Harvey Buxbaum, president of HMB Endoscopy Products, recently participated in an EndoNurse Q&A about endoscopy repair. For more than 20 years, HMB Endoscopy Products has provided new and pre-owned endoscopy equipment, repairs and accessories. Buxbaum believes that flexible endoscopes are as difficult and precarious to maintain now as ever before, but that certain actions can prolong endoscope life significantly.

1. What is the most effective process for leak testing?

The biggest problem with leak testing is that few technicians take the time to do it properly or thoroughly. Leak testing should be done before and after the scope is reprocessed. A thorough leak test requires the scope to be pressurized and checked carefully for leaks.

Leaks can best be seen if the scope is submerged in water. However, this takes time and requires the technician to manipulate the scope to remove all the trapped air and then patiently wait to see if any air bubbles escape out of the scope.

The appearance of a stream of air bubbles, no matter how fast or slow, indicate that there is a problem with the scope and that the scope should be taken out of service and sent to a repair facility. In order to encourage leak testing, simpler devices have been introduced. One of them is a dry pressure tester that uses an air pump to pressurize the scope and a pressure gauge to monitor any escape of the air inside the scope. If the pressure in the gauge goes down, then there is a leak. This method, although not as accurate, is fast and can easily be done in 15 seconds, thus insuring that each scope gets leak tested before and after each procedure.

2. How often should endoscopes be checked for maintenance?

The first line of defense to protect any flexible endoscope is the leak test. In order to avoid extraordinarily expensive repairs, a scope that fails the leak test should immediately be taken out of service and repaired.

Most reputable repair companies will not only advise the scope owner of the immediate problem that caused the leak, but will also alert the person in charge of potential problems that should be addressed now or at some future time. I strongly recommend that the facility should heed this advice and do the recommended preventative maintenance to prevent future, potentially expensive, repairs.

If you are one of the lucky few that have not had a leak in a scope for a year, I recommend that each scope get sent back to your repair facility for preventative maintenance. This is like a “tune up” wherein the angulation can be adjusted and worn parts replaced. Service contracts need to be carefully analyzed because they can be unfair to both the endoscopy center and the service provider.

Most hospitals, outpatient centers and healthcare providers have set up protocols for the routine maintanence of endoscopy related products such as electrosurgical machines, processors, light sources and other electronic endoscopy related products. Other items, such as forceps, heater probes should be sent out for repair as needed.