Single-use flexible bronchoscopy with the Boston Scientific® EXALT™ Model B-an academic quaternary centre experience.

BACKGROUND

The use of single-use flexible bronchoscopes (SUFBs) has increased tremendously as a consequence of the coronavirus disease 2019 (COVID-19) pandemic and concerns regarding scope contamination, despite a paucity of data relating to user satisfaction and technical reviews. This study aimed to assess the performance of Boston Scientific® EXALT™ Model B single-use bronchoscopes in a large academic quaternary referral centre.

METHODS

Following ethical approval, we prospectively collected data on bronchoscopies performed with the Boston Scientific® EXALT™ Model B bronchoscope. Data included patient and user demographics, procedure details (location, indication, SUFB size, procedure, complications), and user satisfaction.

RESULTS

From 2021 to 2024, 108 procedures were performed with the EXALTTM scope. There were 51 female patients (47.2%). The 2.8 channel scope was used in 84 (77.8%) cases while the 2.2 was used in 26 (24.1%) (two cases utilized both scope sizes). Malignancy was the most common indication. Locations included endoscopy (92.6%), intensive care unit (ICU) (1.9%), and theatre (5.6%). The most commonly performed procedure was airway inspection (n=108) while bronchoalveolar lavage (n=75), brushings (n=13), endobronchial (n=23) and transbronchial (n=4) biopsies, cryobiopsies (n=2), electrocautery (n=5), and argon plasma coagulation (n=10) were among others. Average user satisfaction (rated 1-5 in ascending order) was 4.7. The most common reason for dissatisfaction was difficulty passing tools through the working channel (n=7). Two cases required replacement with another SUFB due to image failure. No case required conversion to reusable bronchoscope. There were no bronchoscope-related complications.

CONCLUSIONS

Our study has shown a wide range of applications, high level of user satisfaction and low rate of technical limitations with the Boston Scientific® EXALT™ Model B single use bronchoscope.