CINXE.COM

<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE html> <html lang="en" dir="ltr" version="HTML+RDFa+MathML 1.1" xmlns:dc="http://purl.org/dc/terms/" xmlns:foaf="http://xmlns.com/foaf/0.1/" xmlns:og="http://ogp.me/ns#" xmlns:rdfs="http://www.w3.org/2000/01/rdf-schema#" xmlns:sioc="http://rdfs.org/sioc/ns#" xmlns:sioct="http://rdfs.org/sioc/types#" xmlns:skos="http://www.w3.org/2004/02/skos/core#" xmlns:xsd="http://www.w3.org/2001/XMLSchema#" xmlns:mml="http://www.w3.org/1998/Math/MathML"> <head profile="http://www.w3.org/1999/xhtml/vocab">  <link rel="dns-prefetch" href="//securepubads.g.doubleclick.net" /> <link rel="dns-prefetch" href="//d1bxh8uas1mnw7.cloudfront.net" /> <link rel="dns-prefetch" href="//scholar.google.com" /> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <link rel="shortcut icon" href="https://gut.bmj.com/sites/default/themes/bmjj/favicon.ico" type="image/vnd.microsoft.icon" /> <meta name="viewport" content="width=device-width, initial-scale=1" /> <script>window.dataLayer = window.dataLayer || [];window.dataLayer.push({"page":{"hwTitle":"Single-use scopes may reduce various environmental impacts of gastroscopy in some situations but probably not in routine practice of endoscopy units","hwUrl":"https://gut.bmj.com/content/early/2024/10/30/gutjnl-2024-334018","hwPath":"/content/early/2024/10/30/gutjnl-2024-334018","hwType":"journal page"},"user":{"hwMemberID":"","hwLoggedIntoInstitutionID":"","hwLoggedIntoInstitution":"","hwAccessUsageTerms":"guest","hwRegisteredUser":"no","hwHasFullTextAccess":"no","hwEntitled":"no","mail":"e3b0c44298fc1c149afbf4c8996fb92427ae41e4649b934ca495991b7852b855"},"content":{"hwIssueDate":"2024-10-30","hwIssueDateTime":"2024-10-30 00:00:00","hwPublicationDate":"2024-10-30","hwPublicationDateTime":"2024-10-30 09:00:14","hwNlmArticleType":"letter","hwDOI":"10.1136/gutjnl-2024-334018","hwAuthors":"Mathieu Pioche,Guillaume Vidal,Madj Ben Rejeb,R\u00e9mi Collin,J\u00e9r\u00e9mie Jacques","hwContributors":"","hwIsEarlyRelease":"yes","hwEissn":"1468-3288","hwPissn":"0017-5749","hwVolume":"","hwIssue":"","hwArticleType":"Letter","hwTabView":"main_tab","hwViewType":"","hwAccessType":"Paywall","hwOpenAccess":"no","hwFreeAccess":"no","hwTaxonomy":"","hwCorpusCode":"gutjnl","hwType":"article","hwSubtitle":null,"hwOverline":null,"hwPisaId":"gutjnl;gutjnl-2024-334018v1","hwFirstPage":null,"hwLastPage":null,"hwIsLatestVersion":"yes","hwIsCurrentIssue":"no","hwIsOpenIssue":"no","hwHasFullText":"yes","hwHasPDF":"yes","hwParentTitle":"Gut","hwElectronicPubDate":"2024-10-30","hwElectronicPubDateTime":"2024-10-30 09:00:14"}}); //--><!]]></script> <link rel="canonical" href="https://gut.bmj.com/content/early/2024/10/30/gutjnl-2024-334018" /> <meta name="Generator" content="Drupal 7 (http://drupal.org)" /> <link rel="alternate" type="application/pdf" title="Full Text (PDF)" href="/content/early/2024/10/30/gutjnl-2024-334018.full.pdf" /> <link rel="alternate" type="text/plain" title="Full Text (Plain)" href="/content/early/2024/10/30/gutjnl-2024-334018.full.txt" /> <meta name="type" content="article" /> <meta name="category" content="letter" /> <meta name="HW.identifier" content="/gutjnl/early/2024/10/30/gutjnl-2024-334018.atom" /> <meta name="HW.pisa" content="gutjnl;gutjnl-2024-334018v1" /> <meta name="DC.Format" content="text/html" /> <meta name="DC.Language" content="en" /> <meta name="DC.Title" content="Single-use scopes may reduce various environmental impacts of gastroscopy in some situations but probably not in routine practice of endoscopy units" /> <meta name="DC.Identifier" content="10.1136/gutjnl-2024-334018" /> <meta name="DC.Date" content="2024-10-30" /> <meta name="DC.Publisher" content="BMJ Publishing Group" /> <meta name="DC.Rights" content="© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ." /> <meta name="DC.AccessRights" content="restricted" /> <meta name="DC.Description" content="We read with interest the letter from Han et al about our study1 and we thank those authors for underlining points to be discussed about the real place of single use and reusable endoscope strategies. Although the benefits for reducing cross-infections seem significant, assessing the positive indirect environmental impact is difficult, as the number of patients involved in high-infection risk2 care remains very low compared with the daily endoscopy practice evaluated in this study, with conventional gastroscopes, disinfected in the standard way, in a routine activity and not in intensive care units with high-level disinfection processes.3 Moreover, this study focused on gastroscopes, with low risk of cross-infections in opposition to duodenoscopes. Of course, the weight of the endoscope’s plastic is an important element in the analysis, explaining the difference between our results and those …" /> <meta name="DC.Contributor" content="Mathieu Pioche" /> <meta name="DC.Contributor" content="Guillaume Vidal" /> <meta name="DC.Contributor" content="Madj Ben Rejeb" /> <meta name="DC.Contributor" content="Rémi Collin" /> <meta name="DC.Contributor" content="Jérémie Jacques" /> <meta name="article:published_time" content="2024-10-30" /> <meta name="article:section" content="Letter" /> <meta name="citation_title" content="Single-use scopes may reduce various environmental impacts of gastroscopy in some situations but probably not in routine practice of endoscopy units" /> <meta name="citation_journal_title" content="Gut" /> <meta name="citation_publisher" content="BMJ Publishing Group" /> <meta name="citation_publication_date" content="2024/10/30" /> <meta name="citation_mjid" content="gutjnl;gutjnl-2024-334018v1" /> <meta name="citation_id" content="gutjnl-2024-334018v1" /> <meta name="citation_public_url" content="https://gut.bmj.com/content/early/2024/10/30/gutjnl-2024-334018" /> <meta name="citation_abstract_html_url" content="https://gut.bmj.com/content/early/2024/10/30/gutjnl-2024-334018.abstract" /> <meta name="citation_full_html_url" content="https://gut.bmj.com/content/early/2024/10/30/gutjnl-2024-334018.full" /> <meta name="citation_pdf_url" content="https://gut.bmj.com/content/gutjnl/early/2024/10/30/gutjnl-2024-334018.full.pdf" /> <meta name="citation_issn" content="0017-5749" /> <meta name="citation_issn" content="1468-3288" /> <meta name="citation_doi" content="10.1136/gutjnl-2024-334018" /> <meta name="citation_pmid" content="39477534" /> <meta name="citation_article_type" content="Letter" /> <meta name="citation_section" content="Letter" /> <meta name="citation_author" content="Mathieu Pioche" /> <meta name="citation_author_institution" content="Gastroenterology and Endoscopy" /> <meta name="citation_author_institution" content="Edouard Herriot Hospital" /> <meta name="citation_author_orcid" content="http://orcid.org/0000-0002-6482-2375" /> <meta name="citation_author" content="Guillaume Vidal" /> <meta name="citation_author_institution" content="University Hospital of Clermont-Ferrand" /> <meta name="citation_author_institution" content="Gastroeterology, Hopital Dupuytren, University Hospital of Limoges" /> <meta name="citation_author" content="Madj Ben Rejeb" /> <meta name="citation_author_institution" content="Department of Gastroenterology and Hepatology" /> <meta name="citation_author_institution" content="CH Saint Flour" /> <meta name="citation_author" content="Rémi Collin" /> <meta name="citation_author_institution" content="University Hospital of Clermont-Ferrand" /> <meta name="citation_author_institution" content="Gastroeterology, Hopital Dupuytren, University Hospital of Limoges" /> <meta name="citation_author" content="Jérémie Jacques" /> <meta name="citation_author_institution" content="Gastroenterology" /> <meta name="citation_author_institution" content="Hopital Dupuytren" /> <meta name="citation_author_institution" content="UMR 7252" /> <meta name="citation_author_institution" content="CNRS XLIM" /> <meta name="citation_reference" content="citation_journal_title=Gut;citation_author=M. Pioche;citation_author=H. Pohl;citation_author=JA. Cunha Neves;citation_title=Environmental impact of single-use versus reusable gastroscopes;citation_volume=73;citation_year=2024;citation_pmid=39122363;citation_doi=10.1136/gutjnl-2024-332293" /> <meta name="citation_reference" content="citation_journal_title=Antimicrob Resist Infect Control;citation_title=Investigation of possible transmission of a susceptible microorganism through a contaminated duodenoscope; a case report;citation_volume=10;citation_year=2021" /> <meta name="citation_reference" content="citation_journal_title=Gastrointest Endosc;citation_author=MA. Gromski;citation_author=MS. Sieber;citation_author=S. Sherman;citation_title=Double high-level disinfection versus liquid chemical sterilization for reprocessing of duodenoscopes used for ERCP: a prospective randomized