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 EXALT^TM 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.

Keywords: Single-use flexible bronchoscope (SUFB); bronchoscopy; interventional pulmonology

 

Highlight box

Key findings

• In a quaternary referral center with an interventional pulmonology program, the Boston Scientific^® EXALT™ Model B single-use bronchoscope was found to be both safe and versatile with a high level of user satisfaction following its use in 108 procedures.

What is known and what is new?

• Single-use flexible bronchoscopes may represent a viable, safe and cost-effective avenue in reducing potential endoscopic cross contamination from reusable scopes, as outlined in previous studies. They have also compared favourably in terms of environmental impact.

• Our study is the largest to date to confirm that the Boston Scientific^® EXALT™ Model B single-use bronchoscope demonstrates a high level of user satisfaction and technical performance in a large bronchoscopy unit with an interventional pulmonology program.

What is the implication, and what should change now?

• Single-use flexible bronchoscopes offer several advantages over reusable bronchoscopes including accessibility, portability, and potential to reduce infection transmission though robust direct comparative data is lacking. Our study augments the growing knowledge surrounding single-use flexible bronchoscopy use in the setting of the bronchoscopy suite.

Cite this article as: Tangney N, O’Reilly E, O’Donnell M, O’Mahony A, Deasy K, Ibrahim H, Pozza A, Kennedy MP. Single-use flexible bronchoscopy with the Boston Scientific^® EXALT™ Model B—an academic quaternary centre experience. J Thorac Dis 2025;17(10):7585-7593. doi: 10.21037/jtd-2025-840