Authors' objectives:

VHA’s Office of Patient Care Services asked that TAP identify any research addressing the risk associated with cleaning and reusing laparoscopic instruments originally designed for single use. Comparison of clinical outcomes associated with using disposable/single-use instruments versus reprocessing single-use instruments is of particular interest.

Authors' recommendations: The small handful of highly variable (for quality of design and reporting) studies included here provide no definitive answers for laparoscopic instruments issues: any risk associated with reprocessing by current standards or re-use of instruments originally designed to be disposed of after single use remains undefined by credible research. Those systematic reviews that are available hardly qualify by post-2000 standards and cover primary studies of sufficient age that they are unlikely to apply to current practice or instrument design. Reviews and included studies further are procedure- or microorganism- specific and may not generalize to other settings.The single area of consistency highlighted here is that cost studies lacking considerations of outcome find reusable instruments less costly than disposable ones. Two small randomized studies (Colak, 2004; and Paolucci, 1995; both in Table 2), failed to find significant clinical differences between disposable and reused instruments for laparoscopic cholecystectomy, but other quality attributes lacking in these studies raise more questions than answers.Finally, TAP’s searches of AHRQ’s database of ongoing trials (www.clinicaltrials.gov) failed to identify in-progress studies likely to provide definitive answers any time in the near future.

Project Status: Completed

URL for project: http://www4.va.gov/VATAP/docs/cleaninginstruments2010.pdf

Year Published: 2010

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: VA Technology Assessment Program

Contact Address: Liz Adams, VA Technology Assessment Program, Office of Patient Care Services (11T), VA Boston Healthcare System Room 4D-142, 150 South Huntington Avenue, Boston, MA 02130 USA Tel: +1 617 278 4469; Fax: +1 617 264 6587;

Contact Name: elizabeth.adams@med.va.gov

Contact Email: elizabeth.adams@med.va.gov

Copyright: VA Technology Assessment Program (VATAP)