Endoscope reprocessing – painted into a corner?

The inherent issue of reusable complex instruments – such as flexible endoscopes – being incompatible with heat-based sterilization has been recognized for decades, prompting ever-developing guidelines for optimal reprocessing [1] [2]. High level disinfection (HLD) is an integral part of quality endoscopy, which combined with appropriate manual cleaning and drying/storage has been thought to offer a satisfactory safeguard against retained contamination and potential microbial transmission between patients. Indeed, most reported endoscope-transmitted infections used to be linked to technical failures or lack of adherence to reprocessing standards.