Efficacy and safety of reuse of disposable laparoscopic instruments in laparoscopic cholecystectomy: a prospective randomized study

Çolak, Tahsin; Ersöz, Gülden; Akça, Tamer; Kanık, Arzu; Aydın, Serdar

doi:10.1007/s00464-004-8112-x

Cited by 24 publications

(31 citation statements)

References 13 publications

(16 reference statements)

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“…In some cases, clinical trials are performed to evaluate the safety and effectiveness of reusing SUDs [21,22]. However, most studies involve laboratory experiments designed either to evaluate the efficacy of different sterilization methods [23][24][25] or to study the effects of reprocessing on the material properties (e.g., tensile strength) of devices [26][27][28].…”

Section: Relevant Literaturementioning

confidence: 99%

Safety-cost trade-offs in medical device reuse: a Markov decision process model

Sloan

2006

Health Care Manage Sci

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Healthcare expenditures in the US are approaching 2 trillion dollars, and hospitals and other healthcare providers are under tremendous pressure to rein in costs. One cost-saving approach which is gaining popularity is the reuse of medical devices which were designed only for a single use. Device makers decry this practice as unsanitary and unsafe, but a growing number of third-party firms are willing to sterilize, refurbish, and/or remanufacture devices and resell them to hospitals at a fraction of the original price. Is this practice safe? Is reliance on single-use devices sustainable? A Markov decision process (MDP) model is formulated to study the trade-offs involved in these decisions. Several key parameters are examined: device costs, device failure probabilities, and failure penalty cost. For each of these parameters, expressions are developed which identify the indifference point between using new and reprocessed devices. The results can be used to inform the debate on the economic, ethical, legal, and environmental dimensions of this complex issue.

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Section: Relevant Literaturementioning

confidence: 99%

Safety-cost trade-offs in medical device reuse: a Markov decision process model

Sloan

2006

Health Care Manage Sci

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“…13,14,16,27 Evidence of the clinical significance of residual contamination or mechanical failure reported in vitro is lacking, however, and other reports have indicated that reuse of certain disposable devices is safe, ethical, and cost-effective. 12,[28][29][30][31] By subjecting this disposable port and its components to repeated cycles of simulated use, decontamination, and sterilization, our goal was to mimic the physical fatigue experienced by the port in a clinical setting. We have demonstrated that VHP is effective at eliminating bacteria from the ports despite the physical fatigue that may occur with multiple uses.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of vaporized hydrogen peroxide for repeated sterilization of a single‐use single‐incision laparoscopic surgery port

et al. 2018

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“…For example ERCP accessories, angiography guidewires, and even disposable laparoscopic instruments have been reused after proper sterilization without detrimental effect in terms of increased the risk of infection. [27–30]…”

Section: Discussionmentioning

confidence: 99%

Hand-assisted laparoscopic surgery using Gelport

Gupta

Bhartia

2005

J Min Access Surg

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Introduction:Minimally invasive surgery has revolutionized general surgery during the past 10 years. However, for more advanced surgical procedures, the acceptance of the minimally invasive approach has been slower than expected. Advanced laparoscopic surgery is complex and time-consuming. The major drawbacks of laparoscopic surgery are two-dimensional view, lack of depth perception and loss of tactile sensation. This has led to the innovation of hand-assisted laparoscopic surgery (HALS). The objective of the present study was to determine that safety of HALS.Materials and Methods:We preformed 18 HALS procedures in our department between July 2003 and January 2005 on patients who had given their informed consent for the use of Gelport. Out of these, 15 were colectomy, 2 nephrectomy and 1 splenectomy. Out of the 18 patients, 13 were males and 5 were females with the age group ranging from 44 to 72 years.Results:Hand-assisted laparoscopic surgery could be completed in 17 patients maintaining all the oncological principals of surgery. The mean operating times were 120 min for right haemicolectomy, 135 min for left colectomy, 150 min for splenectomy, and 150 min for nephrectomy. The patient undergoing radical nephrectomy by HALS had to be converted to open surgery. As the tumour was large and adherent to the spleen and posterior peritoneal wall. Postoperative recovery was excellent with an average hospital stay of 5 days. Histopathology report showed wide clearance and till date we have a good follow up of 30–380 days.Conclusion:Hand-assisted laparoscopic surgery allows tactile sensation and depth perception thereby may simplify the complex procedures. This may result in reduction of operating time and conversion rates at the same time maintaining all the oncological principles. Hand-assisted laparoscopic surgery strikes a perfect balance between an extended open laparotomy incision and an excessively tedious laparoscopic exercise. Hand assistance is an initial tool for the trainee laparoscopic surgeon or a last resort for the experienced laparoscopic surgeon.

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Efficacy and safety of reuse of disposable laparoscopic instruments in laparoscopic cholecystectomy: a prospective randomized study

Abstract: This study showed that reusing DLI did not change the operative and postoperative outcomes or the infection rate for laparoscopic cholecystectomy when strict rules for disinfection were followed.

Cited by 24 publications

References 13 publications

Safety-cost trade-offs in medical device reuse: a Markov decision process model

Safety-cost trade-offs in medical device reuse: a Markov decision process model

Efficacy of vaporized hydrogen peroxide for repeated sterilization of a single‐use single‐incision laparoscopic surgery port

Hand-assisted laparoscopic surgery using Gelport

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