Sterilisation and Disinfection Acceptation Test of Reusable Single Port and Miniport Laparoscopic Instruments

D A Van Dam, MD, S Beeksma, W J Meijerink, MD PhD. VU University Medical Centre Amsterdam

Objective: to determine if newly designed reusable laparoscopic HiQ LS (Olympus, Hamburg Germany) for single port surgery and AdTech®mini (BBraun, Melsungen Germany) miniport instruments meet the disinfections and sterilisation standards used in the VU university medical centre, Amsterdam The Netherlands. The HiQ instrument line has distinctively fixed, curved shafts with undetachable rotating parts that remaining covered during cleaning procedures. The AdTech®mini instruments are detachable to individual parts with accessible rotating parts and is similar in shape compared to the conventional rigid laparoscopic instruments. However, the characteristic small diameter (3.5 -4.5 mm) of these miniport instruments could compromise the cleaning procedures.
Design and methods: an acceptation test including multiple cycles of soil and cleaning following standard VU University Medical Centre procedures was performed on the new instruments. Cleaning procedure consists of intensive cleaning by hand with alkaline agent and ultrasonic cleaning followed by mechanical cleaning. Cleaned instruments are subjected to visual inspection and protein testing. Results are digitally recorded.
Results: multiple different types of instruments of both instrument lines were subjected to the acceptation test. One instrument of the HiQ line had mechanical failure after the 2nd test cycle and the acceptation test was ended. A second HiQ instrument was opened after the 4th test cycle for additional visual inspection, and opened further after the 5th cycle. A third HiQ instrument received only mechanical cleaning in the first test cycle to control for the effect of the hand-cleaning before the mechanical washing. With the exception of the instrument receiving only mechanical washing, all instruments were clean. The opened instrument showed no internal residue of the test agent. No contamination was found at evaluation after the first 10 clinical cases.
Conclusion: the newly designed laparoscopic HiQ LS and AdTech®mini miniport instruments can be reused when following the standard VU university medical centre protocol for disinfection and sterilisation as stated for laparoscopic instruments. It is mandatory to perform the pre-mechanical hand wash to guarantee sterilisation. Reusability of specialized laparoscopic instruments after standard cleaning protocols could be crucial for the future use and development of the minimal invasive surgery. Additional costs for extended or repeated cleaning procedures, or purchase of specialized sterilisation equipment could neutralize any financial advantage that single port surgery could have over conventional laparoscopic instruments.
 

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