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Clin Endosc : Clinical Endoscopy



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Original Article
Costs involved in compliance with new endoscope reprocessing guidelines
David Hoffman, Christina Cool
Received June 28, 2023  Accepted September 21, 2023  Published online January 26, 2024  
DOI:    [Epub ahead of print]
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
/Aims: In March 2022, the Association for the Advancement of Medical Instrumentation (AAMI) released the American National Standards Institute (ANSI)/AAMI ST91:2021, their latest update on comprehensive, flexible, and semirigid endoscope reprocessing. These updated standards recommend the sterilization of high-risk endoscopes when possible and provide new recommendations for the precleaning, leak testing, manual cleaning, visual inspection, automated reprocessing, drying, storage, and transport of endoscopes.
ANSI/AAMI ST91:2021 was compared with ANSI/AAMI ST91:2015 for major reprocessing differences that result in either time and/or cost increases. Time estimates were captured by explicit recommendation inclusion or taken from the literature. All the costs were estimated using publicly available resources.
The updated standards represent a potential 24.3-minute and 52.35 to 67.57 United States dollars increase per procedure in terms of reprocessing time and spending, respectively, not including capital investments. Capital costs per procedure were highly dependent on the procedure volume of the facility.
The new AAMI standards recommend several major changes, such as sterilization, for facilities to reprocess and manage endoscopes between uses. As more facilities increase their reprocessing methods to reflect the updated standards, they do so at a cost and introduce several delays. As the reprocessing landscape evolves, facilities should consider their true costs and alternative solutions, such as single-use endoscopes.
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Endoscopic Instruments and Electrosurgical Unit for Colonoscopic Polypectomy
Hong Jun Park
Clin Endosc 2016;49(4):350-354.   Published online July 11, 2016
AbstractAbstract PDFPubReaderePub
Colorectal polypectomy is an effective method for prevention of colorectal cancer. Many endoscopic instruments have been used for colorectal polypectomy, such as snares, forceps, endoscopic clips, a Coagrasper, retrieval net, injector, and electrosurgery generator unit (ESU). Understanding the characteristics of endoscopic instruments and their proper use according to morphology and size of the colorectal polyp will enable endoscopists to perform effective polypectomy. I reviewed the characteristics of endoscopic instruments for colorectal polypectomy and their appropriate use, as well as the basic principles and settings of the ESU.


Citations to this article as recorded by  
  • Expert consensus on the clinical application of high‐frequency electrosurgery in digestive endoscopy (2020, Shanghai)
    Yu Bai, Fan Yang, Cui Liu, De Feng Li, Shi Wang, Rong Lin, Zhen Ding, Wen Bo Meng, Zhao Shen Li, En Qiang Linghu
    Journal of Digestive Diseases.2022; 23(1): 2.     CrossRef
  • Thermic Epidermic Tissue Surgical Generator Using Bipolar Electrode
    Dhanalakshmi K.S, Azhagu Jaisudhan Pazhani A, Anusha Padmavathy R
    Innovations in Information and Communication Technology Series.2021; : 68.     CrossRef
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Original Article
Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video)
Chang-Il Kwon, Gwangil Kim, Il-Kwun Chung, Won Hee Kim, Kwang Hyun Ko, Sung Pyo Hong, Seok Jeong, Don Haeng Lee
Clin Endosc 2014;47(6):544-554.   Published online November 30, 2014
AbstractAbstract PDFSupplementary MaterialPubReaderePub

In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives.


This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed.


A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm2/sec vs. 1.57 mm2/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities.


ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.


Citations to this article as recorded by  
  • Comparison of synchronous dual wavelength diode laser versus conventional endo-knives for esophageal endoscopic submucosal dissection: an animal study
    Jian Tang, Shufang Ye, Xueliang Ji, Jun Li, Feng Liu
    Surgical Endoscopy.2018; 32(12): 5037.     CrossRef
  • Technological review on endoscopic submucosal dissection: available equipment, recent developments and emerging techniques
    Georgios Mavrogenis, Juergen Hochberger, Pierre Deprez, Morteza Shafazand, Dimitri Coumaros, Katsumi Yamamoto
    Scandinavian Journal of Gastroenterology.2017; 52(4): 486.     CrossRef
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  • 3 Web of Science
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