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    Borescope inspections reveal significant debris and defects in surgical instruments, even new ones. Enhanced cleaning protocols are needed as manufacturer instructions appear insufficient for ensuring instrument safety.

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    Area of Science:

    • Medical device inspection
    • Surgical instrument reprocessing
    • Patient safety

    Background:

    • Inadequately processed surgical instruments pose infection risks.
    • Borescope use for endoscope channels is documented, but not for surgical instruments.
    • This study addresses the gap in surgical instrument lumen inspection.

    Purpose of the Study:

    • To assess the utility of borescopes for inspecting surgical instrument lumens.
    • To characterize internal anatomy and defects in surgical instruments.
    • To evaluate the impact of reprocessing on residual debris.

    Main Methods:

    • Sterilized arthroscopic shaver handpieces and suction tips were inspected using borescopes and tablet cameras.
    • Internal anatomy, lumen defects, and debris were photographed and characterized.
    • The effectiveness of recleaning on residual contamination was assessed.

    Main Results:

    • 88% of instruments had rough internal features; 94% showed debris or discoloration.
    • New shavers contained retained soil and brush bristles despite following cleaning instructions.
    • Recleaning was effective for suction tips but less so for shavers, necessitating replacement.

    Conclusions:

    • Borescope examinations are valuable for detecting internal instrument defects and contamination.
    • Manufacturer cleaning instructions may be insufficient for complex surgical instruments.
    • Findings led to strengthened risk assessment and enhanced cleaning practices.