Flexible Endoscope Reprocessing: The Full Cycle, Step by Step

What endoscope reprocessing is

People who ask what is endoscope reprocessing usually mean the whole cycle that returns a used scope to a state safe for the next patient. Flexible endoscopes touch mucous membranes, so they are generally treated as semi-critical devices needing at least high-level disinfection, a classification discussed in the Spaulding classification.

Reprocessing is done by trained staff in a dedicated area with a clear flow from dirty to clean. Each scope model has its own instructions for use (IFU), which override any generic checklist.

Bedside pre-cleaning and transport

Pre-cleaning starts immediately after the procedure, before soil dries. The usual sequence is:

• Wipe the insertion tube with a cloth moistened in detergent solution
• Suction detergent solution through the suction channel, then flush air and water channels, as the IFU allows
• Detach the scope from the light source and processor, fit protective caps where required
• Transport it in a closed, labelled container to the reprocessing room, without delay

Leak test and manual cleaning

A leak test checks that the outer sheath and internal channels are intact before the scope is immersed. A scope that fails must be taken out of service, because fluid entering the scope causes costly damage and cross-contamination.

Manual cleaning follows: remove valves and caps, immerse the scope in fresh detergent, brush all accessible channels with the correct size of brush until no visible soil remains, clean the ports and the distal end, and flush all channels. Use only single-use or properly reprocessed brushes and discard the detergent after each scope.

Channel brushes must match the channel diameter stated in the IFU; a brush that is too small leaves a film on the wall, and one that is too large can damage the lining. Inspect the brush after use for bristle loss.

High-level disinfection, rinsing and drying

High-level disinfection (HLD) is performed either manually in a basin or in an automated endoscope reprocessor (AER). The scope is fully immersed in an approved disinfectant at the contact time and temperature on the label, with all channels filled. See automated endoscope reprocessors for what an AER adds.

After HLD, rinse thoroughly with water of suitable quality, usually filtered or sterile as local guidelines require, and then dry with filtered air and an alcohol flush where permitted. Drying and storage are covered in detail in flexible endoscope storage.

Records, quality and common mistakes

Record the scope serial number, the operator, the machine or disinfectant batch, the leak test result and the time of each cycle, so that you can trace every patient use. Monitor disinfectant concentration according to the manufacturer's test strips, and audit the process regularly.

Typical failures include delayed pre-cleaning, wrong brush sizes, reuse of detergent, short contact time, poor rinsing and wet storage. Training and competency checks for staff reduce these. Remember that rules for single-use components, water quality and monitoring vary between guidelines such as those issued by ESGE-ESGENA, AORN and national health authorities, so confirm which applies to your facility and the UAE health authorities that license it.

Competency matters as much as equipment. Staff should be trained, assessed before working unsupervised, and reassessed regularly, with records kept.

Next step

Beckfinity can advise on reprocessing and sterilisation equipment for UAE hospitals. See the sterilization range or contact our specialists to plan a reprocessing area that matches your scope volume.