Diagnostic and Clinical Performance of Single-Use Versus Reusable Gastrointestinal Endoscopes: A Systematic Review and Meta-Analyses
In brief
Single-use duodenoscopes required crossover to reusable in 7% of ERCPs, with comparable performance
In a review of 50 studies covering nearly one million procedures, single-use and partially single-use endoscopes performed similarly to reusable devices, but 7% of ERCPs using the single-use EXALT Model D needed to switch to a reusable duodenoscope. Reported infection risks from reusable scopes were low (0.01-0.8%) but uncertain, so the evidence does not yet justify replacing reusable endoscopes wholesale.
- Journal
- Journal of gastroenterology and hepatology (Q1)
- Published
- 7 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Natalie Tyldesley-Marshall, Yen-Fu Chen, Jefferson Buendia, Anna Brown, Thomas Matthews, Janette Parr, et al.
- PMID
- 42568228
- DOI
- 10.1111/jgh.70637
Why clinicians should know about it
- Picked for Gastroenterology (top studies of the week, 9 August 2026): Single‑use vs reusable endoscopes systematic review
- Picked for Infectious Diseases (top studies of the week, 9 August 2026).
- Picked for Health Policy (top studies of the week, 9 August 2026).
- Picked for Hepatology (top studies of the week, 9 August 2026).
Abstract
BACKGROUND: Endoscopic procedures are fundamental in the diagnosis and management of gastrointestinal disorders. However, concerns over pathogen transmission have driven the development of single-use and partially single-use endoscopes (reusable endoscopes with disposable components). A comprehensive synthesis of comparative evidence is essential to inform decisions regarding clinical adoption. METHODS: We systematically searched MEDLINE, EMBASE, Web of Science, Cochrane Library, and trial registries for randomized controlled trials, non-randomized comparative studies, diagnostic accuracy studies, and case series. Outcomes assessed included technical performance, diagnostic accuracy, infection risk, and adverse events. We also included systematic reviews estimating infection risk associated with exogenous pathogens for reusable gastrointestinal endoscopes. Summary data were pooled using a random-effects model where appropriate, and other findings synthesized narratively. The protocol was registered prospectively on PROSPERO (CRD42024496913). RESULTS: Of 6979 records screened, 50 studies (965 960 patients) were included. Our meta-analyses demonstrated that in endoscopic retrograde cholangiopancreatography (ERCP), crossover from single-use (EXALT Model D) to reusable duodenoscopes occurred in 7% of cases (95% CI 6-9). Across endoscope types, single-use and partially single-use devices demonstrated similar or slightly reduced technical performance and diagnostic accuracy compared with reusable counterparts. Estimated infection risks from contaminated reusable endoscopes ranged from 0.01% to 0.8%, although these figures are limited by high risk of detection and reporting bias. CONCLUSIONS: The current evidence does not support wholesale replacement of reusable gastrointestinal endoscopes with single-use or partially single-use models. More robust and standardized data are needed to quantify infection risks from reusable endoscopes and inform evidence-based policy and procurement decisions.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.