Evaluation of single-use reprocessed laparoscopic instrument sterilization

Lopes, Cristiane de Lion Botero Couto; Graziano, Kazuko Uchikawa; Pinto, Terezinha de Jesus Andreoli

doi:10.1590/s0104-11692011000200020

Cited by 15 publications

(29 citation statements)

References 13 publications

(11 reference statements)

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“…The "single use" concept for expensive devices should be reviewed. Evidences for the possibility to sterilize the single use devices even with the contamination-challenge are present [25]. For economic issues we safely re-used vessel sealing bipolar devices several times which could be cost-effective [22] [26] [27].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy Assisted Distal Gastrectomy for Cancer at a Tertiary Center in Egypt. Is It Safe and Feasible?

Amin¹,

Salem²,

Fakhry³

et al. 2017

JCT

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Background: Laparoscopic radical gastrectomy for cancer has significant short-and long-term advantages. The feasibility and safety of laparoscopicdistal gastrectomy for cancer (LADG) is unclear in low to middle income countries as resources are limited. Therefore, the aim of this study was to evaluate the safety and feasibility of (LADG) in low to middle income countries; Egypt as an example. Methods: Thirty four Patients with stage I-II cancer at the pylorus and antrum have been enrolled for LADG between 2012 and 2015 with the reuse of single use vascular sealing device has been evaluated. Results: Finally 27 patients had been included in the study and successful LADG has been done for all selected cases. The average operative time was 151 ± 10 minutes. The average estimated blood loss was 73.3 ± 13 ml. No intra-operative complications have been recorded. The average time for postoperative patient ambulation was 9 hours (SD ± 1.8) and for oral fluid intake was 3.5 SD ± 1 days. The average duration of the hospital stay was 9.3 ± 1.2 days. The average number of retrieved lymph nodes was 21.7 ± 3.8 days. All the cases had free surgical margin. The median number of reuse of the vascular sealing device was 3.8 times (3 -5 times). Conclusion: Laparoscopic distal gastrectomy for cancer could be safe and feasible in developing countries and give similar results for that of developed countries. Safe reuse of single use expensive parts of some instruments for laparoscopy could help in utilization of these advanced surgeries in low to middle income countries. Long term follow up as well as comparative studies with open surgery are required.

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Section: Discussionmentioning

confidence: 99%

Laparoscopy Assisted Distal Gastrectomy for Cancer at a Tertiary Center in Egypt. Is It Safe and Feasible?

Amin¹,

Salem²,

Fakhry³

et al. 2017

JCT

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“…Sterilization of assembled laparoscopic instruments was studied previously 8 - 10 , concluding both positive and negative related to the practice of autoclaving assembled instruments, in spite of methodological issues arising form several of these papers.…”

Section: Discussionmentioning

confidence: 99%

“…The scientific literature does not provide a conclusive answer about the safety of saturated steam pressure sterilization, of the assembled laparoscopic instrument 8 - 10 , and it recommends conducting a new laboratory experimental test study 11 . To have an updated view we consulted the following portals and electronic databases on May 2016: PUBMED, BVS, EMBASE, SCOPUS e WEB OF SCIENCE, using the Boolean AND operator and controlled descriptors Medical Subject Headings (MeSH) steam, sterilization, laparoscopy e instruments.…”

Section: Introductionmentioning

confidence: 99%

“…To have an updated view we consulted the following portals and electronic databases on May 2016: PUBMED, BVS, EMBASE, SCOPUS e WEB OF SCIENCE, using the Boolean AND operator and controlled descriptors Medical Subject Headings (MeSH) steam, sterilization, laparoscopy e instruments. Three already known old articles were found 8 - 10 , published in the years 1991, 1995 and 2011, with no recent publications on the subject studied.…”

Section: Introductionmentioning

confidence: 99%

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Microbiological evaluation of the steam sterilization of assembled laparoscopic instruments

Camargo

Graziano

Almeida

et al. 2016

Rev. Latino-Am. Enfermagem

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Objective:assess the safety of steam sterilization of assembled laparoscopic instruments with challenge contamination. Method:a laboratory experimental study, using as test samples trocars and laparoscopic graspers. Geobacillus stearothermophillus ATCC-7953 was used, with a microbial population of 106UFC/Filter paper substrate, removed from the biological indicator. Three of them were introduced into each instrument at the time of assembly, and sterilized at pressurized saturated steam, 134oC for 5 minutes. After sterilization, the instrument was disassembled and each filter paper substrate was inoculated in soybean casein culture and incubated at 56oC for 21 days. In case of absence of growth, they were subjected to heat shock of 80oC, for 20 minutes and re-incubated for 72 hours. Sample size: 185 graspers and 185 trocars, with 95% power. We paired the experiments with comparative negative control groups (5 graspers and 5 trocars with challenge contamination, sterilized disassembled) and positive control (30 filter paper supports, unsterilized), subject to the same incubation procedures. Results:there was no microbial growth in experimental and negative control. The results of the positive control were satisfactory. Conclusion:this study provided strong scientific evidence to support the safety of steam sterilizing of the assembled laparoscopic instrument.

