SpyGlass application for duodenoscope working channel inspection: Impact on the microbiological surveillance

Figure 1 A scheme depicting the working channel of a duodenoscope. Insertion tube (130 cm) starting from the biopsy channel opening at the proximal part (A) and bending section (10 cm) proximal to the elevator mechanism (B).

Figure 2 Abnormal visual inspection findings (orange arrow) inside the working channels, including scratches (A and B), scratch with an adherent peel (B), buckling (C), stains (A and B), dark-colored debris (D), light-colored debris (E), other debris (F), clear fluid (F and G), and opaque fluid (H).

Figure 3 Comparison of visual inspection findings between > 12-mo-old and ≤ 12mo-old duodenoscopes. ^aIndicates statistically significant difference.

Figure 4 Scratches, buckling, and stains (orange arrow) appeared at the same location inside the working channel during the follow-up inspections (B-D). Buckling and stains progressively increased in length and width (A-D). A scratch (D) was found. Debris (E and F) and clear fluid (E-H) disappeared after one or more cycles of reprocessing.

Figure 5 Comparison of visual inspection findings between the bending section and insertion tube. ^aIndicates statistically significant difference.