Evaluation of efficacy of repeated decontamination and sterilization of single-incision laparoscopic surgery ports intended for 1-time use

Abstract

Objective: To determine the efficacy of repeated decontamination and sterilization of a disposable port intended for 1-time use during single-incision laparoscopy.

Study design: Experimental; prospective, controlled design.

Methods: Six single-access ports used 4 times and 6 single-access ports used 8 times to perform various clean, minimally invasive surgeries were evaluated. Ports were decontaminated in an enzymatic cleaner (dilution, 3:100) and cleaned with a scrub brush for 5 minutes. The ports were then sterilized with hydrogen peroxide vapor for 50 minutes using a standard protocol at a concentration of 6 mg/L, followed by a vapor diffusion phase. Samples taken from the foam, insufflating tubing, and rigid cannula portion of each port were collected with aseptic technique for aerobic-anaerobic cultures. Port material samples were set up on a tryptic soy agar plate with 5% sheep blood, a MacConkey agar plate, and a Columbia agar plate with 5% sheep blood (CAP). Anaerobic isolate cultures were set up on Centers for Disease Control and Prevention (CDC) blood agar and CAP.

Results: None of the ports used 4 times had positive bacteriologic culture. Two of the ports used 8 times had a light growth of bacteria. The first positive sample cultured Staphylococcus spp. and Micrococcus spp. The second positive sample cultured Staphylococcus epidermidis. The positive cultures were obtained from the foam component in an enriched broth.

Conclusion: Single-incision ports could be used safely 4 times and pose a low risk of infection to the patient under conditions of this study.