Use of a plastic banded bag over the control body of the endoscope as a splash guard to minimize the biological hazard during the COVID-19 outbreak

We read with great interest the ESGE and ESGENA Position Statement [1] on gastrointestinal endoscopy and the COVID-19 pandemic detailing guidance to assure the highest level of protection to healthcare professionals and patients in our endoscopy departments. The COVID-19 outbreak compels us to rethink our standard precautions of care [2] in order to keep a safe working environment.

As stated in the position statement, there is a high risk of periendoscopic transmission of SARS-CoV-2 because of the aerosols generated and the contact with body fluids, secretions, and contaminated surroundings. Inherent in endoscopic procedures, inadvertent splatter of bodily fluids occurs primarily when inserting or removing an accessory from the working channel, but also from a malfunctioning valve and when adjusting the air/water or suction button.

In addition to following current guidelines, which highlight the advantages of using single-use devices such as disposable valves [3], in order to prevent extensive splashing, we would like to suggest the use of a sterile, circular banded bag with an elastic opening ([Fig. 1a]), generally used as a drape to isolate non-sterile equipment like an X-ray device in operating rooms (Microtek Medical B.V., Zutphen, The Netherlands), placed over the control body of the endoscope as a splash guard ([Fig. 1b]) to potentially protect all endoscopy personnel during procedures. A locking forceps or surgical tape can be used to tighten the bag over the scope. When manipulation of the working channel is required, the endoscope accessories can be used to easily puncture through the thin plastic bag, creating a small opening that does not interfere with instrument channel handling and preserves the splash guard function.

Fig. 1 Photographs showing: a the 50-inch, sterile, circular banded bag with an elastic opening that is generally used as a drape for non-sterile equipment in operating rooms; b the bag positioned over the control body of the endoscope and tightened over the scope with a locking forceps to act as a splash guard.

During these extraordinary times, we should be aware of ordinary means that can be readily applied in all endoscopy procedures to effectively minimize the biological hazard that healthcare professionals are exposed to, therefore contributing to the global effort in preventing COVID-19 dissemination.

Publication History

Article published online:
26 August 2020

• References

• 1 Gralnek IM, Hassan C, Beilenhoff U. et al. ESGE and ESGENA Position Statement on gastrointestinal endoscopy and the COVID-19 pandemic. Endoscopy 2020; DOI: 10.1055/a-1155-6229.
• 2 Caulderwood AH, Day LW. ASGE Quality Assurance in Endoscopy Committee. et al. Infection control during GI Endoscopy. Gastrointest Endosc 2018; 87: 1167-1179
• 3 Beilenhoff U, Biering H, Blum R. et al. Reprocessing of flexible endoscopes and endoscopic accessories used in gastrointestinal endoscopy: Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology Nurses and Associates (ESGENA) – Update 2018. Endoscopy 2018; 50: 1205-1234