Manual versus automated methods for cleaning reusable accessory devices used for minimally invasive surgical...

Area of Science:

• Medical Devices
• Surgical Instrument Reprocessing
• Minimally Invasive Surgery

Background:

• Effective cleaning of surgical instruments is critical for patient safety.
• Minimally invasive surgery (MIS) utilizes complex accessory devices that can be challenging to clean.
• The design of accessory devices, specifically the presence or absence of ports, may impact cleaning efficacy.

Purpose of the Study:

• To quantitatively evaluate the cleaning efficacy of ported versus non-ported laparoscopic accessory devices.
• To compare manual cleaning methods with automated cleaning using the SI-Auto Narrow lumen cleaner.
• To assess the impact of retro-flushing in automated cleaning processes.

Main Methods:

• Simulated-use study employing quantitative methods.
• Laparoscopic scissors and forceps were contaminated with artificial test soil and bacterial surrogates (Enterococcus faecalis, Geobacillus stearothermophilus).
• Devices were subjected to manual cleaning, automated cleaning with the SI-Auto Narrow lumen cleaner (with and without retro-flushing), and sonication alone.

Main Results:

• Manual cleaning left significantly more soil residuals in non-ported devices compared to ported devices.
• Automated cleaning with retro-flushing achieved >99% reduction in soil parameters for both ported and non-ported devices.
• Automated cleaning of ported devices resulted in a 10(3)-10(4)-fold reduction in bacterial numbers, outperforming other methods.
• Sonication alone was insufficient for effective soil and organism removal from inner channels.

Conclusions:

• Non-ported accessory devices are inherently more difficult to clean effectively than ported devices.
• Automated cleaning utilizing retro-flushing is recommended for reprocessing non-ported laparoscopic accessory devices.
• The design of surgical instruments significantly influences the success of reprocessing protocols.