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Journal articles on the topic 'Surgical instrument'

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Author: Grafiati

Published: 4 June 2021

Last updated: 12 February 2022

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1

Caudle, Abigail Suzanne, Jason B. Fleming, Brian M. Garcia, Marina Lozano, Darryl Rigby, Rita Manuel-Byrd, Lisa McMillian, et al. "Optimizing surgical instrument sets for cases involving breast and plastic surgeons." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 33. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.33.

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33 Background: Processing operative instrumemt sets is a major cost for surgical cancer care. Optimizing standard sets requires availability of instruments reflecting varied surgeon preferences while minimizing unnecessary instruments. Additionally, increasing utilization of oncoplastic reconstruction after mastectomy and lumpectomy requiring breast and plastic surgery sets further expands the number of instruments required. The goal of our study was to optimize standard sets used for cases combining breast and plastic surgeons and to determine cost savings Methods: Baseline data was recorded over a 2 week period (13 cases) including number of instruments available and number unused for non- flap breast-plastics combo (BPC) cases. An independent observer timed instrument set-up times. 22 breast and 14 plastic surgeons were polled for their requested instruments for designated cases. A BPC set was designed based on this data and reviewed with surgeons to update preference cards. After a 6 week implamentation/education period, repeat data was recorded (18 cases). Cost of instrument processing was based on labor and supply cost of $0.22/instrument. Results: Two breast surgery sets (65 and 97 instruments) and one plastics set ( 93 instruments) were used at baseline. The median number of available instrumeets was 172.5/case, with median 126.5 instruments unused. A mean of 3.8 separately packaged instruments were required per case with mean set-up time of 4m46s. The new BPC set contains 103 instruments. A median of 106.5 instruments were available after implementation. The median number of unused was reduced by 53% to 59.5, with a drop in number of separately processed instruments to 2.5. Mean set-up time was reduced to 2m16s. Reducing the size of of standard sets reduced processing costs by $12.10 or $19.14/case (depending on the breast set used for comparison). Combining sets resulted in an additional cost savings of $6.56/case by reducing extra packaging costs. Conclusions: combining breast and plastic sets and eliminating unnecessary instruments resulted in cost savings of $18.66-$25.70/case. It also reduced OR instrument set-up time by 2.5 minutes/case which has significant impact at high volume centers.

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2

Prephan, LuAnn. "Surgical instrument availability." AORN Journal 81, no. 5 (May 2005): 1015–22. http://dx.doi.org/10.1016/s0001-2092(06)60467-5.

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3

Dembitzer, Anne, and Edwin J. Lai. "Retained Surgical Instrument." New England Journal of Medicine 348, no. 3 (January 16, 2003): 228. http://dx.doi.org/10.1056/nejmicm020710.

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4

Anonymous. "SURGICAL INSTRUMENT CASE." Journal of Refractive Surgery 10, no. 4 (July 1994): 474. http://dx.doi.org/10.3928/1081-597x-19940701-22.

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5

Anonymous. "Femoral Surgical Instrument." Orthopedics 22, no. 6 (June 1999): 628. http://dx.doi.org/10.3928/0147-7447-19990601-15.

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6

Muddu, Bisalahalli. "My favourite surgical instrument." BMJ 331, no. 7529 (December 8, 2005): 1383. http://dx.doi.org/10.1136/bmj.331.7529.1383.

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7

Welsh, B. E. "The Surgical Instrument Maker." Journal of the Royal Society of Medicine 82, no. 6 (June 1989): 380. http://dx.doi.org/10.1177/014107688908200632.

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8

Atabey, Atay. "A New Surgical Instrument." Plastic and Reconstructive Surgery 94, no. 3 (September 1994): 552–54. http://dx.doi.org/10.1097/00006534-199409000-00024.

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9

Warburton, Patricia, Charlotte Haigh, Tom Roper, Benedict Rogers, and David Ricketts. "The surgeon behind the instrument." Journal of Perioperative Practice 29, no. 9 (June 27, 2019): 276–80. http://dx.doi.org/10.1177/1750458919860332.

