Single-use flexible bronchoscope evaluation for bronchoalveolar lavage.

Background: Since their initial release in 2009, single-use flexible bronchoscopes (SUFBs) have significantly evolved from simple tools largely used for airway inspection with limited functionality to highly advanced instruments with the same capabilities as reusable flexible bronchoscopes (RFBs). Despite this, scrutiny still exists. The purpose of this study was to better understand the performance and preference of six industry leading SUFBs.

Methods: Thirty-one physicians who regularly use bronchoscopes performed two simulated bronchoalveolar lavages (BALs) on low fidelity lung models with six SUFBs: Ambu aScope 4 and 5 (with integrated sampler system), Boston Scientific Exalt Model B, Olympus H-SteriScope, and Verathon B-Flex and B-Flex 2 (all with a Lukens trap). After completing BALs with each scope, physicians answered an 18-question survey with a five-point rating system where 1 indicated unacceptable, 3 indicated satisfactory, and 5 indicated excellent.

Results: The Ambu aScope 5 Broncho HD rated highest in each of the 18 evaluated categories with an overall average performance score of 4.47 and sampling score of 4.40. A two-sample t-test found that the average score of the Ambu aScope 5 HD was significantly higher than the other SUFBs for both performance and sampling.

Conclusions: All six SUFBs included in the study scored above "satisfactory" in both the performance and sampling metrics measured. Of the six, the aScope 5 Broncho HD with an integrated sampling system had the highest average rating for both performance and sampling metrics, followed by the Exalt Model B for performance and the aScope 4 Broncho for sampling. As the annual volume of procedures continues to increase, SUFBs that combine safety, superb performance, and convenience will help further evolve bronchoscopy.