study;citation_pages=927-31;citation_volume=93;citation_year=2021;citation_pmid=32745532;citation_doi=10.1016/j.gie.2020.07.057" /> <meta name="citation_reference" content="citation_journal_title=J Endourol;citation_author=NF. Davis;citation_author=S. McGrath;citation_author=M. Quinlan;citation_title=Carbon Footprint in Flexible Ureteroscopy: A Comparative Study on the Environmental Impact of Reusable and Single-Use Ureteroscopes;citation_pages=214-7;citation_volume=32;citation_year=2018;citation_pmid=http://www.n;citation_doi=10.1089/end.2018.0001" /> <meta name="citation_reference" content="citation_journal_title=Gastrointest Endosc;citation_author=NNT. Le;citation_author=LV. Hernandez;citation_author=N. Vakil;citation_title=Environmental and health outcomes of single-use versus reusable duodenoscopes;citation_pages=1002-8;citation_volume=96;citation_year=2022;citation_pmid=35718068;citation_doi=10.1016/j.gie.2022.06.014" /> <meta name="citation_reference" content="citation_journal_title=Gut;citation_author=A. Dhar;citation_author=B. Hayee;citation_author=E. Wesley;citation_title=Reducing low risk of transmissible infection in duodenoscopes: at what cost to the planet?;citation_volume=71;citation_year=2022;citation_pmid=33972356;citation_doi=10.1136/gutjnl-2021-324821" /> <meta name="citation_reference" content="citation_journal_title=Endoscopy;citation_author=J. Lacroute;citation_author=J. Marcantoni;citation_author=S. Petitot;citation_title=The carbon footprint of ambulatory gastrointestinal endoscopy;citation_pages=918-26;citation_volume=55;citation_year=2023;citation_pmid=37156511;citation_doi=10.1055/a-2088-4062" /> <meta name="citation_reference" content="citation_journal_title=Endoscopy;citation_title=Environmental impact of small-bowel capsule endoscopy;citation_year=2024" /> <meta name="twitter:title" content="Single-use scopes may reduce various environmental impacts of gastroscopy in some situations but probably not in routine practice of endoscopy units" /> <meta name="twitter:card" content="summary_large_image" /> <meta name="twitter:image" content="https://gut.bmj.com/sites/default/files/highwire/gutjnl/73/12.cover-source.jpg" /> <meta name="twitter:description" content="We read with interest the letter from Han et al about our study1 and we thank those authors for underlining points to be discussed about the real place of single use and reusable endoscope strategies. Although the benefits for reducing cross-infections seem significant, assessing the positive indirect environmental impact is difficult, as the number of patients involved in high-infection risk2 care remains very low compared with the daily endoscopy practice evaluated in this study, with conventional gastroscopes, disinfected in the standard way, in a routine activity and not in intensive care units with high-level disinfection processes.3 Moreover, this study focused on gastroscopes, with low risk of cross-infections in opposition to duodenoscopes. Of course, the weight of the endoscope’s plastic is an important element in the analysis, explaining the difference between our results and those …" /> <meta name="og-title" property="og:title" content="Single-use scopes may reduce various environmental impacts of gastroscopy in some situations but probably not in routine practice of endoscopy units" /> <meta name="og-url" property="og:url" content="https://gut.bmj.com/content/early/2024/10/30/gutjnl-2024-334018" /> <meta name="og-site-name" property="og:site_name" content="Gut" /> <meta name="og-description" property="og:description" content="We read with interest the letter from Han et al about our study1 and we thank those authors for underlining points to be discussed about the real place of single use and reusable endoscope strategies. Although the benefits for reducing cross-infections seem significant, assessing the positive indirect environmental impact is difficult, as the number of patients involved in high-infection risk2 care remains very low compared with the daily endoscopy practice evaluated in this study, with conventional gastroscopes, disinfected in the standard way, in a routine activity and not in intensive care units with high-level disinfection processes.3 Moreover, this study focused on gastroscopes, with low risk of cross-infections in opposition to duodenoscopes. Of course, the weight of the endoscope’s plastic is an important element in the analysis, explaining the difference between our results and those …" /> <meta name="og-type" property="og:type" content="article" /> <meta name="og-image" property="og:image" content="https://gut.bmj.com/sites/default/files/highwire/gutjnl/73/12.cover-source.jpg" /> <link rel="alternate" type="application/vnd.ms-powerpoint" title="Powerpoint" href="/content/early/2024/10/30/gutjnl-2024-334018.ppt" /> <title>Single-use scopes may reduce various environmental impacts of gastroscopy in some situations but probably not in routine practice of endoscopy units | Gut</title> <link type="text/css" rel="stylesheet" href="/sites/default/files/advagg_css/css__9WadPqSXN_RPxHWoEHX_wKHQ-qixdHsJUF0EpX22wes__JSql6f8WjpCnC1YTwmCE5OxywyR2jRBx5Kulvx5Di0k__RBpwsggTa-66iCd391Lg7-ZmaIvHPOUAGYyVtdCScb8.css" media="all" />  <script src="https://cookie-cdn.cookiepro.com/scripttemplates/otSDKStub.js" type="text/javascript" charset="UTF-8" data-domain-script="565e50dd-f6e9-46d6-91cd-5c40a270264f"></script> <script type="text/javascript"> function OnetrustAdsConsent(){ if(googletag.apiReady){ //console.log("GoogleTag API ready") googletag.pubads().disableInitialLoad(); if(OptanonActiveGroups.match(/,4,/)){ googletag.pubads().setRequestNonPersonalizedAds(0); //googletag.pubads().refresh(); } else{ googletag.pubads().setRequestNonPersonalizedAds(1); googletag.pubads().refresh(); } } else{ OnetrustAdsConsent(); } } function OptanonWrapper() { OnetrustAdsConsent(); } </script>  <script type="text/javascript" src="/sites/default/files/advagg_js/js__DdxPgqGimsdUot2QWNz_pGsHzqNGpx6RMCWHpL8YWkg__c6zfK6oHHbLpTal5PdQxeQI3xGoCM8IXWtEHwIZr560__RBpwsggTa-66iCd391Lg7-ZmaIvHPOUAGYyVtdCScb8.js"></script> <script type="text/javascript" src="https://securepubads.g.doubleclick.net/tag/js/gpt.js"></script> <script type="text/javascript" src="/sites/default/files/advagg_js/js__RplUf5n1SHvT_MHHQProZaAaHxo7a_9YZuaKWYnqVeQ__t8vznsHJmtJcTuSP5JnWJ92mdmFUGaXxtxwBatvNwmc__RBpwsggTa-66iCd391Lg7-ZmaIvHPOUAGYyVtdCScb8.js"></script> <script type="text/javascript" src="https://d1bxh8uas1mnw7.cloudfront.net/assets/embed.js"></script> <script type="text/javascript" src="/sites/default/files/advagg_js/js__RxmsdK7-WlnwoO5NREEVy8MRi0OqO4ZhkOHaMokGNlw__IAyE4mioyYmepJfxC77gDsM0J1xDyesxXH7WjkUNmyc__RBpwsggTa-66iCd391Lg7-ZmaIvHPOUAGYyVtdCScb8.js"></script> <script type="text/javascript" defer="defer" async="async" src="//cdn.foxycart.com/bmjpg.ecommerce.highwire.org/loader.js"></script> <script type="text/javascript" async="async" src="https://scholar.google.com/scholar_js/casa.js"></script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script> <script type="text/javascript"> <![CDATA[//><!]]> </script>   <script> let cookies = parseCookies(); let bmj_uuid = cookies.bmj_uuid; let bmj_ppid = cookies.bmj_ppid; window.dataLayer = window.dataLayer || []; const anonMailId = 'e3b0c44298fc1c149afbf4c8996fb92427ae41e4649b934ca495991b7852b855'; function checkUserLoginStatus(dataLayer) { const userMail = dataLayer.find((item) => item.user)?.user?.mail; if (!userMail) { return false; } return userMail !== anonMailId; } let nonAnonMailId = ((dataLayer.find(item => item.user)?.user)?.mail) === anonMailId ? null : (dataLayer.find(item => item.user)?.user)?.mail; let userId = ((dataLayer.find(item => item.user)?.user)?.['data-ics']) ?? ((dataLayer.find(item => item.user)?.user)?.mail && nonAnonMailId) ?? bmj_ppid ?? bmj_uuid; document.cookie = 'bmj_ppid=' + userId + '; domain=.bmj.com; path=/; max-age=31622400; SameSite=None; Secure'; googletag.cmd.push(function() { googletag.pubads().setPublisherProvidedId(userId); googletag.pubads().setTargeting("islogged", checkUserLoginStatus(dataLayer) ? "true" : "false"); googletag.enableServices(); }); window.dataLayer.push({ 'bmj_uuid': bmj_uuid }); </script> </head> <body class="html not-front not-logged-in no-sidebars page-node page-node- page-node-265192 node-type-highwire-article">  <noscript><iframe src="//www.googletagmanager.com/ns.html?id=GTM-KMTW8J" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript> <script type="text/javascript">(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-KMTW8J');</script>  <div id="skip-link"> <a href="#main-content" class="element-invisible element-focusable">Skip to main content</a> </div> <div class="page" id="page"> <section class="container-fluid content-header"> <header role="banner" class="section section-header row"> <div class="zone zone-superheader"> <div class="region region-superheader"> <div class="region-inner region-superheader-inner"> <div class="region region-superheader"> <div id="block-panels-mini-jnl-template-bmjj-uid-strng" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_template_bmjj_uid_strng"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-dfp-pane" > <div class="pane-content"> <div id="dfp-ad-top-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-top" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-top"); }); </script> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> <div class="site-info mobile-hidden"> </div> <div class="zone zone-header row mobile-hidden"> <div class="region region-header"> <div class="region-inner region-header-inner"> </div> </div> </div> </header>  <section class="row visible-sm visible-md visible-lg header header-platform mobile-hidden"> <div class="col-narrow-3 col-normal-3 col-large-3 logo-bmj"> <div class="l-inline"> <p class="logo-bmj-journals"><a href="http://journals.bmj.com/" title="BMJ Journals"><img src="/sites/default/themes/bmjj/img/logos/logo-bmj-journals.svg" title="BMJ Journals" alt="BMJ Journals"/></a></p> </div> </div> <div class="col-narrow-9 col-normal-9 col-large-9 no-right-padding"> <div class="region region-top"> <div class="region-inner"> <div class="region region-platmenu"> <div id="block-menu-menu-platform-menu" class="block block-menu" class="block block-menu"> <div class="content"> <ul class="menu"><li class="first leaf"><a href="/subscribe" data-hide-link-title="0" class="header-subscribe-link" data-icon-position="">Subscribe</a></li> <li class="leaf"><a href="/" id="menu-login" class="drop-menu link-icon-right link-icon"><span class="title">Log In</span> <span class="icon icon-arrow-down"></span></a> <a href="# " class="menu-attach-block-drop-link external expand-on-click" data-block-id="panels_mini|challenge_opportunity_pane_dropdown" id="<front>-drop-link-728" data-icon-position="" data-hide-link-title="0">More</a><div class="menu-attach-block-wrapper"> <div id="block-panels-mini-challenge-opportunity-pane-dropdown" class="block block-panels-mini article-login bmjj-login" class="block block-panels-mini"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-challenge_opportunity_pane_dropdown-2"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-society-logins society-logins" > <div class="pane-content"> <span class="ui-button ui-state-default ui-dialog-titlebar-close" title="close"></span><div class="shib-login-link"><a href="/login/shibboleth?subcode=bmjjournals&env=prod&uri=https%3A//gut.bmj.com/accallback/content%25252Fearly%25252F2024%25252F10%25252F30%25252Fgutjnl-2024-334018" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via Institution</a></div><div class="openathens-login-link"><a href="https://openathens-sp.highwire.org/session/init?entityID=https%3A//idp.eduserv.org.uk/openathens&hw-shib-return-uri=https%3A//gut.bmj.com/accallback/content%25252Fearly%25252F2024%25252F10%25252F30%25252Fgutjnl-2024-334018&subcode=bmjjournals" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via OpenAthens</a></div><a href="https://www.bsg.org.uk/login.html" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via BSG</a> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-opportunity-challenge" > <div class="pane-content"> <div class='opportunity-challenge-login'><h3>Log in using your username and password</h3><div class="drupal-login compact"><form action="/content/early/2024/10/30/gutjnl-2024-334018" method="post" id="highwire-user-login--4" accept-charset="UTF-8"><div><div id="edit-customtext--4" class="form-item form-item-label-before form-type-item"> <span class="customtext">For personal accounts OR managers of institutional accounts</span> </div> <div class="form-item form-item-label-invisible form-type-textfield form-item-name"> <label class="element-invisible" for="edit-name--4">Username <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Username" type="text" id="edit-name--4" name="name" value="" size="30" maxlength="60" class="form-text required" /> </div> <div class="form-item form-item-label-invisible form-type-password form-item-pass"> <label class="element-invisible" for="edit-pass--4">Password <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Password" type="password" id="edit-pass--4" name="pass" size="30" maxlength="128" class="form-text required" /> </div> <input type="hidden" name="form_build_id" value="form-LWlAKJHJGpb9_aMXXsdnYnl8rzJX-u6k6r9pT5tOBHc" /> <input type="hidden" name="form_id" value="highwire_user_login" /> <div class="bmjj-reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot your log in details?</a><a href="/user/register?destination=node/265192" class="" data-icon-position="" data-hide-link-title="0">Register a new account?</a></div><div class="form-actions form-wrapper" id="edit-actions--4"><input type="submit" id="edit-submit--4" name="op" value="Log in" class="form-submit" /></div><div class="reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot</a> your user name or password?</div></div></form></div></div> </div> </div> </div> </div> </div> </div> </div> </div> </li> <li class="leaf"><a href="/cart" class="link-icon-right link-icon"><span class="title">Basket</span> <span class="icon icon-basket"></span></a></li> <li class="last leaf"><a href="/search" id="menu-search" class="drop-menu link-icon-right link-icon"><span class="title">Search</span> <span class="icon icon-search"></span></a> <a href="# " class="menu-attach-block-drop-link external expand-on-click" data-block-id="panels_mini|jnl_template_bmjj_search_box" id="search-drop-link-729" data-icon-position="" data-hide-link-title="0">More</a><div class="menu-attach-block-wrapper"> <div id="block-panels-mini-jnl-template-bmjj-search-box" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display one-layout " id="mini-panel-jnl_template_bmjj_search_box-1"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-seach-quicksearch block-search pull-left" > <div class="pane-content"> <form class="highwire-quicksearch button-style-mini button-style-mini" action="/content/early/2024/10/30/gutjnl-2024-334018" method="post" id="highwire-search-quicksearch-form-1" accept-charset="UTF-8"><div><div class="form-item form-item-label-invisible form-type-textfield form-item-keywords"> <label class="element-invisible" for="search_rightsidebar_keywords_1202056923">Search for this keyword </label> <input placeholder="search" type="text" id="search_rightsidebar_keywords_1202056923" name="keywords" value="" size="60" maxlength="128" class="form-text" /> </div> <input data-icon-only="1" data-font-icon="icon-search" data-icon-position="after" type="submit" id="search_rightsidebar_submit_1969668721" name="op" value="Search" class="form-submit" /><input type="hidden" name="form_build_id" value="form-hVwujdpT4s9NSpcQ7ghGY9NeFNtqJIU1gZbyhLYpCw8" /> <input type="hidden" name="form_id" value="highwire_search_quicksearch_form_1" /> </div></form> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-6 pull-right advanced-search-link" > <div class="pane-content"> <a href="/search">Advanced search</a> </div> </div> </div> </div> </div> </div> </div> </div> </li> </ul> </div> </div> </div> </div> </div> </div> </section> <div class="row header header-journal"> <div class="col-mobile-7 col-narrow-2 col-normal-4 logo-journal"> <a href="/"><img src="https://resources.bmj.com/repository/journals-network-project/images/journal-logos/logo-gut.svg" alt="Gut" id="logo-img"></a> </div> <div class="col-mobile-5 col-narrow-10 col-normal-8 no-right-padding nav-journal"> <div class="region region-journmenu"> <div id="block-system-main-menu" class="block block-system mobile-hidden block-menu" class="block block-system mobile-hidden block-menu"> <div class="content"> <ul class="menu"><li class="first leaf"><a href="http://gut.bmj.com/pages/education-in-gastroenterology" class="" data-icon-position="" data-hide-link-title="0">CME/CPD</a></li> <li class="leaf"><a href="/content/early/recent" class="" data-icon-position="" data-hide-link-title="0">Latest content</a></li> <li class="leaf"><a href="/content/current" class="" data-icon-position="" data-hide-link-title="0">Current issue</a></li> <li class="leaf"><a href="/content/by/year" class="" data-icon-position="" data-hide-link-title="0">Archive</a></li> <li class="leaf"><a href="http://gut.bmj.com/pages/authors/" class="" data-icon-position="" data-hide-link-title="0">Authors</a></li> <li class="last leaf"><a href="http://gut.bmj.com/pages/about/" class="" data-icon-position="" data-hide-link-title="0">About</a></li> </ul> </div> </div> <div id="block-panels-mini-mobile-slide-out-menu" class="block block-panels-mini mobile-only" class="block block-panels-mini mobile-only"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-mobile_slide_out_menu"> <div class="panel-panel panel-col"> <div><div id="" class="highwire-responsive-toggle-group"><div class="panel-pane pane-panels-mini pane-jnl-template-bmjj-search-box" > <h2 class="pane-title"><span class="icon-search"></span></h2> <div class="pane-content"> <div class="panel-display one-layout " id="mini-panel-jnl_template_bmjj_search_box"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-seach-quicksearch block-search pull-left" > <div class="pane-content"> <form class="highwire-quicksearch button-style-mini button-style-mini" action="/content/early/2024/10/30/gutjnl-2024-334018" method="post" id="highwire-search-quicksearch-form-0" accept-charset="UTF-8"><div><div class="form-item form-item-label-invisible form-type-textfield form-item-keywords"> <label class="element-invisible" for="search_rightsidebar_keywords_2060179718">Search for this keyword </label> <input placeholder="search" type="text" id="search_rightsidebar_keywords_2060179718" name="keywords" value="" size="60" maxlength="128" class="form-text" /> </div> <input data-icon-only="1" data-font-icon="icon-search" data-icon-position="after" type="submit" id="search_rightsidebar_submit_625881059" name="op" value="Search" class="form-submit" /><input type="hidden" name="form_build_id" value="form-L7ZcPe0Iw38Au4sehi6eLSvGJOj8yd6kQWLqiupO0ak" /> <input type="hidden" name="form_id" value="highwire_search_quicksearch_form_0" /> </div></form> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-5 pull-right advanced-search-link" > <div class="pane-content"> <a href="/search">Advanced search</a> </div> </div> </div> </div> </div> </div> </div> <div class="panel-pane pane-block pane-menu-menu-mobile-slideout-menu pane-menu" > <h2 class="pane-title"><span class="icon-menu"></span></h2> <div class="pane-content"> <ul class="menu"><li class="first leaf"><a href="/" class="menu-close link-icon-only link-icon"><span class="icon icon-close"></span> <span class="title element-invisible">Close</span></a> <a href="# " class="menu-attach-block-drop-link external expand-on-click" data-block-id="panels_mini|mobile_slide_out_autobot_menu" id="<front>-drop-link-781" data-icon-position="" data-hide-link-title="0">More</a><div class="menu-attach-block-wrapper"> <div id="block-panels-mini-mobile-slide-out-autobot-menu" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display one-layout " id="mini-panel-mobile_slide_out_autobot_menu"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-menu-tree pane-main-menu" > <h2 class="pane-title">Main menu</h2> <div class="pane-content"> <div class="menu-block-wrapper menu-block-ctools-main-menu-1 menu-name-main-menu parent-mlid-main-menu:0 menu-level-1"> <ul class="menu"><li class="first leaf menu-mlid-15072"><a href="http://gut.bmj.com/pages/education-in-gastroenterology" class="" data-icon-position="" data-hide-link-title="0">CME/CPD</a></li> <li class="leaf menu-mlid-15073"><a href="/content/early/recent" class="" data-icon-position="" data-hide-link-title="0">Latest content</a></li> <li class="leaf menu-mlid-15074"><a href="/content/current" class="" data-icon-position="" data-hide-link-title="0">Current issue</a></li> <li class="leaf menu-mlid-15075"><a href="/content/by/year" class="" data-icon-position="" data-hide-link-title="0">Archive</a></li> <li class="leaf menu-mlid-15076"><a href="http://gut.bmj.com/pages/authors/" class="" data-icon-position="" data-hide-link-title="0">Authors</a></li> <li class="last leaf menu-mlid-15077"><a href="http://gut.bmj.com/pages/about/" class="" data-icon-position="" data-hide-link-title="0">About</a></li> </ul></div> </div> </div> </div> </div> </div> </div> </div> </div> </li> <li class="leaf"><a href="/subscribe" data-hide-link-title="0" class="callout-link" data-icon-position="">Subscribe</a></li> <li class="leaf"><a href="/" class="mobile-drop-down callout-link link-icon-right link-icon"><span class="title">Log in</span> <span class="icon icon-plus"></span></a> <a href="# " class="menu-attach-block-drop-link external expand-on-click" data-block-id="panels_mini|jnl_template_bmjj_login" id="<front>-drop-link-780" data-icon-position="" data-hide-link-title="0">More</a><div class="menu-attach-block-wrapper"> <div id="block-panels-mini-jnl-template-bmjj-login" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-jnl_template_bmjj_login"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-society-logins society-logins opportunity-challenge-login" > <div class="pane-content"> <span class="ui-button ui-state-default ui-dialog-titlebar-close" title="close"></span><div class="shib-login-link"><a href="/login/shibboleth?subcode=bmjjournals&env=prod&uri=https%3A//gut.bmj.com/accallback/content%25252Fearly%25252F2024%25252F10%25252F30%25252Fgutjnl-2024-334018" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via Institution</a></div><div class="openathens-login-link"><a href="https://openathens-sp.highwire.org/session/init?entityID=https%3A//idp.eduserv.org.uk/openathens&hw-shib-return-uri=https%3A//gut.bmj.com/accallback/content%25252Fearly%25252F2024%25252F10%25252F30%25252Fgutjnl-2024-334018&subcode=bmjjournals" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via OpenAthens</a></div><a href="https://www.bsg.org.uk/login.html" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via BSG</a> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-opportunity-challenge" > <div class="pane-content"> <div class='opportunity-challenge-login'><h3>Log in using your username and password</h3><div class="drupal-login compact"><form action="/content/early/2024/10/30/gutjnl-2024-334018" method="post" id="highwire-user-login--3" accept-charset="UTF-8"><div><div id="edit-customtext--3" class="form-item form-item-label-before form-type-item"> <span class="customtext">For personal accounts OR managers of institutional accounts</span> </div> <div class="form-item form-item-label-invisible form-type-textfield form-item-name"> <label class="element-invisible" for="edit-name--3">Username <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Username" type="text" id="edit-name--3" name="name" value="" size="30" maxlength="60" class="form-text required" /> </div> <div class="form-item form-item-label-invisible form-type-password form-item-pass"> <label class="element-invisible" for="edit-pass--3">Password <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Password" type="password" id="edit-pass--3" name="pass" size="30" maxlength="128" class="form-text required" /> </div> <input type="hidden" name="form_build_id" value="form-cj68aXd7yAPUBnsVSEA4s2g2gFszogAA5vWf5gyd1zY" /> <input type="hidden" name="form_id" value="highwire_user_login" /> <div class="bmjj-reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot your log in details?</a><a href="/user/register?destination=node/265192" class="" data-icon-position="" data-hide-link-title="0">Register a new account?</a></div><div class="form-actions form-wrapper" id="edit-actions--3"><input type="submit" id="edit-submit--3" name="op" value="Log in" class="form-submit" /></div><div class="reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot</a> your user name or password?</div></div></form></div></div> </div> </div> </div> </div> </div> </div> </div> </div> </li> <li class="last leaf"><a href="http://journals.bmj.com/" data-hide-link-title="0" class="bmj-link" data-icon-position="">BMJ Journals</a></li> </ul> </div> </div> </div></div> </div> </div> </div> </div> </div> </div> </div> </section> <section role="main" class="section section-content container-fluid"> <div class="crumb-navigation"> <div class="row"> <div class="col-mobile-12 col-narrow-9 col-normal-9 col-wide-10 breadcrumbs"> <h2 class="element-invisible">You are here</h2><div class="item-list"><ul class="breadcrumb"><li class="first"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Home</a></li> <li><a href="/content/early/recent" class="" data-icon-position="" data-hide-link-title="0">Online First</a></li> <li class="last"><span class="active">Single-use scopes may reduce various environmental impacts of gastroscopy in some situations but probably not in routine practice of endoscopy units</span></li> </ul></div> </div> <div class="mobile-hidden col-narrow-3 col-normal-3 col-wide-2 email-alerts"> <span> <a href="https://myaccount.bmj.com/myaccount/signup.html?regService=etoc-alerts&corpusCode=gutjnl&fwdUrl=https://gut.bmj.com/" class="email-alerts-label"><i class="icon icon-article-alerts"></i>Email alerts</a> </span> </div> </div> </div> <div class="container"> <div class="zone zone-content row"> <div class="region region-content col-narrow-12"> <div class="region-inner region-content-inner"> <a id="main-content"></a> <div class="region region-content"> <div id="block-system-main" class="block block-system" class="block block-system"> <div class="content"> <div class="panel-display two-layout " > <div class="panel-row-wrapper panel-row-first row"> <div class="top-wrapper col-narrow-12"> <div class="panel-panel panel-region-top"> <div class="inside"><div class="panel-pane pane-panels-mini pane-article-tabset-mobile mobile-only" id="mobile-article-tab-container"> <div class="pane-content"> <div class="panel-display two-layout " id="mini-panel-article_tabset_mobile_"> <div class="panel-row-wrapper row"> <div class="left-wrapper col-mobile-6"> <div class="panel-panel panel-region-left"> <div class="inside"><div class="panel-pane pane-bmjj-mob-tab-title" id="mobile-tab-title"> <div class="pane-content"> <p><span class="icon-article-text"></span>Article Text</p> </div> </div> </div> </div> </div> <div class="right-wrapper col-mobile-6"> <div class="panel-panel panel-region-right"> <div class="inside"><div class="panel-pane pane-bmjj-mobile-article-menu" > <div class="pane-content"> <a href="#block-system-main" class="mobile-article-tab" data-icon-position="" data-hide-link-title="0">Article menu <span class="icon-plus icon-toggle"></span></a><div class="mobile-art-drop-down"></div> </div> </div> </div> </div> </div> </div>  </div> </div> </div> </div> </div> </div> </div>  <div class="panel-row-wrapper row relative" id="article-top"> <div class="left-wrapper col-narrow-2 col-normal-1 col-wide-1 tab-pane"> <div class="panel-panel panel-region-left"> <div class="inside"><div class="panel-pane pane-highwire-panel-tabs pane-panels-ajax-tab-tabs nav nav-tabs nav-stacked articleToolbar mobile-hidden" id="nav-tabs"> <div class="pane-content"> <div class="item-list"><ul class="tabs inline panels-ajax-tab"><li class="active first"><a href="/content/early/2024/10/30/gutjnl-2024-334018" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_tab_art" data-target-id="highwire_article_tabs" data-entity-context="node:265192" data-trigger="" data-url-enabled="1"><span class="icon-article-text"></span>Article <br/>Text</a><a href="/panels_ajax_tab/jnl_template_bmjj_tab_art/node:265192/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=""><a href="/content/early/2024/10/30/gutjnl-2024-334018.info" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_art_info" data-target-id="highwire_article_tabs" data-entity-context="node:265192" data-trigger="info" data-url-enabled="1"><span class="icon-article-info"></span>Article <br/>info</a><a href="/panels_ajax_tab/jnl_template_bmjj_art_info/node:265192/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=""><a href="/content/early/2024/10/30/gutjnl-2024-334018.citation-tools" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_cite_tool" data-target-id="highwire_article_tabs" data-entity-context="node:265192" data-trigger="citation-tools" data-url-enabled="1"><span class="icon-citation-tools"></span>Citation <br/>Tools</a><a href="/panels_ajax_tab/jnl_template_bmjj_cite_tool/node:265192/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=""><a href="/content/early/2024/10/30/gutjnl-2024-334018.share" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_share" data-target-id="highwire_article_tabs" data-entity-context="node:265192" data-trigger="share" data-url-enabled="1"><span class="icon-share"></span>Share</a><a href="/panels_ajax_tab/jnl_template_bmjj_share/node:265192/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=""><a href="/content/early/2024/10/30/gutjnl-2024-334018.responses" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_tab_elets" data-target-id="highwire_article_tabs" data-entity-context="node:265192" data-trigger="responses" data-url-enabled="1"><span class="icon-responses"></span>Rapid Responses</a><a href="/panels_ajax_tab/jnl_template_bmjj_tab_elets/node:265192/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=""><a href="/content/early/2024/10/30/gutjnl-2024-334018.altmetrics" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_tab_altmetrics" data-target-id="highwire_article_tabs" data-entity-context="node:265192" data-trigger="altmetrics" data-url-enabled="1"><span class="icon-article-stats"></span>Article <br/>metrics</a><a href="/panels_ajax_tab/jnl_template_bmjj_tab_altmetrics/node:265192/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> <li class=" last"><a href="/content/early/2024/10/30/gutjnl-2024-334018.alerts" class="panels-ajax-tab-tab" data-panel-name="jnl_template_bmjj_art_alert" data-target-id="highwire_article_tabs" data-entity-context="node:265192" data-trigger="alerts" data-url-enabled="1"><span class="icon-article-alerts"></span>Alerts</a><a href="/panels_ajax_tab/jnl_template_bmjj_art_alert/node:265192/1" rel="nofollow" style="display:none" class="js-crawler-link"></a></li> </ul></div> </div> </div> </div> </div> </div> <div class="right-wrapper col-narrow-9 col-normal-10 col-wide-10 article-pane panel-region-main"> <div class="panel-panel panel-region-right"> <div class="inside"><div class="panel-pane pane-bmjj-challenge-modal col-mobile-2 col-narrow-1 pull-right " > <div class="pane-content"> <a href="" class="" data-icon-position="" data-hide-link-title="0"><a href="#" id="chal-modal" class="article-pdf-download"><img alt="Download PDF" src="/sites/default/themes/bmjj/img/icon-pdf.png" /><strong>PDF</strong></a></a> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-entity-field pane-node-field-highwire-article-cat article-category col-narrow-9 col-normal-10" > <div class="pane-content"> <div class="field field-name-field-highwire-article-cat field-type-text field-label-hidden"><div class="field-items"><div class="field-item even">Letter</div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-article-citation col-mobile-10 col-narrow-10 col-normal-11 article-title" > <div class="pane-content"> <div class="highwire-article-citation highwire-citation-type-highwire-article node265192" data-node-nid="265192" id="node-265192--21319737907" data-pisa="gutjnl;gutjnl-2024-334018v1" data-pisa-master="gutjnl;gutjnl-2024-334018" data-apath="/gutjnl/early/2024/10/30/gutjnl-2024-334018.atom"><cite class="highwire-cite highwire-cite-highwire-article highwire-citation-bmjj-title clearfix"> <div class="highwire-cite-title">Single-use scopes may reduce various environmental impacts of gastroscopy in some situations but probably not in routine practice of endoscopy units</div> <span class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="gutjnl;gutjnl-2024-334018" data-atom-uri="/gutjnl/early/2024/10/30/gutjnl-2024-334018.atom" data-request-view="full"></span></span> </cite> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-panel-tabs-container col-narrow-12 clear" > <div class="pane-content"> <div data-panels-ajax-tab-preloaded="jnl_template_bmjj_tab_art" id="panels-ajax-tab-container-highwire_article_tabs" class="panels-ajax-tab-container"><div class="panels-ajax-tab-loading" style ="display:none"><img class="loading" src="https://gut.bmj.com/sites/all/modules/contrib/panels_ajax_tab/images/loading.gif" alt="Loading" title="Loading" /></div><div class="panels-ajax-tab-wrap-jnl_template_bmjj_tab_art"><div class="panel-display panel-1col clearfix" > <div class="panel-panel panel-col"> <div><div class="panel-pane pane-highwire-markup author-affiliates col-narrow-12 author-affiliates-corresp article" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><a href="http://orcid.org/0000-0002-6482-2375" class="bmjj-markup-orcid-logo" target="_blank">http://orcid.org/0000-0002-6482-2375</a><span class="name">Mathieu Pioche</span><span class="xref-aff">1</span>, </li><li class="contributor" id="contrib-2"><span class="name">Guillaume Vidal</span><span class="xref-aff">2</span><span class="xref-sep">,</span><span class="xref-aff">3</span>, </li><li class="contributor" id="contrib-3"><span class="name">Madj Ben Rejeb</span><span class="xref-aff">4</span>, </li><li class="contributor" id="contrib-4"><span class="name">Rémi Collin</span><span class="xref-aff">2</span><span class="xref-sep">,</span><span class="xref-aff">3</span>, </li><li class="last" id="contrib-5"><span class="name">Jérémie Jacques</span><span class="xref-aff">5</span><span class="xref-sep">,</span><span class="xref-aff">6</span></li></ol><ol class="affiliation-list"><li class="aff"><address><sup>1</sup><span class="institution">Gastroenterology and Endoscopy</span>, <span class="institution">Edouard Herriot Hospital</span>, <span class="addr-line">Lyon</span>, France</address></li><li class="aff"><address><sup>2</sup><span class="institution">University Hospital of Clermont-Ferrand</span>, <span class="addr-line">Clermont-Ferrand</span>, France</address></li><li class="aff"><address><sup>3</sup><span class="institution">Gastroeterology, Hopital Dupuytren, University Hospital of Limoges</span>, <span class="addr-line">Limoges</span>, France</address></li><li class="aff"><address><sup>4</sup><span class="institution">Department of Gastroenterology and Hepatology</span>, <span class="institution">CH Saint Flour</span>, <span class="addr-line">Saint-Flour</span>, <span class="addr-line">Rhône-Alpes</span>, France</address></li><li class="aff"><address><sup>5</sup><span class="institution">Gastroenterology</span>, <span class="institution">Hopital Dupuytren</span>, <span class="addr-line">Limoges</span>, France</address></li><li class="aff"><address><sup>6</sup><span class="institution">UMR 7252</span>, <span class="institution">CNRS XLIM</span>, <span class="addr-line">Limoges</span>, France</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1"><span class="corresp-label">Correspondence to</span> Dr Mathieu Pioche, Gastroenterology and endoscopy, Edouard Herriot Hospital, Lyon, France; <span class="em-link"><span class="em-addr">mathieu.pioche{at}chu-lyon.fr</span></span></li></ol></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup abstract-with-bc" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" id="content-block" xmlns:xhtml="http://www.w3.org/1999/xhtml"><span class="related-urls"></span></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-1" > <div class="pane-content"> <p><a href="https://doi.org/10.1136/gutjnl-2024-334018" target="_new">https://doi.org/10.1136/gutjnl-2024-334018</a></p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-altmetrics" > <h2 class="pane-title">Statistics from Altmetric.com</h2> <div class="pane-content"> <div data-badge-details="right" data-badge-type="medium-donut" data-doi="10.1136/gutjnl-2024-334018" data-hide-no-mentions="true" class="altmetric-embed"></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-bmjj-jumplinks" > <div class="pane-content"> <div class="highwire-list-wrapper"><div class="highwire-list"><ul></ul></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-custom pane-2 permissions-box" > <h2 class="pane-title">Request Permissions</h2> <div class="pane-content"> <p>If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.</p> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-ajax-pane-content permissions-box pane-highwire-permission-link" id="request-permissions"> <h2 class="pane-title"><span class='panels-ajax-pane-title' data-pid='new-70fd4c70-563e-4b94-ae3b-2a97f3980c13'></span></h2> <div class="pane-content"> <div class='panels-ajax-pane panels-ajax-pane-new-70fd4c70-563e-4b94-ae3b-2a97f3980c13' data-pid='new-70fd4c70-563e-4b94-ae3b-2a97f3980c13'></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article extract-view"><span class="highwire-journal-article-marker-start"></span><ul class="kwd-group"><li class="kwd"><a href="/keyword/endoscopy" class="hw-term hw-article-keyword hw-article-keyword-endoscopy" rel="nofollow">endoscopy</a></li></ul><p id="p-1">We read with interest the letter from Han <em>et al</em> about our study<span class="xref-bibr">1</span> and we thank those authors for underlining points to be discussed about the real place of single use and reusable endoscope strategies.</p><p id="p-2">Although the benefits for reducing cross-infections seem significant, assessing the positive indirect environmental impact is difficult, as the number of patients involved in high-infection risk<span class="xref-bibr">2</span> care remains very low compared with the daily endoscopy practice evaluated in this study, with conventional gastroscopes, disinfected in the standard way, in a routine activity and not in intensive care units with high-level disinfection processes.<span class="xref-bibr">3</span> Moreover, this study focused on gastroscopes, with low risk of cross-infections in opposition to duodenoscopes. Of course, the weight of the endoscope’s plastic is an important element in the analysis, explaining the difference between our results and those … </p><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="https://gut.bmj.com/content/early/2024/10/30/gutjnl-2024-334018.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-markup footnotes" > <div class="pane-content"> <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section fn-group" id="fn-group-1"><h2>Footnotes</h2><ul><li class="fn-other" id="fn-1"><p id="p-10"><span class="fn-label">Contributors</span> MP is the guarantor, other authors have participated in measuring the different procedures volume and distance.</p></li><li class="fn-other" id="fn-2"><p id="p-11"><span class="fn-label">Funding</span> The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.</p></li><li class="fn-conflict" id="fn-3"><p id="p-12"><span class="fn-label">Competing interests</span> None declared.</p></li><li class="fn-other" id="fn-4"><p id="p-13"><span class="fn-label">Provenance and peer review</span> Not commissioned; internally peer reviewed.</p></li></ul></div></div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-dfp-pane" > <div class="pane-content"> <div id="dfp-ad-mpu-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-mpu" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-mpu"); }); </script> </div> </div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-template-bmjj-challenge article-login" > <h2 class="pane-title">Read the full text or download the PDF:</h2> <div class="pane-content"> <div class="panel-display three-layout " id="mini-panel-jnl_template_bmjj_challenge"> <div class="panel-row-wrapper row"> <div class="left-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-left"> <div class="inside"><div class="panel-pane pane-add-to-cart" > <div class="pane-content"> <span class="highwire-foxycart-add-to-cart-ahah highwire-foxycart-add-to-cart-ahah" data-text="Buy this article (%short-price)" data-apath="/gutjnl/early/2024/10/30/gutjnl-2024-334018.atom" data-type="link" data-font-icon="" data-parent-id="135429"></span> </div> </div> </div> </div> </div> <div class="middle-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-middle"> <div class="inside"><div class="panel-pane pane-bmjj-article-subscribe-button" > <div class="pane-content"> <a href="/subscribe" class="btn btn-default btn-lg" data-icon-position="" data-hide-link-title="0">Subscribe</a> </div> </div> </div> </div> </div> <div class="right-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-right article-login"> <div class="inside"><div class="panel-pane pane-custom pane-3" > <div class="pane-content"> <button type="submit" class="btn btn-default btn-lg" id="sign-in" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false" aria-hidden="true">Log in <svg class="icon icon-white icon-arrow-down"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="/sites/default/themes/bmjj/img/defs.svg#icon-arrow-down"></use></svg></button> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-challenge-opportunity-pane-dropdown" > <div class="pane-content"> <div class="panel-display panel-1col clearfix" id="mini-panel-challenge_opportunity_pane_dropdown"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-society-logins society-logins" > <div class="pane-content"> <span class="ui-button ui-state-default ui-dialog-titlebar-close" title="close"></span><div class="shib-login-link"><a href="/login/shibboleth?subcode=bmjjournals&env=prod&uri=https%3A//gut.bmj.com/accallback/content%25252Fearly%25252F2024%25252F10%25252F30%25252Fgutjnl-2024-334018" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via Institution</a></div><div class="openathens-login-link"><a href="https://openathens-sp.highwire.org/session/init?entityID=https%3A//idp.eduserv.org.uk/openathens&hw-shib-return-uri=https%3A//gut.bmj.com/accallback/content%25252Fearly%25252F2024%25252F10%25252F30%25252Fgutjnl-2024-334018&subcode=bmjjournals" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via OpenAthens</a></div><a href="https://www.bsg.org.uk/login.html" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via BSG</a> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-opportunity-challenge" > <div class="pane-content"> <div class='opportunity-challenge-login'><h3>Log in using your username and password</h3><div class="drupal-login compact"><form action="/content/early/2024/10/30/gutjnl-2024-334018" method="post" id="highwire-user-login" accept-charset="UTF-8"><div><div id="edit-customtext" class="form-item form-item-label-before form-type-item"> <span class="customtext">For personal accounts OR managers of institutional accounts</span> </div> <div class="form-item form-item-label-invisible form-type-textfield form-item-name"> <label class="element-invisible" for="edit-name">Username <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Username" type="text" id="edit-name" name="name" value="" size="30" maxlength="60" class="form-text required" /> </div> <div class="form-item form-item-label-invisible form-type-password form-item-pass"> <label class="element-invisible" for="edit-pass">Password <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Password" type="password" id="edit-pass" name="pass" size="30" maxlength="128" class="form-text required" /> </div> <input type="hidden" name="form_build_id" value="form-y7hfByrijRKznuao3lNXlq4fRgK73v6n9yVOQ0_8c9s" /> <input type="hidden" name="form_id" value="highwire_user_login" /> <div class="bmjj-reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot your log in details?</a><a href="/user/register?destination=node/265192" class="" data-icon-position="" data-hide-link-title="0">Register a new account?</a></div><div class="form-actions form-wrapper" id="edit-actions"><input type="submit" id="edit-submit" name="op" value="Log in" class="form-submit" /></div><div class="reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot</a> your user name or password?</div></div></form></div></div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div>  </div> </div> </div> </div> </div> </div> </div></div> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-jnl-template-bmjj-challenge article-login col-narrow-12 clear hidden" > <h2 class="pane-title">Read the full text or download the PDF:</h2> <div class="pane-content"> <div class="panel-display three-layout " id="mini-panel-jnl_template_bmjj_challenge-1"> <div class="panel-row-wrapper row"> <div class="left-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-left"> <div class="inside"><div class="panel-pane pane-add-to-cart" > <div class="pane-content"> <span class="highwire-foxycart-add-to-cart-ahah highwire-foxycart-add-to-cart-ahah" data-text="Buy this article (%short-price)" data-apath="/gutjnl/early/2024/10/30/gutjnl-2024-334018.atom" data-type="link" data-font-icon="" data-parent-id="135429"></span> </div> </div> </div> </div> </div> <div class="middle-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-middle"> <div class="inside"><div class="panel-pane pane-bmjj-article-subscribe-button" > <div class="pane-content"> <a href="/subscribe" class="btn btn-default btn-lg" data-icon-position="" data-hide-link-title="0">Subscribe</a> </div> </div> </div> </div> </div> <div class="right-wrapper col-narrow-12 col-normal-4"> <div class="panel-panel panel-region-right article-login"> <div class="inside"><div class="panel-pane pane-custom pane-4" > <div class="pane-content"> <button type="submit" class="btn btn-default btn-lg" id="sign-in" data-toggle="dropdown" aria-haspopup="true" aria-expanded="false" aria-hidden="true">Log in <svg class="icon icon-white icon-arrow-down"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="/sites/default/themes/bmjj/img/defs.svg#icon-arrow-down"></use></svg></button> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-panels-mini pane-challenge-opportunity-pane-dropdown" > <div class="pane-content"> <div class="panel-display panel-1col clearfix" id="mini-panel-challenge_opportunity_pane_dropdown-1"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-society-logins society-logins" > <div class="pane-content"> <span class="ui-button ui-state-default ui-dialog-titlebar-close" title="close"></span><div class="shib-login-link"><a href="/login/shibboleth?subcode=bmjjournals&env=prod&uri=https%3A//gut.bmj.com/accallback/content%25252Fearly%25252F2024%25252F10%25252F30%25252Fgutjnl-2024-334018" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via Institution</a></div><div class="openathens-login-link"><a href="https://openathens-sp.highwire.org/session/init?entityID=https%3A//idp.eduserv.org.uk/openathens&hw-shib-return-uri=https%3A//gut.bmj.com/accallback/content%25252Fearly%25252F2024%25252F10%25252F30%25252Fgutjnl-2024-334018&subcode=bmjjournals" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via OpenAthens</a></div><a href="https://www.bsg.org.uk/login.html" class="button society-login-link" data-icon-position="" data-hide-link-title="0">Log in via BSG</a> </div> </div> <div class="panel-separator"></div><div class="panel-pane pane-highwire-opportunity-challenge" > <div class="pane-content"> <div class='opportunity-challenge-login'><h3>Log in using your username and password</h3><div class="drupal-login compact"><form action="/content/early/2024/10/30/gutjnl-2024-334018" method="post" id="highwire-user-login--2" accept-charset="UTF-8"><div><div id="edit-customtext--2" class="form-item form-item-label-before form-type-item"> <span class="customtext">For personal accounts OR managers of institutional accounts</span> </div> <div class="form-item form-item-label-invisible form-type-textfield form-item-name"> <label class="element-invisible" for="edit-name--2">Username <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Username" type="text" id="edit-name--2" name="name" value="" size="30" maxlength="60" class="form-text required" /> </div> <div class="form-item form-item-label-invisible form-type-password form-item-pass"> <label class="element-invisible" for="edit-pass--2">Password <span class="form-required" title="This field is required.">*</span></label> <input placeholder="Password" type="password" id="edit-pass--2" name="pass" size="30" maxlength="128" class="form-text required" /> </div> <input type="hidden" name="form_build_id" value="form-rZAkkTbDMJ7VE4MnjB4UZAUQwzBJnFH69LSy8yPQkHc" /> <input type="hidden" name="form_id" value="highwire_user_login" /> <div class="bmjj-reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot your log in details?</a><a href="/user/register?destination=node/265192" class="" data-icon-position="" data-hide-link-title="0">Register a new account?</a></div><div class="form-actions form-wrapper" id="edit-actions--2"><input type="submit" id="edit-submit--2" name="op" value="Log in" class="form-submit" /></div><div class="reset-password"><a href="/user/password" class="" data-icon-position="" data-hide-link-title="0">Forgot</a> your user name or password?</div></div></form></div></div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div>  </div> </div> </div> </div> </div> <a href="#" id="article-bottom"></a> </div> <div class="col-narrow-1 mobile-hidden back-top" id="back-top"> <div class="panel-panel panel-region-left"> <div class="inside" id="back-top-inner"><div class="panel-pane pane-bmjj-back-to-top article-go-to-top" > <div class="pane-content"> <a href="#block-system-main" class="back-to-top" data-icon-position="" data-hide-link-title="0"><svg class="icon-article icon-arrow-up-top" aria-hidden="true"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="/sites/default/themes/bmjj/img/defs.svg#icon-arrow-up"></use></svg></a><a href="#article-bottom" class="back-to-top back-to-bottom" data-icon-position="" data-hide-link-title="0"><svg class="icon-article icon-arrow-up-top" aria-hidden="true"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="/sites/default/themes/bmjj/img/defs.svg#icon-arrow-down"></use></svg></a> </div> </div> </div> </div> </div> </div>  <div class="panel-row-wrapper panel-row-last row" id="article-bottom-row"> <div class="bottom-wrapper col-narrow-12"> <div class="panel-panel panel-region-bottom"> <div class="inside"><div class="panel-pane pane-snippet pane-footer-marketing-slots" > <div class="pane-content"> <div class="snippet footer-marketing-slots" id="footer-marketing-slots"> <div class="snippet-content"> <iframe data-src="https://jobs.bmj.com/widget/bootstrap/job/#i=180" class="optanon-category-3" id="mdgxWidgetiFrame" title="careers widget"></iframe> <script type="text/javascript" src="//trendmd.s3.amazonaws.com/trendmd.min.js"></script> <script type="text/plain" class="optanon-category-4">TrendMD.register( {journal_id: 39235, element: '#trendmd-suggestions', track_id: null} );</script> <div id="trendmd-suggestions"></div> </div> </div> </div> </div> </div> </div> </div> </div>  </div> </div> </div> </div> </div> </div> </div> </div> </section>  </div>  <footer role="contentinfo" class="section section-footer container-fluid" id="footer"> <section class="zone zone-footer row footer-journal-societies"> <div class="region region-footer col-narrow-12"> <div class="region-inner region-footer-inner"> <div class="region region-footersoc"> <div id="block-panels-mini-footer-society-images" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-footer_society_images"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-societies-logos" > <div class="pane-content"> <ul><li><a href="http://www.bsg.org.uk/"><img src="https://resources.bmj.com/repository/journals-network-project/images/society-logos/society-logo-bsg.png" alt="British Society of Gastroenterology" /></a></li></ul> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </section> <section role="contentinfo" class="section section-footer"> <div class="zone zone-footer footer-links"> <nav class="row"> <div class="region region-footerlinks1"> <div id="block-menu-block-1" class="block block-menu-block" class="block block-menu-block"> <div class="content"> <div class="menu-block-wrapper menu-block-1 menu-name-menu-footer-menu-1 parent-mlid-0 menu-level-1"> <ul class="menu"><li class="first expanded menu-mlid-15078 col-mobile-12 col-narrow-3 col-normal-3 col-wide-3"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Content</a><ul class="menu"><li class="first leaf menu-mlid-15079"><a href="/content/early/recent" class="" data-icon-position="" data-hide-link-title="0">Latest</a></li> <li class="leaf menu-mlid-15080"><a href="/content/current" class="" data-icon-position="" data-hide-link-title="0">Current issue</a></li> <li class="leaf menu-mlid-15081"><a href="/content/by/year" class="" data-icon-position="" data-hide-link-title="0">Archive</a></li> <li class="leaf menu-mlid-15082"><a href="http://gut.bmj.com/pages/education-in-gastroenterology" class="" data-icon-position="" data-hide-link-title="0">Education in Gastroenterology</a></li> <li class="leaf menu-mlid-15083"><a href="http://gut.bmj.com/pages/browse-by-topic/" class="" data-icon-position="" data-hide-link-title="0">Browse by collection</a></li> <li class="leaf menu-mlid-15084"><a href="https://gut.bmj.com/pages/visual-abstracts" class="" data-icon-position="" data-hide-link-title="0">Visual Abstracts</a></li> <li class="leaf menu-mlid-15085"><a href="http://gut.bmj.com/pages/most-read-articles/" class="" data-icon-position="" data-hide-link-title="0">Most read articles</a></li> <li class="leaf menu-mlid-15086"><a href="http://gut.bmj.com/pages/top-cited-articles/" class="" data-icon-position="" data-hide-link-title="0">Top cited articles</a></li> <li class="last leaf menu-mlid-15087"><a href="http://gut.bmj.com/pages/eletters" class="" data-icon-position="" data-hide-link-title="0">Responses</a></li> </ul></li> <li class="expanded menu-mlid-15088 col-mobile-12 col-narrow-3 col-normal-3 col-wide-3"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Journal</a><ul class="menu"><li class="first leaf menu-mlid-15089"><a href="http://gut.bmj.com/pages/about/" class="" data-icon-position="" data-hide-link-title="0">About</a></li> <li class="leaf menu-mlid-15090"><a href="http://gut.bmj.com/site/about/edboard.xhtml" class="" data-icon-position="" data-hide-link-title="0">Editorial board</a></li> <li class="leaf menu-mlid-15091"><a href="https://myaccount.bmj.com/myaccount/signup.html?regService=etoc-alerts&corpusCode=gutjnl&fwdUrl=https://gut.bmj.com/" class="" data-icon-position="" data-hide-link-title="0">Sign up for email alerts</a></li> <li class="leaf menu-mlid-15092"><a href="http://gut.bmj.com/pages/subscribe/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Subscribe</a></li> <li class="last leaf menu-mlid-15093"><a href="http://gut.bmj.com/pages/thank-you-to-our-reviewers/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Thank you to our reviewers</a></li> </ul></li> <li class="expanded menu-mlid-15094 col-mobile-12 col-narrow-3 col-normal-3 col-wide-3"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Authors</a><ul class="menu"><li class="first leaf menu-mlid-15095"><a href="http://gut.bmj.com/pages/authors/" class="" data-icon-position="" data-hide-link-title="0">Instructions for authors</a></li> <li class="leaf menu-mlid-15096"><a href="http://mc.manuscriptcentral.com/gut" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Submit an article paper</a></li> <li class="leaf menu-mlid-15097"><a href="http://authors.bmj.com/policies/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Editorial policies</a></li> <li class="leaf menu-mlid-15098"><a href="http://openaccess.bmj.com/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Open Access at BMJ</a></li> <li class="last leaf menu-mlid-15099"><a href="http://authors.bmj.com/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">BMJ Author Hub</a></li> </ul></li> <li class="last expanded menu-mlid-15100 col-mobile-12 col-narrow-3 col-normal-3 col-wide-3"><a href="/" class="" data-icon-position="" data-hide-link-title="0">Help</a><ul class="menu"><li class="first leaf menu-mlid-15101"><a href="http://gut.bmj.com/pages/contact-us/" class="" data-icon-position="" data-hide-link-title="0">Contact us</a></li> <li class="leaf menu-mlid-15102"><a href="http://journals.bmj.com/cgi/reprintform" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Reprints</a></li> <li class="leaf menu-mlid-15103"><a href="http://www.bmj.com/company/products-services/rights-and-licensing/permissions" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Permissions</a></li> <li class="leaf menu-mlid-15104"><a href="https://www.bmj.com/company/for-advertisers-and-sponsor/" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Advertising</a></li> <li class="last leaf menu-mlid-15105"><a href="http://myaccount.bmj.com/myaccount/customerservice/salesforce-form.html" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Feedback form</a></li> </ul></li> </ul></div> </div> </div> </div> </nav> <div class="row"> <nav class="col-mobile-12 col-narrow-3 col-normal-3 col-wide-3"> <div class="region region-footersocial"> <div id="block-panels-mini-social-icons" class="block block-panels-mini" class="block block-panels-mini"> <div class="content"> <div class="panel-display panel-1col clearfix" id="mini-panel-social_icons"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-bmjj-social-icons" > <div class="pane-content"> <ul class="menu"><li class="leaf"><a href="http://gut.bmj.com/pages/rss-feeds" class="link-icon-only link-icon"><span class="icon icon-rss"></span><span class="title element-invisible"> RSS</span></a></li><li class="leaf"><a href="http://twitter.com/Gut_BMJ" class="link-icon-only link-icon"><span class="icon icon-twitter"></span><span class="title element-invisible"> Twitter</span></a></li><li class="leaf"><a href="http://www.facebook.com/Gut.BMJ" class="link-icon-only link-icon"><span class="icon icon-facebook"></span><span class="title element-invisible"> Facebook</span></a></li><li class="leaf"><a href="http://blogs.bmj.com/gut" class="link-icon-only link-icon"><span class="icon icon-blog"></span><span class="title element-invisible"> Blog</span></a></li><li class="leaf"><a href="https://soundcloud.com/bmjpodcasts/sets/gut-podcast" class="link-icon-only link-icon"><span class="icon icon-soundcloud"></span><span class="title element-invisible"> Soundcloud</span></a></li><li class="leaf"><a href="https://www.youtube.com/@GastroenterologyatBMJ-z9e" class="link-icon-only link-icon"><span class="icon icon-youtube"></span><span class="title element-invisible"> YouTube</span></a></li></ul> </div> </div> </div> </div> </div> </div> </div> </div> </nav> </div> </div> </section> <section class="row footer-platform"> <div class="col-mobile-12 col-narrow-4 logoBMJ"> <a href="http://www.bmj.com/company"><svg class="logo-bmj-svg" aria-hidden="true"><use xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="#logo-bmj"></use><svg></svg></svg></a> </div> <div class="col-mobile-12 col-narrow-8 legal"> <div class="legal-inner"> <ul> <li><a href="http://www.bmj.com/company/legal-information/">Website Terms & Conditions</a></li> <li><a href="http://www.bmj.com/company/your-privacy/">Privacy & Cookies</a></li> <li><a href="http://www.bmj.com/company/contact-us/">Contact BMJ</a></li> </ul>  <button id="ot-sdk-btn" class="ot-sdk-show-settings">Cookie Settings</button>  <p><small><span class="online-issn issn">Online ISSN: 1468-3288</span><span class="print-issn issn">Print ISSN: 0017-5749</span></small><br /> <small>Copyright © 2024 BMJ Publishing Group Ltd & British Society of Gastroenterology. All rights reserved.</small></p> </div> </div> </section> <div class="region region-absolute-bottom"> <div class="region-inner region-absolute-bottom-inner"> <div class="region region-absolute-bottom"> <div id="block-panels-mini-bottom-ad" class="block block-panels-mini text-center" class="block block-panels-mini text-center"> <div class="content"> <div class="panel-display one-layout " id="mini-panel-bottom_ad"> <div class="panel-panel panel-col"> <div><div class="panel-pane pane-dfp-pane" > <div class="pane-content"> <div id="dfp-ad-bottom-wrapper" class="dfp-tag-wrapper"> <div id="dfp-ad-bottom" class="dfp-tag-wrapper"> <script type="text/javascript"> googletag.cmd.push(function() { googletag.display("dfp-ad-bottom"); }); </script> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </div> </footer> <script type="text/javascript" src="/sites/default/files/advagg_js/js__xcXbPzItgCxLeD5Uy3L62U87U9ne3iv4g12sHKvzY80__MQ39WNLMHbEWS9SH5grYUB74j6iCxSoGMz9-a66u8_E__RBpwsggTa-66iCd391Lg7-ZmaIvHPOUAGYyVtdCScb8.js"></script> <script type="text/javascript" src="/sites/default/files/advagg_js/js__Jd5dsvNznZMdglFu8sSni1wCsUfzvQbApHPAZwt5TY4__65Mqa1DMRwcSvPxjJEn6BXgMm-ckF3oOvkUTG9HRADI__RBpwsggTa-66iCd391Lg7-ZmaIvHPOUAGYyVtdCScb8.js" defer="defer"></script> <script type="text/javascript" src="/sites/default/files/advagg_js/js__3YMnGGenZXx95e2d4w4qdZ8l2Nb4ScWnb6eRd_RG1Rk__bLDjtRazOW5NHwJqxd6XFtHApU0Yj0Keahi0hcnwqJ4__RBpwsggTa-66iCd391Lg7-ZmaIvHPOUAGYyVtdCScb8.js"></script> </body> </html>