Robotic-Assisted Surgery Presents Unique Sterile Processing Challenges

Highly complex instruments can pose major challenges to processes and procedures, especially for robotic surgery. This was the key takeaway from a presentation, “Challenges for Processing: Robot-Assisted Surgery,” delivered by Matthias Tschoener, Dr Sc Nat, and head of Applications Department, Research and Development at Dr. Weigert, at the 2022 Healthcare Sterile Processing Association Annual Conference & Expo, held in San Antonio, Texas, April 23-27, 2022.

Tschoener presented methods and experiences from validation and European practices on how safe automated processing can succeed in the long term. He described the suitable processes and procedures that demonstrate compliance with their requirements of various regulations, eg in performance qualification according to ISO 15883-1. Speaking with Infection Control Today® (ICT®), Tschoerner also discussed how sterile processors in the United States could learn from their European counterparts.

“We are engaged in international standardization at our organization, so the processes come very close,” Tschoerner told ICT®. “Every [German] washer/disinfector [units] must be validated at minimum once a year. This process may be different in other countries [like] the US.”

His presentation covered the critical parameters of cleaning and disinfection, and he discussed those factors with ICT® that he listed as chemistry, temperature, and mechanics. The entire process is relevant to the results starting in the OR which includes many different parts. One component is how well the manual pretreatment is done directly affects how well the outcome turns out to be; however, certain pretreatments are disadvantageous like peroxides and steamers. It depends on the instruments and how contaminated they are.

“Sometimes we have instruments that are lightly contaminated, for example urine bottles that you can rinse very easily,” Tschoerner said, “If you have orthopedic instruments like bone drills, [then] you have to use much more mechanic [cleaning method]…and this makes a higher demand on the cleaning process.”

It is key that the compliance of automated procedures with performance requirements can be demonstrated with specific load carriers and performance testing. Finally, the good performance and material compatibility of mild-alkaline enzymatic cleaners need to be demonstrated. More complex instruments become, the more challenging cleaning them can be.