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A number of simple instruments are widely used to handle bone and tissue during orthopaedic surgical procedures. In many cases these instruments were invented by surgeons some years ago and have stood the test of time. Sometimes the current use of an instrument is different from its intended use. The originating surgeons often had active enquiring minds and contributed to surgical practice in many different fields. Many of them held important posts in surgical societies and associations. The aim of this review was to briefly describe the relevant instrument and give a short biography of some of the more interesting surgeons who contributed to instruments still used in surgical practice today.

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10

Daniel, Linda. "Instrument Processing." AORN Journal 58, no. 1 (July 1993): 17. http://dx.doi.org/10.1016/s0001-2092(07)65092-3.

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11

Vavra, Curtiss J. "Instrument Counts." AORN Journal 58, no. 2 (August 1993): 210–12. http://dx.doi.org/10.1016/s0001-2092(07)65217-x.

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12

Murphy, Ellen K. "Instrument Counts." AORN Journal 58, no. 2 (August 1993): 212. http://dx.doi.org/10.1016/s0001-2092(07)65218-1.

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13

O'Neale, Mary. "Sterile processing; instrument safety; instrument counts; aseptic technique." AORN Journal 53, no. 1 (January 1991): 146–49. http://dx.doi.org/10.1016/s0001-2092(07)66122-5.

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14

Clarke, DB, M. Hong, N. Kureshi, L. Fenerty, G. Thibault-Halman, and RC D’Arcy. "P.102 Simulation-based training for surgical instrument recognition." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 44, S2 (June 2017): S39—S40. http://dx.doi.org/10.1017/cjn.2017.186.

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Background: Surgical simulation training offers trainees the opportunity to practice surgical skills before entering the operating room. The objectives of this study were to determine the effect of simulation for learning instruments for burr hole surgery and whether this learning is translated to real instrument recognition with retention. Methods: Randomized trials of PGY1 neurosurgery residents and perioperative nurses were conducted, using PeriopSim™ for instrument recognition, as well as real instruments. Group A performed simulation tasks using PeriopSim™ prior to identifying real instruments, whereas Group B identified real instruments prior to performing simulation tasks. Nurses’ recall was assessed at seven days. Results: Sixteen residents and 100 nurses were recruited. All participants showed significant overall improvement in their scores for simulated tasks. Group A demonstrated enhanced accuracy and speed of identifying real instruments compared with Group B (p<0.001). Furthermore, knowledge recall testing at one week demonstrated retained learning, shown by 97% accuracy in instrument identification. Conclusions: Our results demonstrate that recognition of surgical instruments improves with repeated use of the PeriopSim™ platform. Instrument knowledge acquired through simulation training results in improved identification and retained recognition of real instruments.

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15

Yamashita, Kazuhiko, Kaori Kusuda, Yoshitomo Ito, Masaru Komino, Kiyohito Tanaka, Satoru Kurokawa, Michitaka Ameya, et al. "Evaluation of Surgical Instruments With Radiofrequency Identification Tags in the Operating Room." Surgical Innovation 25, no. 4 (May 2, 2018): 374–79. http://dx.doi.org/10.1177/1553350618772771.

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Background. Surgical instrument retention and instrument breakage compromise surgery quality and lead to medical malpractice. We developed an instrument tracking system that could alert surgeons to instrument retention during surgery and monitor instrument use to reduce the risk of breakage. Methods. This prospective, experimental clinical trial included 15 patients undergoing inguinal hernia surgery or lumpectomy under general anesthesia at Saiseikai Kurihashi Hospital. Radiofrequency identification (RFID)-tagged surgical instruments were used, and a detection antenna was placed on a mayo stand during the operation. We analyzed the 1-loop detection ratio (OLDR)—that is, the capability of the antenna to detect devices in a single reading—and the total detection rate (TDR)—that is, the data accumulated for the duration of the operation—of the RFID-tagged instruments. Results. Data analysis revealed that the OLDR was 95% accurate, whereas the TDR was 100% accurate. The antenna could not detect the RFID tag when there was interference from electrocautery noise radiation, and 6% of instrument movement was undetected by the antenna; however, the TDR and instrument use were detected at all times. Conclusions. Surgical instruments can be tracked during surgery, and this tracking can clarify the usage rate of each instrument and serve as a backup method of instrument counting. However, this study was conducted on a small scale, and RFID tags cannot be attached to small surgical instruments used in complex operations such as neurosurgery. Further efforts to develop a tracking system for these instruments are warranted.

