Skip to main content Accessibility help
×
Home
Hostname: page-component-59b7f5684b-z9m8x Total loading time: 1.033 Render date: 2022-10-03T16:06:24.081Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "displayNetworkTab": true, "displayNetworkMapGraph": false, "useSa": true } hasContentIssue true

Challenging Residual Contamination of Instruments for Robotic Surgery in Japan

Published online by Cambridge University Press:  31 October 2016

Yuhei Saito*
Affiliation:
Surgical Center, University of Tokyo Hospital, Tokyo, Japan
Hiroshi Yasuhara
Affiliation:
Surgical Center, University of Tokyo Hospital, Tokyo, Japan
Satoshi Murakoshi
Affiliation:
Surgical Center, University of Tokyo Hospital, Tokyo, Japan
Takami Komatsu
Affiliation:
Surgical Center, University of Tokyo Hospital, Tokyo, Japan
Kazuhiko Fukatsu
Affiliation:
Surgical Center, University of Tokyo Hospital, Tokyo, Japan
Yushi Uetera
Affiliation:
Surgical Center, University of Tokyo Hospital, Tokyo, Japan
*
Address correspondence to Yuhei Saito, MS, Surgical Center, University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan 113-8655 (saitoyu-ope@h.u-tokyo.ac.jp).

Abstract

BACKGROUND

Recently, robotic surgery has been introduced in many hospitals. The structure of robotic instruments is so complex that updating their cleaning methods is a challenge for healthcare professionals. However, there is limited information on the effectiveness of cleaning for instruments for robotic surgery.

OBJECTIVE

To determine the level of residual contamination of instruments for robotic surgery and to develop a method to evaluate the cleaning efficacy for complex surgical devices.

METHODS

Surgical instruments were collected immediately after operations and/or after in-house cleaning, and the level of residual protein was measured. Three serial measurements were performed on instruments after cleaning to determine the changes in the level of contamination and the total amount of residual protein. The study took place from September 1, 2013, through June 30, 2015, in Japan.

RESULTS

The amount of protein released from robotic instruments declined exponentially. The amount after in-house cleaning was 650, 550, and 530 µg/instrument in the 3 serial measurements. The overall level of residual protein in each measurement was much higher for robotic instruments than for ordinary instruments (P<.0001).

CONCLUSIONS

Our data demonstrated that complete removal of residual protein from surgical instruments is virtually impossible. The pattern of decline differed depending on the instrument type, which reflected the complex structure of the instruments. It might be necessary to establish a new standard for cleaning using a novel classification according to the structural complexity of instruments, especially for those for robotic surgery.

Infect Control Hosp Epidemiol 2017;38:143–146

Type
Original Articles
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Dancer, SJ, Stewart, M, Coulombe, C, Gregori, A, Virdi, M. Surgical site infections linked to contaminated surgical instruments. J Hosp Infect 2012;81:231238.CrossRefGoogle Scholar
2. Southworth, PM. Infections and exposures: reported incidents associated with unsuccessful decontamination of reusable surgical instruments. J Hosp Infect 2014;88:127131.CrossRefGoogle Scholar
3. Rutala, WA, Gergen, MF, Weber, DJ. Efficacy of a washer-disinfector in eliminating healthcare-associated pathogens from surgical instruments. Infect Control Hosp Epidemiol 2014;35:883885.CrossRefGoogle ScholarPubMed
4. Alfa, MJ. Monitoring and improving the effectiveness of cleaning medical and surgical devices. Am J Infect Control 2013;41:S56S59.CrossRefGoogle Scholar
5. Evangelista, SS, Santos, SG, Stoianoff, MAR, Oliveira, AC. Analysis of microbial load on surgical instruments after clinical use and following manual and automated cleaning. Am J Infect Control 2015;43:522527.CrossRefGoogle Scholar
6. Nyström, B. Disinfection of surgical instruments. J Hosp Infect 1981;2:363368.CrossRefGoogle ScholarPubMed
7. Rutala, WA, Gergen, MF, Jones, JF, Weber, DJ. Levels of microbial contamination on surgical instruments. Am J Infect Control 1998;26:143145.CrossRefGoogle ScholarPubMed
8. Saito, Y, Kobayashi, H, Uetera, Y, Yasuhara, H, Kajiura, T, Okubo, T. Microbial contamination of surgical instruments used for laparotomy. Am J Infect Control 2014;42:4347.CrossRefGoogle ScholarPubMed
9. Rutala, WA, Gergen, MF, Weber, DJ. Microbial contamination on used surgical instruments. Infect Control Hosp Epidemiol 2014;35:10681070.CrossRefGoogle ScholarPubMed
10. Nayuni, NK, Cloutman-Green, E, Hollis, M, Hartley, J, Martin, S, Perrett, D. Critical evaluation of ninhydrin for monitoring surgical instrument decontamination. J Hosp Infect 2013;84:97102.CrossRefGoogle ScholarPubMed
11. Michels, W, Roth, K, Eibl, R. Assessment of cleaning efficacy based on the protein-surface relationship. Central Service 2013;3:212215.Google Scholar
12. Carter, A, Krüger, S, Schmidt, V, et al. Guideline compiled by the DGKH, DGSV and AKI for validation and routine monitoring of automated cleaning and disinfection processes for heat-resistant medical devices as well as advice on selecting washer-disinfectors. Central Service 2007;15:148.Google Scholar
13. Tan, A, Ashrafian, H, Scott, AJ, et al. Robotic surgery: disruptive innovation or unfulfilled promise? A systematic review and meta-analysis of the first 30 years. Surg Endosc 2016;30:43304352.CrossRefGoogle ScholarPubMed
14. Wehrl, M, Michels, W. A method for testing the cleaning of MIS robotic instruments. Central Service 2013;3:202207.Google Scholar
15. Ayliffe, G. Decontamination of minimally invasive surgical endoscopes and accessories. J Hosp Infect 2000;45:263277.CrossRefGoogle ScholarPubMed
16. Deshpande, A, Smith, GWG, Smith, AJ. Biofouling of surgical power tools during routine use. J Hosp Infect 2015;90:179185.CrossRefGoogle ScholarPubMed
17. US Food and Drug Administration (FDA). Reprocessing medical devices in health care settings: validation methods and labeling. FDA website. http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM253010.pdf. Published 2015. Accessed July 2, 2016.Google Scholar
18. Baxter, RL, Baxter, HC, Campbell, GA, et al. Quantitative analysis of residual protein contamination on reprocessed surgical instruments. J Hosp Infect 2006;63:439444.CrossRefGoogle Scholar
19. Lucas, AD, Nagaraja, S, Gordon, EA, Hitchins, VM. Evaluating device design and cleanability of orthopedic device models contaminated with a clinically relevant bone test soil. Biomed Instrum Technol 2015;49:354362.CrossRefGoogle ScholarPubMed
20. Saito, Y, Yasuhara, H, Murakoshi, S, Komatsu, T, Fukatsu, K, Uetera, Y. Novel concept of cleanliness of instruments for robotic surgery. J Hosp Infect 2016;93:360361.CrossRefGoogle ScholarPubMed
21. Alfa, MJ, Nemes, R, Olson, N, Mulaire, A. Manual methods are suboptimal compared with automated methods for cleaning of single-use biopsy forceps. Infect Control Hosp Epidemiol 2006;27:841846.CrossRefGoogle ScholarPubMed
5
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Challenging Residual Contamination of Instruments for Robotic Surgery in Japan
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Challenging Residual Contamination of Instruments for Robotic Surgery in Japan
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Challenging Residual Contamination of Instruments for Robotic Surgery in Japan
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *