Clinical Study : Broncoflex™

Background: Single use flexible bronchoscopes (SUFBs) have come to the forefront in the COVID-19 pandemic due to the need to minimise risk of infectious transmission as well as carry out bedside procedures for critically unwell patients¹. Multiple companies have released SUFBs with varying technical metrics including bronchoscope size, turning angle and thumb force required for scope angulation, which all differ slightly from the standard reusable bronchoscope. We hypothesized that clinician bronchoscope preference would vary depending on gender, hand size and level of experience.

Methods: 39 participants including physicians, surgeons, anaesthetists, radiologists and endoscopy nurses with a range of expertise ranging from first time bronchoscopists to consultant level experience were  invited to participate in a trial of all commercially available SUFBs (Figure 1).

Participants were asked to trial each bronchoscope by manoeuvring the scope down plastic tubing (which included a 90 degree angle) and passing a forceps to “biopsy” a foam pseudo-tumour (Figure 2-3). Likert scales (1-5) were used for evaluation of scope parameters including ergonomics, comfort, ease of technical procedures and overall impression, with a total maximum score of 55. Participant parameters including gender, hand size and level of experience were collected.

Results: TSC Broncoflex^TM was the preferred bronchoscope overall with an average score of 45.4/55 including 82.1% for ergonomics and 83% for usage.

. Male participants preferred TSC Broncoflex^TM  (p=0.04).

. Participants with large glove size ranked the Vathin© and TSC Broncoflex^TM bronchoscopes highest (44.4/55; 44/55).

. The nursing group ranked both TSC Broncoflex^TM and Pentax© equally (50.2/55).

1. Mouritsen JM, Ehlers L, Kovaleva J, Ahmad I, El-Boghdadly K. A systematic review and cost effectiveness analysis of reusable vs. single-use flexible bronchoscopes. Vol. 75, Anaesthesia. Blackwell Publishing Ltd; 2020. p. 529–40.