Is it safe to reuse disposable laparoscopic trocars? An in vitro testing.
BACKGROUND
The reuse of disposable laparoscopic instruments carries a risk of transmitting infectious diseases such as hepatitis and HIV. We evaluated the safety of reusing disposable trocars by studying the chances of their harboring infectious viruses after resterilization in an in vitro setting.


METHODS
Disposable laparoscopic trocars were exposed to horse blood contaminated with high or low viral concentrations of herpes simplex virus type 1 (HSV1) and attenuated polio virus type 1 at room temperature for 2 h. HSV1 was chosen as the surrogate for lipid viruses that include hepatitis B and HIV virus; polio virus represented the nonlipid viruses that cause infections in immunocompromised patients and are more resistant to sterilization. The trocars were subsequently cleaned and resterilized by low-temperature steam and formaldehyde at 80 degrees C for 3 h. Viral cultures were then repeated after sterilization.


RESULTS
A cytopathic effect (CPE) was demonstrated at both concentrations for HSV1 in all trocars before but not after sterilization. For the polio virus, CPE was evident in 50% of the trocars (two of four) exposed to high viral concentration after sterilization.


CONCLUSIONS
Disposable trocars are difficult to resterilize and may harbor infectious viruses after their initial use. Therefore, the reuse of disposable trocars in laparoscopic surgery cannot be recommended.
Chan
A C
AC
Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, China.
Ip
M
M
Koehler
A
A
Crisp
B
B
Tam
J S
JS
Chung
S C
SC
D004209:Disposable Equipment / Q000706:statistics & numerical data; D004866:Equipment Contamination / Q000517:prevention & control / Q000706:statistics & numerical data; D017743:Equipment Reuse / Q000706:statistics & numerical data; D004869:Equipment Safety / Q000706:statistics & numerical data; D018259:Herpesvirus 1, Human; D066298:In Vitro Techniques; D010535:Laparoscopy / Q000706:statistics & numerical data; D017955:Poliovirus; D013242:Sterilization / Q000379:methods; D013525:Surgical Instruments / Q000706:statistics & numerical data / Q000821:virology