A comparison of single-use bronchoscopes & reusable bronchoscopes for interventional pulmonology applications

J. Kurman*^a (Dr), B. Benn^a (Dr), S. Islam^b (Dr)

^a Medical College of Wisconsin, Milwaukee, UNITED STATES ; ^b Medical College of Georgia, Augusta, UNITED STATES

* jkurman@mcw.edu

Background

Single-use flexible bronchoscopes (SUFB) have existed for a number of years but have generally been considered to be inferior to reusable flexible bronchoscopes (RFB). As such, SUFB have largely been relegated to use in the intensive care and operating room for simpler procedures, such as airway inspection and bronchoalveolar lavage. Interventional pulmonologists have long preferred RFB given their superior operating characteristics. Recently, there has been a proliferation of new SUFB from several different manufacturers who suggest this latest generation is suitable for use during interventional pulmonology procedures.

Methods

Two sizes of SUFB from four different manufacturers were compared to their RFB counterparts using a cadaver model. Categories assessed included bending capability, scope rigidity, maneuverability, handling, optics, channel shape & size, and suction. All tests were performed by board certified interventional pulmonologists.

Results

Most of the SUFB had equivalent or superior flexion and extension compared to the RFB, even with relatively stiff instruments present in the working channel. Instruments included large forceps, loaded valve deployment catheters, various stents, biopsy needles, and dilation balloons. Many of the SUFB were able to cannulate the upper lobe apical segmental airway bilaterally, which was used to assess scope rigidity, maneuverability, and handling. Optics, as assessed by depth of field and field of view, were equivalent between the RFB and one brand of SUFB. The other SUFB were inferior in this category. Channel shape was circular for all but one brand of SUFB. Suction ability varied among the scopes but was generally within several seconds of each other.

Conclusion

The latest generation of SUFB are a significant advancement over their predecessors. Many of their attributes are comparable to or even superior to RFB. SUFB may represent a viable alternative to RFB for interventional pulmonology procedures in the bronchoscopy suite, operating room, and intensive care unit.

Disclosure of funding source(s): none