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16

Petersen, Carol. "Latex guidelines; moving supplies and instruments; herbal medications; instrument counts; tracking prostheses." AORN Journal 71, no. 4 (April 2000): 886–90. http://dx.doi.org/10.1016/s0001-2092(06)62273-4.

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17

Messiha, Khalil. "The Ancient Egyptian surgical Instrument." Bulletin of the Center Papyrological Studies 3, no. 1 (December 1, 1986): 17–29. http://dx.doi.org/10.21608/bcps.1986.70874.

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18

Modrzejewski, Andrzej, Ewa Zamojska-Kościów, Edyta Tracz, and Mirosław Parafiniuk. "Surgical instrument left inside abdomen." Polish Journal of Surgery 90, no. 5 (September 21, 2018): 1–5. http://dx.doi.org/10.5604/01.3001.0012.6199.

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Leaving surgical instruments in the patient’s body is one of the most difficult situations in the professional career of an operator and it can also have severe consequences for the patient. Contrary to world literature, there are no reports of such incidents in Polish publications. Lack of such reports creates an illusion that leaving surgical instruments in the patient’s body does not happen in Poland, which is an unsubstantiated thesis. This paper presents two cases of leaving hemostats in the abdominal cavity. According to the authors, similar publications may facilitate critical assessment of the existing rules for inspecting instruments and surgical material by surgical teams. Importantly, confirming the compliance of instruments and material by surgical nurses is not the only criterion of assessment in this matter for the operator.

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19

Nathan, Richard. "Surgical instrument turns up unexpectedly." Nature Medicine 2, no. 12 (December 1996): 1292. http://dx.doi.org/10.1038/nm1296-1292c.

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20

Cowperthwaite, Liz, and Rebecca L. Holm. "Guideline Implementation: Surgical Instrument Cleaning." AORN Journal 101, no. 5 (May 2015): 542–52. http://dx.doi.org/10.1016/j.aorn.2015.03.005.

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21

Bieck, Richard, Reinhard Fuchs, and Thomas Neumuth. "Surface EMG-based Surgical Instrument Classification for Dynamic Activity Recognition in Surgical Workflows." Current Directions in Biomedical Engineering 5, no. 1 (September 1, 2019): 37–40. http://dx.doi.org/10.1515/cdbme-2019-0010.

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AbstractWe introduce a wearable-based recognition system for the classification of natural hand gestures during dynamic activities with surgical instruments. An armbandbased circular setup of eight EMG-sensors was used to superficially measure the muscle activation signals over the broadest cross-section of the lower arm. Instrument-specific surface EMG (sEMG) data acquisition was performed for 5 distinct instruments. In a first proof-of-concept study, EMG data were analyzed for unique signal courses and features, and in a subsequent classification, both decision tree (DTR) and shallow artificial neural network (ANN) classifiers were trained. For DTR, an ensemble bagging approach reached precision and recall rates of 0.847 and 0.854, respectively. The ANN network architecture was configured to mimic the ensemble-like structure of the DTR and achieved 0.952 and 0.953 precision and recall rates, respectively. In a subsequent multi-user study, classification achieved 70 % precision. Main errors potentially arise for instruments with similar gripping style and performed actions, interindividual variations in the acquisition procedure as well as muscle tone and activation magnitude. Compared to hand-mounted sensor systems, the lower arm setup does not alter the haptic experience or the instrument gripping, which is critical, especially in an intraoperative environment. Currently, drawbacks of the fixed consumer product setup are the limited data sampling rate and the denial of frequency features into the processing pipeline.

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22

Heller, Jim. "Revising instrument processing practices." AORN Journal 74, no. 5 (November 2001): 716–21. http://dx.doi.org/10.1016/s0001-2092(06)61772-9.

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23

Dorsey, Roberta. "Off-Site Instrument Sterilizing." AORN Journal 47, no. 4 (April 1988): 975–88. http://dx.doi.org/10.1016/s0001-2092(07)66552-1.

