Future decision making on health care will need to consider broader environmental and sustainability issues. One example is adoption of single-use endoscopes instead of reusable endoscopes in gastroenterology, largely due to their perceived benefit of reducing cross-infection. Besides considerations related to technical performance, there are differences not only in the cost to healthcare but also in the impact they have on the environment. The primary aim of this systematic review was to synthesize evidence on the costs and consequences of using single-use gastrointestinal endoscopes vs. reusable ones adopting various reprocessing methods. The secondary aim was to review and discuss the way in which environmental impact is costed and reported by the studies included in this review.

We searched multiple databases and the internet to September 2024. We included and quality-assessed partial and full economic evaluations according to predetermined criteria.

Seven studies (2 cost analyses and 5 cost-utility analyses [CUA]) were included. All focused on duodenoscopes for endoscopic retrograde cholangiopancreatography. Five studies compared single-use with reusable duodenoscopes whereas two studies compared different reprocessing methods for reusable duodenoscopes. The most common outcomes were infection risk (n = 6) and quality-adjusted life years (n = 5). Environmental impact was considered in only two studies. All studies stated that the per-procedure cost was higher using single-use endoscopes but three CUAs indicated that single-use endoscopes were more cost-effective. Several studies used doubtful assumptions, reducing their credibility.

Future economic evaluations of single-use vs. reusable endoscopes require more robust comparative evidence and should include costs and consequences beyond health, especially environmental impact.

Received: 11 December 2024

Accepted after revision: 28 May 2025

Article published online:
29 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Mandana Zanganeh, Yufei Jiang, Norman Waugh, Anna Brown, Yen-Fu Chen, Ramesh P. Arasaradnam, Lazaros Andronis. Single-use versus reusable endoscopes in gastroenterology: Systematic review of full and partial economic evaluations. Endosc Int Open 2025; 13: a26451463.
DOI: 10.1055/a-2645-1463