Advantages and limitations of automatic flexible endoscope reprocessors

The advantages and limitations of automatic flexible endoscope reprocessors (AFERs) are presented. These medical devices can increase patient safety and minimize personnel exposure to the liquid chemical germicide and its vapors. Some models feature a printer to document important reprocessing parameters, an in-line tap water filtration system to reduce the likelihood of endoscope (and patient) contamination, and a heater to satisfy the elevated temperature requirements of some liquid chemical germicide labels. Although they offer significant advantages compared with manual reprocessing, AFERs have their limitations. Current models do not automate every endoscope reprocessing step and are not typically designed to reprocess every endoscope channel. Some AFER models may have to be periodically decontaminated to ensure that their internal components do not support microbial colonization. Moreover, their cost per cycle can be considerably more than manual reprocessing without necessarily reducing overall reprocessing time. Its limitations notwithstanding, an AFER is likely to be an asset in a busy endoscopy center. In addition to comparing automated and manual reprocessing, this article addresses important reprocessing issues and purchasing concerns.