Advice
The technology
The technology
The Ambu aScope 4 RhinoLaryngo (Ambu Ltd) is a sterile, flexible and single-use rhinolaryngoscope. It is used to visualise the upper airway anatomy during rhinolaryngoscopy procedures in adults. According to the company, this device can be used for acute emergency ear, nose and throat (ENT) conditions within emergency departments as well as for non-urgent ENT conditions in outpatient clinics. There are 2 designs: the Ambu aScope 4 RhinoLaryngo Slim endoscope is for nasal endoscopy and laryngoscopy, and the Ambu aScope 4 RhinoLaryngo Intervention endoscope is for therapeutic procedures such as biopsy and suction. The endoscopes need to be connected to the Ambu aView 2 Advance portable monitor to display the images. The imaging data can be sent to the hospital picture archiving and communication system (PACS) to give access from the hospital's electronic healthcare records.
Innovations
The aim of the single-use Ambu aScope 4 RhinoLaryngo is to reduce the risk of cross-infection and remove the need for complex reprocessing associated with conventional reusable rhinolaryngoscopes.
Current care pathway
Flexible nasal endoscopes are used to look inside the nose, at the back of the nose and throat, and at the voice box and the tongue. Reusable rhinolaryngoscopes are reprocessed and decontaminated before repeated use.
Population, setting and intended user
The technology is intended for people aged 18 and over having routine diagnostic and therapeutic rhinolaryngoscopy procedures. It is used for visualising the upper airways or for therapeutic rhinolaryngoscopy procedures in adults. The technology can be used for acute emergency ENT conditions within emergency departments and may also be used for ENT conditions in outpatient clinics. The device may also be used in non-traditional environments, leading to a potential increased capacity for the delivery of care.
Costs
Technology costs
The cost of Ambu aScope 4 RhinoLaryngo Slim is £105 (excluding VAT). The cost of Ambu aScope 4 RhinoLaryngo Intervention is £179 (excluding VAT). The cost for the reusable aView 2 Advance monitor is £4,000. Within the first year of purchase, the aView 2 Advance monitor is under manufacturer warranty and is replaced free of charge in the event of failure. Beyond 12 months, spare parts and new monitors are chargeable.
Costs of standard care
An evaluation and cost comparison analysis (Mistry et al. 2020) reports that in outpatient clinics, incremental costs of reusable rhinolaryngoscope eyepieces and videoscopes when compared with single-use rhinolaryngoscopes are £30 and £11. It also reports that in acute surgical units, incremental costs of reusable rhinolaryngoscope eyepieces and videoscopes when compared with single-use rhinolaryngoscopes are -£4 and -£73. The costs vary by clinical setting because the staff time needed to carry out the procedure is different in each setting.
Resource consequences
The technology has launched in the UK. This technology is routinely used by clinicians within NHS trusts. If adopted, the technology would be used in place of standard care and is not considered to need any significant changes to current infrastructure.
A potential benefit is that single-use rhinolaryngoscopes reduce the risk of cross-infection. During high-demand situations and out of hours, when there are limited resources for disinfection of equipment, a single-use option may be beneficial. There is potential to remove the complex and costly reprocessing associated with reusable rhinolaryngoscopes. A cost comparison analysis (Mistry et al. 2020) reported that single-use rhinolaryngoscopes provide a clinically comparable, potentially cost-minimising, alternative to the reusable rhinolaryngoscope for use in acute surgical assessment units.