Sustainability and disposable duodenoscope’s – is “green endoscopy” achievable? First results from a prospective national recycling project

Aims 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. We evaluated the recycling process of single-use duodenoscope (aScopeDuodeno; Ambu A/S, Denmark) in routine clinical practice

Methods Single-use duodenoscopes were pre-cleaned and disinfected before stored and transferred to the recycling facility. 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. The main outcomes of this pilot project are the overall percentage of recyclable materials and the reduction of CO2-footprint.

Results 52 scopes were recycled and analyzed. The overall weight of an aScope Duodeno is 665gr, there of plastics 75,5%=507,92gr, metals 22,8%=153,18gr, rubber 0,6%=4,14gr and others 0,2%=0,00gr. 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 1.467gr per scope and 2207kg per tons.

Conclusions 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 aScopeDuodeno will be recyclable.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
14 April 2023