Introduction:
Single-use devices and equipment have been widely adopted in flexible endoscopy and currently almost all reusable accessories are abandoned due to hygiene, medico-legal and economic reasons. During the last 10 years also single-use endoscopes were deployed in the clinical routine, mainly in bronchoscopy and recently for duodenoscopy (ERCP) and gastroscopy to eliminate the risk of cross-contamination. A complete recycling of these scopes can reduce the ecological burden and may lead to a greener endoscopy. We evaluated the recycling process of single-use duodenoscope (aScope™Duodeno; Ambu A/S, Denmark) in routine clinical practice.
Methods:
After routine clinical use the single-use duodenoscopes were pre-cleaned and disinfected according to protocol before stored and transferred to the recycling facility. As the scopes do not penetrate the mucosa, they were not classified as biohazardous. In the recycling facility they are shredded and steam sterilized. Afterwards the materials are sorted and processed properly. Up to 9 different raw materials can be obtained due to the special processing technology. For the analysis of the recyclable materials of the aScope™Duodeno, samples were sent to the German inspection company DEKRA. The main outcomes of this pilot projectare the overall percentage of recyclable materials and the reduction of CO2-footprint compared to incineration for each scope.
Results:
92 scopes were recycled and analyzed. The overall weight of an aScope™Duodeno is 665gr, there of plastics 75,5%=507,92 gr, metals 22,8%=153,18 gr, rubber 0,6%=4,14gr and others 0,2%=0,00 gr. According to a current interim analysis the overall recyclability of the scope is overall >61% and the amount of CO₂ savings of the recycling compared to incineration is 1.467 gr per scope and 2207 kg per tons.
Conclusion:
This is the first study reporting results of the recyclability of disposable endoscopes. Although it is technically demanding our results are quite promising. After the final material analysis, we expect that over 80% by weight of the aScope™Duodeno will be recyclable and the raw materials obtained could be led back in the ecologic and economic circle with continual re-use of finite resources while limiting relevant inputs and outputs.

Fabian Straulino

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