OAK BROOK, Ill., Dec. 6 /PRNewswire/ -- Being able to examine internal organs through the use of endoscopy has been a major advance in the prevention, detection and treatment of gastrointestinal diseases and disorders, such as ulcers, cancer, and internal bleeding. More than 10 million gastrointestinal (GI) endoscopic procedures are performed annually in the United States to examine the digestive tract, including the esophagus, stomach, small intestines, colon and rectum.
Specially trained physicians use an endoscope to perform endoscopic procedures. The endoscope is a thin, flexible tube that is passed into the digestive tract to provide the physician with a close-up video image of the patient’s digestive system. It has cables for control and channels that permit the passage of devices to sample tissues, stop bleeding, or remove polyps. Like many hi-tech medical instruments, the endoscope is not a disposable device, but is re-used after rigorous cleaning and disinfection.
“Although there is the possibility of transmission of infection with endoscopy, my research suggests that the risk is extremely remote,” stated Douglas B. Nelson, MD, Associate Professor of Medicine at the University of Minnesota Medical School, Minneapolis, a staff physician in gastroenterology at the Minneapolis Veterans Administration Medical Center. “The procedure has a remarkable safety record,” Dr. Nelson said.
Based on medical literature, the Technology Committee of the American Society for Gastrointestinal Endoscopy (ASGE) estimates that the chance that a serious infection could be transmitted by endoscopy is only 1 in 1.8 million(1).
In the largest and most comprehensive review to date, covering all published medical reports between 1966 and 2002, 317 episodes of pathogen transmission were attributed to GI endoscopy. Only 35 of these cases have been reported in the last decade, although more than 10 million procedures are performed annually(2). When bacterial and viral transmissions have been reported, every such instance has resulted from failure to adhere to currently accepted guidelines. There are no reported cases of transmission of infection when these guidelines are followed.
“Patient safety is our number one concern before, during and after each procedure,” stated David J. Bjorkman, MD, MSPH, SM (Epid), and Dean of the University of Utah School of Medicine and President of the ASGE. “The professional training and diligence of the medical teams that perform multiple endoscopies each day are responsible for our sterling safety record. Patients should be reassured that every physician, nurse and technician on the team is trained in the proper use, cleaning and disinfecting procedures necessary to keep the flexible endoscopic instruments disinfected for repeated uses.”
Dr. Bjorkman explained that since ASGE physicians perform approximately 70% of the colonoscopies annually in the U.S., the Society has been a leader in making sure the guidelines for reprocessing the endoscopic instruments are continually reviewed, updated, and followed.
The last major review took place in 2002 at the Gastrointestinal Endoscopy Consensus Conference, sponsored by ASGE and the Society for Healthcare Epidemiology of America (SHEA), and the resulting guideline was endorsed by eight additional professional medical societies and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)(3).
The 34 points/recommendations in the guideline for reprocessing the endoscope address staff training, equipment testing, and thorough instrument cleaning and disinfecting procedures.
Since 1990, healthcare facilities and manufacturers are required to report to the Food and Drug Administration (FDA) any information that reasonably suggests that a device (such as an endoscope) has caused or contributed to a death, injury, or serious illness of a patient.
Any facility in which gastrointestinal endoscopy is performed must have an effective quality assurance program in place to ensure that endoscopes are reprocessed properly. Quality assurance programs for endoscopy must include the supervision, training, and annual competency review of all staff involved in the process, systems that assure availability of appropriate equipment and supplies at all times, and strict procedures for reporting possible problems. ASGE members and their staff adhere to the highest levels of compliance and regularly review and update training processes according to guidelines.
For more information on patient safety during endoscopy or guidelines for reprocessing flexible gastrointestinal endoscopes, please visit the ASGE website at http://www.askasge.org/ or call 1-866-305-ASGE.
The American Society for Gastrointestinal Endoscopy (ASGE), founded in 1941, is the preeminent professional organization dedicated to advancing the practice of Endoscopy. ASGE, with more than 7,500 physician members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education.
About ASGE: http://www.asge.org/ 630-573-0600 Patient Information: http://www.askasge.org/ 866-305-ASGE (1) Kimmey MB, Burnett DA, Carr-Locke DL, DiMarino AJ, Jensen DM, Katon R, et al. Transmission of Infection by gastrointestinal endoscopy. Gastrointest Endoc 1993; 36:885-8. (2) Nelson DB. Infectious disease complications of GI endoscopy: part II, exogenious infections. Gastrointest Endosc 2003; 57:695-711 (3) In addition to ASGE, SHEA, and JCAHO, this guideline is endorsed by the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA), the American Society of Colon and Rectal Surgeons (ASCRS), the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), the Society of Gastroenterological Nurses and Associates (SGNA), the Association of Perioperative Registered Nurses (AORN), the Association for Professionals in Infection Control (APIC), and the Federated Ambulatory Surgery Association (FASA).
American Society for Gastrointestinal Endoscopy
CONTACT: Robert J. Buzogany for American Society for GastrointestinalEndoscopy, +1-440-338-1023, or ASGEnews@msn.com