In his lecture John Mills (Steris) spoke about endoscopy. He pointed out that endoscopic, like minimally invasive surgery, procedures were being used increasingly, with ever smaller more complex instruments containing increasingly more electronic components. One wondered whether high level disinfection was still adequate since the boundaries were increasingly more blurred between diagnostic and interventional, and as such also between non-critical and invasive, procedures. Mills continued by stating that while the Spaulding classification system was effective, modern surgical techniques were yet to be developed at the time of its formulation. The basic trend pointed towards endoscope sterilization, using a range of low-temperature sterilization processes. H2O2 sterilizers with and without plasma had become established, largely thanks to their shorter cycle times compared with ethylene oxide or formaldehyde and the fact that they did not present a risk of toxicity to users or the environment.
Gary Clarke (IHSS), too, spoke about endoscopy. Outsourcing of endoscope reprocessing (decontamination) to specialist establishments was one alternative to traditional organizational practices and also increased patient safety thanks to more specialized personnel. Besides, obtaining certification was a particular challenge for small reprocessing departments. Another benefit was the investment savings made and the space-saving advantages to the hospital. But one problem could be keeping the endoscopes sufficiently moist, especially with long transport routes, and reprocessing them as prescribed within three hours.