Sterilization of laparoscopes. Is soaking sufficient?

Area of Science:

• Minimally Invasive Surgery
• Sterilization and Disinfection Protocols

Background:

• Debate persists regarding optimal sterilization methods for laparoscopic telescopes.
• Current federal hospital policy mandates gas sterilization, impacting instrument availability and surgical scheduling.
• This policy contrasts with observed safety data from using activated glutaraldehyde for instrument soaking.

Purpose of the Study:

• To investigate the microbial contamination levels associated with laparoscopic procedures using activated glutaraldehyde for telescope disinfection.
• To compare microbial findings with established safety thresholds for peritoneal contamination.

Main Methods:

• Cultures were obtained from the umbilical area, laparoscopic telescopes, and pelvic serosal surfaces.
• Microbial analysis included aerobic and anaerobic bacteria, and fungi.
• Cultures were taken after telescopes were soaked in activated glutaraldehyde and following standard skin preparation.

Main Results:

• Common skin organisms were detected even after povidone-iodine and ethyl alcohol skin preparation.
• Similar organisms were occasionally recovered from both the laparoscopic instruments and pelvic surfaces.
• The quantified microbial load was within the peritoneum's capacity to manage healthy organisms.

Conclusions:

• Observed contamination levels are within acceptable limits for the healthy peritoneum.
• Activated glutaraldehyde soaking appears to be a safe and effective disinfection method for laparoscopic telescopes.
• Re-evaluation of current sterilization policies for laparoscopic instruments is warranted based on clinical data.