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“…Como estratégia para contornar o problema, os estabelecimentos de saúde passaram a reutilizá-los. 1 Com o avanço tecnológico, técnicas modernas de assistência foram sendo desenvolvidas, antimicrobianos foram sendo aperfeiçoados e o tratamento das doenças assumiu alta complexidade. Por outro lado, a invasão das bactérias multirresistentes, a inserção de novas formas vivas de microrganismos e a luta contra a resistência bacteriana surgiram nesse contexto, fragilizando o ambiente do cuidado humano e desafi ando as ações do cotidiano dos trabalhadores em saúde, no que se refere à prevenção das infecções hospitalares.…”

Section: Introductionunclassified

Processamento dos materiais médico-hospitalares: uma revisão bibliográfica sobre a eficácia da esterilização

Guerra¹,

Neto²,

Costa³

et al. 2013

Rev Epidemiol Control Infect

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DESCRITORES Esterilização Infecção hospitalar Equipamentos cirúrgicos Saúde pública KEYWORDS Sterilization Cross infection Surgical Equipment Public HealthJustifi cativa e Objetivos: Os instrumentos cirúrgicos são amplamente reprocessados, principalmente em países em desenvolvimento, onde os custos da utilização desses insumos são altos. A literatura científi ca aponta a ausência de processos validados de limpeza e esterilização. O objetivo do trabalho foi avaliar por meio de uma revisão bibliográfi ca evidências que apoiem ou não a prática do reprocessamento e reutilização de instrumentos médico-hospitalares, a princípio de uso único. Método:Foram selecionados 27 artigos em revistas indexadas nas bases de dados LILACS, Pubmed e Medline, e pesquisas no Science Direct publicados sob os unitermos "esterilização", "artigos de uso único", "infecção hospitalar" e "aparelhos cirúrgicos" nos idiomas inglês e português. Foram excluídos os artigos que não contemplavam a temática do estudo. Resultados: Verifi cou-se grande variedade dos instrumentos estudados e formas de reprocessamento. A maioria dos artigos evidencia uma inefi cácia da esterilização, identifi cando microrganismos ao fi nal do processo. Conclusão: Baseado no conhecimento atual é importante considerar cada caso validando protocolos de reprocessamento e reuso dos materiais cirúrgicos com base em conhecimento científi co. A partir da análise dos artigos em estudo, conclui-se que essa prática não pode ser realizada indiscriminadamente. Backgound and Objectives:Surgical instruments are widely reprocessed, mainly in developing countries, where the cost of using these materials is high. Scientifi c literature indicates the absence of validated cleaning and sterilization processes. The study aimed at evaluating, through a literature review, the evidence to support or not the practice of reprocessing and reuse of originally single-use, medical-hospital materials. Methods: A total of 27 articles in English and Portuguese were selected from journals indexed in the LILACS, Pubmed and Medline databases, as well as studies published in ScienceDirect website using the following key words: sterilization, single-use articles, hospital infection and surgical instruments. Articles that did not fi t the study subject were excluded. Results: There was a great variety of studied instruments and reprocessing methods. Most articles emphasize the sterilization ineffectiveness, identifying microorganisms at the end of the process. Conclusion: Based on the current knowledge, it is important to consider each case validating surgical materials reprocessing and reuse protocols based on scientifi c knowledge. Based on the analysis of the study articles, we concluded that this practice cannot be performed indiscriminately.

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Evaluation of single-use reprocessed laparoscopic instrument sterilization

Cited by 15 publications

References 13 publications

Laparoscopy Assisted Distal Gastrectomy for Cancer at a Tertiary Center in Egypt. Is It Safe and Feasible?

Laparoscopy Assisted Distal Gastrectomy for Cancer at a Tertiary Center in Egypt. Is It Safe and Feasible?

Microbiological evaluation of the steam sterilization of assembled laparoscopic instruments

Processamento dos materiais médico-hospitalares: uma revisão bibliográfica sobre a eficácia da esterilização

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