Evaluation of efficacy of repeated decontamination and sterilization of single‐incision laparoscopic surgery ports intended for 1‐time use

Petrovsky, Brian; Monnet, Eric

doi:10.1111/vsu.12761

Cited by 8 publications

(5 citation statements)

References 24 publications

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“…Previous veterinary studies analyzing efficacy of sterilizing single‐use devices have produced contrasting conclusions. In 1 study analyzing sterilization of single‐incision laparoscopic ports with hydrogen peroxide sterilization after cleaning with an enzymatic cleaner, light bacterial growth was found in 2 of 6 foam components after 8 uses . However, in a similar study using hydrogen peroxide sterilization after cleaning with a quaternary disinfectant, no significant increase was found in bacterial growth scores compared with their negative controls after 10 uses .…”

Section: Discussionmentioning

confidence: 99%

Performance and microbiological safety testing after multiple use cycles and hydrogen peroxide sterilization of a 5‐mm vessel‐sealing device

et al. 2019

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Objective To evaluate the functional and microbiological safety of a single‐use laparoscopic vessel‐sealing device in a multiuse setting. Study design Ex vivo study. Sample population Twelve 5‐mm LigaSure Maryland jaw devices. Methods Handsets underwent repeated test cycles until failure. The handset packaging was opened, and handsets were agitated in phosphate‐buffered saline (PBS). The PBS was removed, centrifuged, and submitted for culture. Canine ovariectomy was simulated on cadaveric tissue, after which vascular seal quality was evaluated by pressure testing of sealed porcine carotid arteries. The handsets were cleaned and sterilized with hydrogen peroxide gas and repackaged. Results Mean ± SD cycles to failure was 7.7 ± 2.8, with a minimum of 4 and a maximum of 12 use cycles achieved. Eleven of the 12 handsets failed by failure of handset activation after depression of the activation trigger. Only 1 handset failed to hold an adequate vascular seal under 300 mm Hg of pressure. No handset exhibited positive bacterial culture at any cycle. Conclusion The sterilization method used in this study resulted in an excellent microbiological safety profile. Most of the handsets failed by activation button failure. Clinical significance Under the conditions of this study, hydrogen peroxide sterilization achieved microbiological safety. Handsets can successfully be reused until activation button failure without negative effects on the vascular seal or increased risk of infection to the patient.

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Section: Discussionmentioning

confidence: 99%

Performance and microbiological safety testing after multiple use cycles and hydrogen peroxide sterilization of a 5‐mm vessel‐sealing device

et al. 2019

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“…Due to the cost of equipment, re-sterilization and reuse of instruments that are intended for single use (e.g., LigaSure TM handpiece and SILS TM port) is common in veterinary medicine. There is growing literature to support the safety of this practice [4,5]. Step-by-step descriptions of surgical procedures are outside the scope of this manuscript; the authors suggest further reading in textbooks for more in-depth discussions regarding surgical technique prior to implementing MIS in a veterinary practice [6].…”

Section: Introductionmentioning

confidence: 99%

Use of Minimally Invasive Surgery in the Diagnosis and Treatment of Cancer in Dogs and Cats

Balsa

Culp

2019

Veterinary Sciences

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Surgical management of neoplastic disease is common in veterinary medicine. Minimally invasive surgery (MIS) has gained widespread acceptance by veterinary surgeons and is experiencing rapid growth and frequency of use. Many neoplastic diseases in the abdomen and thorax of dogs and cats can be treated as effectively with MIS as with traditional open surgery. Additionally, MIS allows for less invasive options for organ biopsy in cancer patients either for initial diagnosis or for staging to inform prognosis and treatment. Despite the recent increase in MIS, additional research is required to further characterize the benefits to oncology patients and to ensure that surgical oncologic principles and patient outcomes are not compromised by the use of MIS.

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“…The outer portion of the port, which directly contacts the margins of the incision, is made of porous foam. It has been demonstrated in previous studies that the foam portion of the ports can be effectively sterilized at least four to 10 times with hydrogen peroxide vapor or five times with ethylene oxide . However, the foam portion of the ports is forcibly inserted through the incision by grasping it with two Rochester‐Carmalt forceps and is known to be degraded by repeated insertions .…”

Section: Discussionmentioning

confidence: 99%

“…It has been demonstrated in previous studies that the foam portion of the ports can be effectively sterilized at least four to 10 times with hydrogen peroxide vapor or five times with ethylene oxide . However, the foam portion of the ports is forcibly inserted through the incision by grasping it with two Rochester‐Carmalt forceps and is known to be degraded by repeated insertions . It is possible that small defects in the foam's surface that are created during repeated use may cause an increase in mechanical irritation to tissues, predisposing to seromas, or may harbor bacteria, increasing the risk of infection.…”

Section: Discussionmentioning

confidence: 99%

Paramedian incisional complications after prophylactic laparoscopy‐assisted gastropexy in 411 dogs

et al. 2019

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Objective To determine the frequency and types of paramedian incisional complications after prophylactic laparoscopy‐assisted gastropexy (LAG) in dogs and to evaluate potential risk factors for complications. Study design Multi‐institutional retrospective study. Animals Client‐owned dogs (N = 411). Methods Records for dogs that underwent single‐incision–port laparoscopy‐assisted gastropexy (SIPLAG) or multiple‐port laparoscopy‐assisted gastropexy (MPLAG) at five veterinary referral hospitals were reviewed. Information regarding signalment, surgical procedures, perioperative care, and incisional complications was collected. Follow‐up information was obtained by review of medical records and/or communication with owners. Potential risk factors for complications were examined statistically. Results Paramedian incisional complications were observed in 78 of 411 (19%) dogs. The most common complication was seroma formation, which occurred in 51 (12.4%) dogs. Surgical site infections were observed in 16 (3.9%) dogs, and dehiscence or development of excessive scar tissue at the incision site were each observed in nine (2.2%) dogs. Complications resolved with conservative treatment in 75 of 78 (96.2%) dogs and with surgical treatment in three of 78 (3.8%) dogs. The odds of complications were approximately twice as high in dogs undergoing SIPLAG than in dogs undergoing MPLAG (odds ratio, 2.03; P = .006). Conclusion Minor paramedian incisional complications, particularly seroma formation, were frequently observed after LAG. Most complications were successfully managed conservatively. Single‐incision–port laparoscopy‐assisted gastropexy was associated with a higher complication rate compared with MPLAG. Clinical significance Owners should be informed that there is a relatively high rate of minor paramedian incisional complications after LAG. The risk of complications appears to be higher for SIPLAG than for MPLAG.

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Evaluation of efficacy of repeated decontamination and sterilization of single‐incision laparoscopic surgery ports intended for 1‐time use

Abstract: Single-incision ports could be used safely 4 times and pose a low risk of infection to the patient under conditions of this study.

Cited by 8 publications

References 24 publications

Performance and microbiological safety testing after multiple use cycles and hydrogen peroxide sterilization of a 5‐mm vessel‐sealing device

Performance and microbiological safety testing after multiple use cycles and hydrogen peroxide sterilization of a 5‐mm vessel‐sealing device

Use of Minimally Invasive Surgery in the Diagnosis and Treatment of Cancer in Dogs and Cats

Paramedian incisional complications after prophylactic laparoscopy‐assisted gastropexy in 411 dogs

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