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Sterilization and Maintenance of Laparoscopic Instruments and Equipment

Apr. 28, 2021

Laparoscopic Instruments Companies shares with you information about the sterilization and maintenance of laparoscopic instruments that we hope will be helpful to you

Laparoscopic surgery requires complex and precisely calibrated instruments. The essential difference between instruments used for open procedures and those used for laparoscopic procedures is that the latter are more complex in design, but more delicate in construction. As a result, laparoscopic instruments are more likely to leave a biologic load in their crevices. As a result, laparoscopic instruments are difficult to clean, adequately sterilize and maintain compared to their counterparts used in open surgery.

 

Laparoscopic Instruments

Laparoscopic Instruments

Furthermore, due to their delicate design, they must be cleaned using the gentlest methods in addition to disinfection. In addition, meticulous cleaning and maintenance, in addition to disinfection, must be performed so as not to compromise the safety of the patient, surgeon or other operating room personnel. The increased complexity of laparoscopic procedures and the emergence of drug-resistant strains of bacteria, molds, fungi, and viruses have made effective cleaning and sterilization of instruments an imperative. Sterilization is the absolute elimination or destruction of microorganisms in their life form. It can be accomplished by steam, gas or chemicals. However, disinfection is the relative removal of pathogenic organisms other than spores.

 

Dismantling

 

 

The appearance of Laparoscopic Instruments should be such that they can be easily disassembled. Instruments that cannot be completely disassembled are prone to harbor blood/debris within the shaft and compromise the safety of patients who subsequently use them.

 

Decontamination

 

 

Decontamination is a procedure used to reduce the bioburden of reusable medical devices. The procedure begins in the operating room itself, where nursing staff wipes visible blood tissue and body fluids from the instruments with a damp sterile sponge. During this process, all soiled or contaminated instruments should be placed in a container with a disinfectant solution and allowed to soak for 10 minutes.

Instruments should not be left in this solution for longer periods of time as they may be damaged. Once the instruments have reached the CSSD, decontaminate them with a specially constructed bath before proceeding to the next cycle. Modifications to the standard cleaning process must be effective in cleaning rigid endoscopic instruments. Instruments designed with external gaskets, internal seals that do not completely enclose the internal space, or instruments without gaskets should be placed in a vertical position in the enzyme wash and rinse solution rather than the standard horizontal position, which allows air trapped within the instrument to escape and be replaced with the solution. All solutions should be irrigated through the wash port of the instrument. During manual cleaning, special attention should be paid to the complex and delicate operating mechanisms located at the distal end of many instruments. Ultrasonic cleaners will facilitate cleaning of hard-to-reach areas. At the end of decontamination, instruments should be safe to handle without contact with bloodborne pathogens.

 

Pre-cleaning

 

 

After the instruments reach the sterile supplies handling area, preferably in a controlled environment, an enzymatic pre-cleaning process is recommended. There are many enzymatic products, such as proteases, lipases, and amylases, which are effective in enhancing the cleaning process for difficult-to-clean instruments. These products break down blood and other protein soils to promote cleaning. These enzymes are proteins and must be removed by thorough cleaning.

 

Cleaning

 

 

Any instrument designed for autoclaving requires specialized cleaning prior to sterilization. The user needs to ensure that there is no residual protein material or organic residue on the instrument surface. This is especially important when the instrument has several small moving parts and crevices; the buildup of residue can eventually lead to corrosion damage and pathogen colonization. Many hospitals use the technique of scrubbing instruments with soap. Although physical cleaning is partially effective, enzyme- and detergent-based cleaning agents that dissolve and lift organic material from instrument surfaces are better suited to ensure that instrument surfaces are aware of blood and other body fluids and protein material prior to the disinfection process. For laparoscopic instruments, the use of soft brushes is preferable so that the internal surfaces of the instruments are thoroughly cleaned.

Laparoscopic instruments are best rinsed with tap water to ensure that all particulate matter has been completely removed except for chemical residues used for contamination and cleaning. It is useful to have a "cleaning gun" with a fine-tipped nozzle to flush the shaft from the laparoscopic handheld instruments. The ability to clean these instruments with a jet of water is much better than rinsing water with stagnant water.

Ultrasonic cleaning is an increasingly popular method of cleaning. By far, this method is the most effective method available. Its ease of use and superior efficiency quickly make ultrasonic cleaning the preferred choice. In fact, ultrasonic cleaning is 16 times better than manual cleaning. Place the instrument in the ultrasonicator for 10-15 minutes and use a neutral pH solution. During the ultrasonic cleaning process, the following points should be noted.

Remove all visible debris from the instruments before placing them in the sonicator.

It is best not to mix instruments made of dissimilar metals in the same cycle.

It is important to make sure that there is enough space for the instrument. Ultrasonic cleaners should not be overloaded.

As with all types of cleaning, all instruments should be opened so that the ratchet and case lock are fully exposed to the cleaning process.

Remove and rinse the instruments immediately after the cycle is complete.

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