RE:Behind the ScenesI am not familiar with off site sterilization being used much in Canada, though it can be an option. There are definite logistics costs with this, especially related to transporting sterile instrument trays, unless the latter are wrapped, sealed, labelled, and properly handled. And, transporting instruments off site can be very inefficient in terms of achieving optimal instrument turn around times and cost-effective use.
With regards to using this concept with scopes, off site would be out of the question with reprocessors and high level disinfection, I believe. Treating scopes with the best high level disinfection means that the scope cannot be stored and transported, but must be used immediately, or 'just in time', before a surgery is done. With the VP4, of course, sterilized instruments can be stored or transported. With many reprocessors, scopes are disinfected and then hung up to dry. They are not to be transported, I believe, in this 'hung' storage position. With this latter, there is no pretense of sterility, and this is the source, many believe, of a substantial number of the contamination cases that are occurring. (Inadequate cleaning and disinfection... then leaving the scope to hang and 'dry' in a cupboard to grow more bacteria before it is used again the next day or the next weeks is a standard but, hopefully, soon to be unacceptable antiquanted practice)
The VP4 is very robust and efficient and solves these problems because it provides terminal sterilization, so instruments don't have to be used 'just in time', though they must be enclosed and sealed in a sterile drape material and properly labelled if they are to be stored for any period of time or transported.