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Gynecologic Surgeon Assessment of the Reprocessed Versus New LigaSure Bipolar Vessel Sealing Device in a Simulated
Celeste A Swain1, Bharti Garg2, Amanda Ecker2
1Legacy Health, Department of Minimally Invasive Gynecologic Surgery, Portland, Oregon (Swain and Gould); Oregon Health and Science University, Department of Obstetrics and Gynecology, Portland, Oregon (Swain, Garg, Ecker, and Wong).
Study Objective:
Reprocessing of single-use surgical devices (SUDs) can provide an impactful reduction in surgical waste and greenhouse gas emissions, but there is minimal data on surgeon preference and surgical performance of these reprocessed SUDs compared to new devices. This study aims to compare gynecologic surgeon assessment of the reprocessed versus new laparoscopic LigaSure bipolar vessel sealing devices.
Design:
This was a double-blind, randomized, 2 × 2 cross-over surgical simulation study, in which participants completed a series of surgical tasks with both a new and reprocessed laparoscopic LigaSure. The primary outcome was surgeon assessment of the devices and secondary outcomes included surgeon willingness to use reprocessed SUDs in clinical practice.
Setting:
The 2024 American Association of Gynecologic Laparoscopists (AAGL) Global Congress in New Orleans, LA PATIENTS: A total of 20 gynecologic surgeons from across the United States with varying levels of experience completed the study.
Interventions:
Participants used a new and reprocessed laparoscopic LigaSure device in sequence, with the order randomly assigned. Participants completed a series of instructed surgical tasks using a tissue model, and subsequently assessed each device in regard to tissue handling, tissue dissection, seal completion, tissue cutting, and ergonomics using a continuous numeric scale (0-10). Participants then answered questions about overall device assessment.
Measurements And Main Results:
Wilcoxon signed rank and Generalized Linear Mixed Models were used for statistical analysis. There was no significant difference in any aspects of the assessed performance of the new versus reprocessed device. This persisted with adjustment for surgeon sex and the type of LigaSure used in the simulation model (blunt or Maryland tip). Most participants (70%) accurately guessed which device was reprocessed, but only 30% preferred the new device to the reprocessed. A total of 90% of the participants were willing/interested in using reprocessed laparoscopic LigaSure devices in their surgical practice.
Conclusion:
The findings of this study further support the broader adoption of surgical SUD reprocessing, reinforcing ongoing efforts to mitigate healthcare's contribution to climate change.
