Clin Endosc.  2021 Mar;54(2):236-241. 10.5946/ce.2020.062.

Effectiveness of Solution with 5% Detergent for Cleaning Transnasal Esophagogastroduodenoscopy Lens

• Komazawa Y
• Yuki M
• Fukuba N
• Kobayashi Y
• Ishitobi H
• Nakashima S
• Nagaoka M
• Takahashi Y
• Shizuku T

• KMID: 2514178
• DOI: http://doi.org/10.5946/ce.2020.062

Abstract

Background/Aims
Unsedated transnasal esophagogastroduodenoscopy (EGD) is affected by a poor scope lens-cleaning function. We have previously reported good, albeit limited, effects of an oolong tea washing solution; here, we evaluated the effectiveness of a 5% lens cleaning solution for cleaning an EGD lens.
Methods
Five percent lens cleaning solution (C), 5% dimethicone solution (D), and distilled water (W) were prepared. Study I: Lenses were soiled with pork grease, washed with each washing solution, and their image quality was judged. Study II: Patients (n=996) scheduled for transnasal EGD were randomly assigned to the C- or W-group. Lens cleanliness level, washing solution volume used, and endoscopist stress due to lens contamination were determined.
Results
Study I: The image quality of the lenses washed with (C) was significantly superior. (D) was clinically unsuitable because of spray nozzle clogging. Study II: Lens cleaning in the C-group was significantly superior (p<0.0001) and the solution volume required was significantly reduced (p<0.0001), while endoscopist stress was also lower (p<0.0001).
Conclusions
For transnasal small-caliber EGD, the present 5% lens cleaning solution provided good visibility. It features a high detergency level and is simple to formulate for therapeutic endoscopy applications, such as endoscopic submucosal dissection.

Keyword

Lens cleaner; Small-caliber endoscope; Transnasal esophagogastroduodenoscopy; Visual quality

Figure

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  Fig. 1. Photographic images of two different test charts observed through the lens of a (GIF-XP 260N; Olympus, Tokyo, Japan) endoscope soiled by pork grease and then subjected to cleaning. (A) Level 5 cleanliness. (B) Level 3 cleanliness. (C) Level 1 cleanliness.

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  Fig. 2. The effect of various cleaning solutions on pork grease-soiled lens. The effect of the 5% Cleash solution (C) was consistently superior to that of the 5% dimethicone solution (D) and distilled water (W). Furthermore, visual quality remained high with (C) even with repeated soiling and cleaning procedures.

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  Fig. 3. Solution volume used for lens cleaning during esophagogastroduodenoscopy procedures. The one used in the C-group was significantly smaller as compared to the W-group (p<0.05).

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  Fig. 4. Endoscopist stress level due to lens soiling during esophagogastroduodenoscopy procedures. The stress level from the C-group was lower compared to the W-group.

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  Fig. 5. The level of lens cleanliness during esophagogastroduodenoscopy. The level found in the C-group was significantly higher compared to the W-group.

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