reusable biopsy forceps were cheaper to use, we prospectively evaluated the purchase price, number of uses, repair record, and cleaning costs of all reusable biopsy forceps used in the outpatient endoscopy unit of a large multispecialty clinic. RESULTS: Over a 12-month period, 1581 biopsy sessions were undertaken. Seventeen of 119 forceps required $1890 in repairs over the study period (an average of $1.20 per biopsy session). Cleaning costs, including technician processing and steam autoclave, approximated $3.46 per use, increasing to $5.61 per use if glutaraldehyde soak was substituted for steam autoclave. CONCLUSIONS: Assuming a sixfold difference in purchase price between reusable and disposable forceps, and a per-use repair and cleaning cost of $1.20 and $3.46, respectively, reusable biopsy forceps became cost-effective after seven uses in our institution.

Reusable biopsy forceps: a cost-effective measure for the endoscopy suite.

Some healthcare practitioners have recommended the use of disposable medical accessories as standard practice. Advantages of using disposable medical equipment include the potential for infection prevention, convenience, and decreased reprocessing and storage costs. Disadvantages of reusable accessories include the initial cost, "down time" required for repair and, most importantly, the potential for spreading infection. In this study, the investigators provide a cost analysis of reusable biopsy forceps for a 12-month period from April 1993 through March 1994. This prospective, descriptive study evaluated purchase price, number of uses, repair history, and cleaning costs for reusable biopsy forceps used in the endoscopy unit of a large multi-specialty clinic. Results of the study revealed that the reusable biopsy forceps became cost-effective after seven uses.