Frequency and costs of echo endoscope repairs: results of a survey of endosonographers

Abstract

Background and study aims: The need for repair of endoscopic ultrasound (EUS) equipment appears to be frequent and expensive. To better quantify the costs associated with echo endoscope failure, a survey of endosonographers was carried out.

Methods: A survey questionnaire concerning echo endoscope damage and repair and consequences of echo endoscope downtime over a 12-month period was sent to members of the American Society of Gastrointestinal Endoscopy who had cited an interest in EUS.

Results: Responses were received from 56 of 138 institutions where EUS was carried out (41 %). A median of 325 EUS procedures had been carried out in the past year and a median of two endosonographers were employed who used an average of three echo endoscopes. Two-thirds of institutions trained fellows. A total of 225 repairs were reported for leaks (47 %), mechanical failures (33 %), images or optics difficulties (26 %), or other problems (1 %). Mechanical radial-scanning echo endoscopes tended to break, on average, after 68 procedures, while curved linear-array echo endoscopes failed after an average of 107 procedures. Echo endoscope failures led to rescheduling of procedures at three-quarters of institutions. Institutions paid an average of $ 10 534 over 12 months for echo endoscope repairs. The average repair cost per procedure was $ 41. There was an inverse relationship between quantity of procedures and the per-procedure repair rate ( P < 0.05).

Conclusions: Direct and indirect costs of echo endoscope repairs are significant. Instrument failures are multifactorial; however instrument complexity, instrument age, and institutional inexperience may contribute to repair costs.