Multicenter comparative study of three “non-destructive” methods of detecting the cleanliness of the da Vinci surgical robotic instrument

Abstract

Background: The robotic instrument of the da Vinci surgical system determines the accuracy of roboticassisted surgery, However, the most effective cleaning method of robotic equipment is a challenge for healthcare professionals. This study compared three da Vinci robot-assisted surgery manipulators to detect the effect of "non-destructive" testing of the cleaning effect by two different methods. Methods:The post-surgical cleaning of the da Vinci robotic instruments in the Sun Yat-

Evaluation of microbial occurrence in reusable robotic instruments for minimally invasive surgery: A pilot study

“…As far as we are aware, there are no previous studies investigating the microbiological residues of robotic instruments using culture, while there are several that take protein residues or ATP-measurements into account [13,15]. Our results are in line with the results of Lopes et al who actively contaminated orthopaedic surgical instruments with bacteria and tested manual or manual followed by automated cleaning and sterilisation [16].…”

“…As far as we are aware, there are no previous studies investigating the microbiological residues of robotic instruments using culture, while there are several that take protein residues or ATP-measurements into account [ 13 , 15 ]. Our results are in line with the results of Lopes et al .…”

“…Strict guidelines exist for the sterilisation of medical equipment, with regular validation procedures carried out in accordance with international standards such as ISO 15883, ISO 11737–2:2019 / 17665–1:2006. The aim of this pilot study was to start the development of a standardised microbiological validation process for the CDS procedure on robotic instruments, similar to those already established for protein content [ 6 , 8 , 13 ].…”

“…Chen, et al also examined protein residues when comparing three 'non-destructive' methods of determining the cleanliness of da Vinci surgical robotic instruments. From these studies, specific acceptance criteria have even been formulated for protein residues [6,13]. These studies have also highlighted the barriers to adequately removing such residues from the instrument PLOS ONE [8,9].…”

“…The intricate design of these instruments led us to question whether the process described by the manufacturer and ISO standards is really sufficient to adequately remove microbial residues, particularly from the inside of the instrument. To the best of our knowledge, there is no literature on how to validate the microbiological cleaning process of these instruments, while publications on how to validate cleaning processes that remove protein residues, using either ‘destructive’ or ‘non-destructive’ methods, do exist [ 6 , 13 ]. Some of these methods testing for protein residues employ ATP measurements, which are also elevated if microbes are present, however there is little correlation between the microbial load and measured ATP levels [ 14 ].…”