Which is the best single-use duodenoscope in the market?

A recent study comparing two commercially available single-use disposable duodenoscopes (SDD), Exalt and aScope Duodeno, reports comparable safety and efficacy.

Researchers conducted a comparative study of two SDDs in consecutive endoscopic retrograde cholangiopancreatography (ERCP) procedures carried out by expert endoscopists from nine academic centres. Then, they collected the performance ratings, procedure details, and adverse events.

Two hundred one patients were included, of whom 129 underwent ERCP with Exalt (mean age, 63 years, 51 percent males) and 72 with aScope Duodeno (mean age 65 years, 42 percent males).

Endoscopists performed more than 2,000 ERCPs in both groups (71 percent with Exalt and 93 percent with aScope Duodeno), with a technical success rate of 92 percent for both groups (Exalt: n=119; aScope Duodeno: n=66).

Procedural complexity for all ERCP cases conducted were as follows: grade 1, 35 cases (18 percent); grade 2, 83 cases (41 percent); grade 3, 65 cases (32 percent); and grade 4, 18 cases (9 percent).

Thirteen patients (10 percent) from the Exalt cohort and 16 (22 percent) from the aScope Duodeno cohort had to convert to a reusable duodenoscope.

On a scale of 1 to 5, Exalt and aScope Duodeno were respectively rated as follows: 2.31 vs 2.60 for location and visualization quality; 1.38 vs 1.57 for manoeuvrability based on papillary orientation; 1.48 vs 1.15 for suction/air control; and 2.31 vs 2.34 for elevator efficiency. Notably, adverse events reported were not related to the SDDs.

“Further ongoing enhancements to these devices will improve manoeuvrability and clinical effectiveness,” the researchers said.

“SDDs have been developed to mitigate infectious risks related to reusable duodenoscopes,” they noted.