Evaluation of a single-use gastroscope in patients presenting with suspected upper gastrointestinal hemorrhage: a pilot feasibility study (One-Scope I)

BACKGROUND AND STUDY AIMS Outbreaks of multi-drug resistant bacteria due to contaminated duodenoscopes and the Covid-19 pandemic have driven the development of single-use endoscopes. The first single-use gastroscope (Ambu aScope Gastro) is now available in Europe. Besides waste-disposal and cost issues, the infection risk and performance remain unclear. We aimed to evaluate single-use gastroscopes in patients with upper gastrointestinal bleeding. PATIENTS AND METHODS Twenty consecutive patients presenting with stigmata of upper gastrointestinal bleeding were included in this case series between October and November 2022. The primary aim was the technical success rate defined as access to the descending duodenum and adequate assessment of the upper gastrointestinal tract for the presence of a bleeding site. RESULTS The primary aim was achieved in 19 out of 20 (95%) patients. The bleeding site was identified in 18 patients. A therapeutic intervention with a single-use gastroscope was performed in six cases (two cap-mounted clips, one standard hemoclip, , two variceal band ligations, one hemostatic powder, two adrenaline injections). Technical and clinical success were achieved in all six cases. Two crossovers to a standard gastroscope occurred. CONCLUSIONS In this feasibility study, we propose a possible niche for single-use gastroscopes in patients presenting for urgent endoscopic evaluation and treatment of upper gastrointestinal bleeding.