Environmental and health outcomes of single-use versus reusable duodenoscopes

Post written by Lyndon V. Hernandez, MD, MPH, from GI Associates and the Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.


Concern about serious duodenoscope-related infection from multidrug-resistant organisms has facilitated single-use duodenoscopes (SDs) to permeate the market, promising a safer alternative to reusable duodenoscopes (RDs) by virtually eliminating this risk.

Using mathematical modeling, we compared the carbon footprint (main outcome) and impact on human health (secondary outcome) of SDs versus RDs.

We saw the general direction of the medical device industry veering toward SDs and asked, “What are the unintended consequences of disposable scopes to the environment and, ultimately, to public health?”

In our preliminary analysis, we found that using an SD releases CO2 into the environment that is 24 to 47 times greater than using an RD or an RD with disposable endcaps.

Although SDs may provide incremental public health benefit compared with RDs, it comes at a substantially higher cost to the environment. As the infection rate continues to decrease from more regimented cleaning protocols and enhanced designs such as disposable endcaps to facilitate cleaning, the negative impact to human health from contaminated RDs could be comparable with SDs.

In conclusion, although we traditionally aim for improving our individual patients’ health outcomes, we hope our study can broaden our perspective by also considering how endoscopic care affects the environment and public health.

Hernandez_figureGraphical Abstract

Read the full article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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