Decontamination Requirements in the Netherlands ... - PolyDiagnost

Prof. Paul J van Diest 

Department of Pathology 

University Medical Center Utrecht 

November 18 – 19, 2009 

ARE THERE LIMITATIONS FOR THE USE OF 

MINI- AND MICROENDOSCOPES 

D UE TO D ECONTAMINATION REQUIREMENTS 

IN THE NETHERLANDS ? 

Hansgeorg Schaaf, Dipl.-Ing. 

President and Head of R & D 

POLYDIAGNOST GmbH 

www.polydiagnost.com POLYDIAGNOST GmbH GmbH

What can we find about this topic in the literature ? 


It looks terrible… 

Suction Channel Air / Water Channel 

Figure 1 Scanning electron micrographs of a suction 

channel showing surface defects such as cracks, grooves 

and pits. (a) A series of grooves approximately 20-mmlong 

that were possibly instrument induced. Biological soil is 

associated with the defects and is also attached to 

undamaged areas. (b) Higher magnification of one of the 

defect areas showing soil and various types of microorganisms, 

many surrounded by exopolysaccharides. Bars 

represent 20 mm (a) and 2 mm (b). [] 

[Journal of Hospital Infection (2004) 58, 224-229; A.Pajkos, K.Vickery, Y.Cossart] 

Figure 2 Scanning electron micrographs of two 

different air/water channels with biofilms. 

(a) Low-power view showing a confluent layer 

of soil and biofilm. 

(b) Multilayered biofilm consisting of 

healthy-looking cells surrounded and 

overlayed with amorphous-looking 

exopolysaccharides. 

Bars represent 200 mm (a) and 5 mm (b). [] 


„Cleaned“ working channel of GI-Endoscopes 

Controlled with a high-resolution 10,000 pixel optic 

(1.0mm Outer Diameter / POLYDIAGNOST) 

Joint study with Prof. Dr. Ingo Herrmann, Rom: 

The working channel surfaces of Gastroscopes, Duodenoscopes 

and Bronchoscopes 


„Cleaned“ working channel of Bronchoscopes 

Channel bifurcated 

and distal end 

of these endoscopes 


Micro-Endoscopes 

If endoscopes with huge working channel show these effects 

what can we expect from tiny, compact micro-endoscopes? 

POLYDIAGNOST SalivaScope, distal End 

Optic and Light integrated 

1.1mm Outer Diameter 

0.4mm Working Channel 

0.2mm Irrigation Channel 

POLYDIAGNOST SalivaScope 

With Working- and Irrigation Channel 

1.1mm Outer Diameter 

POLYDIAGNOST former Generation 


Micro-Endoscopes 

POLYDIAGNOST VitrOptik ® (Former Generation) 

Even if this endoscopes autoclavable, 

who can guaranty that the irrigation channel (0.2mm – 0.3mm) are really sterile? 

There is no possibility to clean them with a brush before sterilisation . 


• Cleaning: brushing / washing / rinsing: Who guarantees the elaborateness ? 

• Disinfection: for example Cydex 

• Liquid sterilisation / Plasma sterilisation: 

• peracetic acid (Steris ® ) 

• peroxide (Sterrad ® Johnson & Johnson) 

only allowed for inside diameter > 0.7mm / length < 500mm 

• ETO gas-sterilisation: 

• Autoclave: 

H O W C A N WE DECONTA MINAT E ? 

Drawback: not allowed for tiny working / irrigation channels 

Drawback: not available everywhere - time consuming 

Drawback: micro-endoscopes are damaged after 30 – 50 cycles 


S O L U T I O N : A M O D U L A R S Y S T E M 

C O N S I S T I N G O F : 

a) FRACTURE-PROOF OPTICAL SYSTEM 

with a plan and easily to clean surface and an optic which has 

no integrated channels 

b) STERILE DISPOSABLE ENDOSCOPIC CANNULAS 


The new modular „POLYDIAGNOST-Generation“: rigid Endoscopes 

Modular Cannula Optic with Protection Tube 

Washing of the Optic through the Protection Tube 

Optic Protection Tube with Irrigation Port 

Safe Keeping in Steri-Tray 


Repair 

6,000 Pixel, Outer Diameter: 0.5mm 



1. How can you damage this optic? 

It can become easily bended. 

2. If an endoscopic cannula 

will become kinked 

it doesn t matter – because it is 

a low cost sterile disposable cannula. 


Endoscopic Cannulas 

Outer Diameter: 2.0mm, Ports: 3 




Sterile Packed 


Very important Advantage: 

For one examination you do not need two or three different endoscopes, only by changing the endoscopic 

cannula you have the most cost-effective solution and you need only one optic for a complete examination. 

Optic 

0.55mm OD 

6,000 Pixel 

Endoscopic system with 1.1mm 

cannula 

Optic Body 

Shifter 

Endoscopic 

cannula:0.9mm 

Light Connector 

Endoscopic system with 1.1mm 

cannula ready for use 

Endoscopic system 

with 0.9mm cannula 

ready for use 

Irrigation 

Channel 

Working 

Channel 


Variability by Modularity 

One optic for: Saliva Channel, TMJ, Nose, Lacrimal Channel, Milk Duct and so on 

Long Shifter, short Cannula; e.g. Tear Channel 

Working Channel: Micro-Drill 

Short Shifter, long Cannula; e.g. Saliva Channel 

Working Channel: Laserfiber 

And all times the same Optic 


Modular Oculars 

There are different cannula optics available: 

3,000 Pixel 

6,000 Pixel 

10,000 Pixel 

30,000 Pixel 

Modular Zoom Ocular 

0.45 mm OD 

0.55 mm OD 

0.9 mm OD 

1.3 mm OD 

Important: 

Only 1 ocular is needed 

for different optical systems 

– Low Cost System – 

Modular Fix-Focus Ocular 

System ready for use 


Further modular Options 

Sharp endoscopic cannula for small joint Viewing Forceps (OD: 1.25mm) 

Ophthalmology 

Endo-Cyclo-Photocoagulation (including Diode-Laser) 


Accessories 

Introducer for Markers Marker: Rhombus Marker: Hook 

Biopsy Forceps Grasping Forceps 


Interdisciplinary Application 

The modular design with no decontamination issues advantages: 

a) Only 1 optic is needed during a „full-range examination“ by changing to 

different cannula diameters for required treatments 

b) Select the right „Pixel-Optic“ for the desired resolution 

c) This variability allowed interdisciplinary applications : 

• Saliva Channel 

• Lacrimal Duct / Vitrectomy 

• Milk Duct 

• Root-Canal 

• Small Joint (TMJ and so on) 


T H A N K Y O U V E R Y M U C H F O R 

Y O U R AT T E N T I O N 

POLYDIAGNOST GmbH 

The Art of Endoscopy® 

View Micro see Macro®

Decontamination Requirements in the Netherlands ... - PolyDiagnost

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