Sterilization of Equipment

A great deal of time and consideration is given to the process of sterilizing (reprocessing) our equipment between patients.  Despite the fact that the number of documented cases in the literature of disease transmission from endoscopy (scoping) is so low, of all elements required for accreditation by the College of Physicians & Surgeons of British Columbia, none is so actively discussed, examined and regulated as is the issue of equipment sterilization.  The Pezim Clinic has been carefully reviewed by the College, including on-site inspections.  The Clinic maintains state-of-the-art sterilizers for its metal surgical equipment (surgical operating instruments) and reprocessors for its flexible endoscopy equipment (colonoscopy, flexible sigmoidoscopy).

Wherever possible, disposable one-time-use-only equipment is used, even though much of the cost for such disposable equipment falls to the clinic and cannot be recovered.

In the case of metal equipment designed to be reused, the sterilization process includes programmed steam autoclaving with hard-copy documented time, temperature control and the use of biological indicators .  The very expensive and delicate flexible scopes used for colonoscopy and flexible sigmoidoscopy would be destroyed by steam autoclaving and so are reprocessed instead in a chemical bath within an industry-leading automated endoscope reprocessor purchased by the Clinic.  Sterilization quality-assurance processes include chemical and biological assessment of sterilization efficacy of each endoscope.  The records of all of these assessments become Clinic documents that are retained for years by the Clinic.

Reprocessing a flexible endoscope is a very labor-intensive and expensive proposition, even when utilizing automated reprocessors, and must be done with extreme care by people who are specially trained, experienced, and hold a specialized certificate in Medical Device Reprocessing.  Imagine having to completely sterilize the inside and outside of a $35,000 five foot long Nikon camera 6 to 8 times per day, without damaging it, and you will get some idea of what is involved.  Even slight errors in the process can result in costly repairs to a colonoscope. The Pezim Clinic organizes regular inspections of its flexible instruments by qualified scope technicians in order ensure they are in satisfactory working order and free of defects that could interfere with optimum clinical function or sterilization.

© Pezim Clinic, Vancouver, British Columbia, Canada