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24

Kusuda, Kaori, Kazuhiko Yamashita, Akiko Ohnishi, Kiyohito Tanaka, Masaru Komino, Hiroshi Honda, Shinichi Tanaka, Takashi Okubo, Julien Tripette, and Yuji Ohta. "Management of surgical instruments with radio frequency identification tags." International Journal of Health Care Quality Assurance 29, no. 2 (March 14, 2016): 236–47. http://dx.doi.org/10.1108/ijhcqa-03-2015-0034.

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Purpose – To prevent malpractices, medical staff has adopted inventory time-outs and/or checklists. Accurate inventory and maintenance of surgical instruments decreases the risk of operating room miscounting and malfunction. In our previous study, an individual management of surgical instruments was accomplished using Radio Frequency Identification (RFID) tags. The purpose of this paper is to evaluate a new management method of RFID-tagged instruments. Design/methodology/approach – The management system of RFID-tagged surgical instruments was used for 27 months in clinical areas. In total, 13 study participants assembled surgical trays in the central sterile supply department. Findings – While using the management system, trays were assembled 94 times. During this period, no assembly errors occurred. An instrument malfunction had occurred after the 19th, 56th, and 73th uses, no malfunction caused by the RFID tags, and usage history had been recorded. Additionally, the time it took to assemble surgical trays was recorded, and the long-term usability of the management system was evaluated. Originality/value – The system could record the number of uses and the defective history of each surgical instrument. In addition, the history of the frequency of instruments being transferred from one tray to another was recorded. The results suggest that our system can be used to manage instruments safely. Additionally, the management system was acquired of the learning effect and the usability on daily maintenance. This finding suggests that the management system examined here ensures surgical instrument and tray assembly quality.

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25

Li, Zheng Jeremy. "Mathematical Modeling and Computational Simulation of a New Biomedical Instrument Design." ISRN Biomathematics 2012 (December 10, 2012): 1–5. http://dx.doi.org/10.5402/2012/256741.

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Endo surgiclip instrument is the biomedical instrument that can be applied for endoscopic surgery to assist surgeons in homeostasis and secure mucosal gap surfaces during surgical operations. Since some clinic feedbacks show the surgiclip drop-off incidents which can potentially sever organ and tissue, the improvement of endo surgiclip instrument has been made in these years. Since few research papers were involved in the study of endo surgiclip instrument performance via mathematical modeling and computational simulation, currently some instrumental modifications are mainly based on clinic lab tests which prolong the improvement cycle and increase additional manufacturing cost. This paper introduces a new biomedical surgiclip instrument based on mathematical modeling, computer-aided simulation, and prototype testing. The analytic methodology proposed in this paper can help engineers in biomedical industry develop and improve biomedical instrument. Compared to the current conventional surgiclip instruments, this new surgiclip instrument can properly assist surgeon in surgical procedure with less operational force and no surgiclip drop-off incident. The prototype has also been built and tested. Both computational simulation and prototype testing show close results which validate the feasibility of this newly developed endo surgiclip instrument and the methodologies of mathematical modeling based computational simulation proposed in this paper.

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26

Allen, George. "Ultrasonic scalpel use; effects of comorbidity; single wrap for sterile instrument packs; radiofrequency instruments." AORN Journal 83, no. 1 (January 2006): 222–26. http://dx.doi.org/10.1016/s0001-2092(06)60242-1.

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27

Bower, Janet O. "Surgical Instrument Manufacturing in Southern Germany." AORN Journal 64, no. 5 (November 1996): 710–14. http://dx.doi.org/10.1016/s0001-2092(06)63260-2.

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28

Chobin, Nancy. "Surgical Instrument Decontamination: A Multistep Process." AORN Journal 110, no. 3 (August 29, 2019): 253–62. http://dx.doi.org/10.1002/aorn.12784.

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29

Wahyuningsri, Wahyuningsri, GM Sindarti, and Irawan Irawan. "The Performance of Scrub Nurse In Implementing Hernioraphy Herniotomi Operation Management (HTHR) In Central Surgical Instalance RSUD Kanjuruhan Kepanuren." Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) 4, no. 2 (October 16, 2017): 174–80. http://dx.doi.org/10.26699/jnk.v4i2.art.p174-180.

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Nurse instrument is professional nursing personnel who is given authority and responsibility in the management of surgical instruments of any type of surgery, has the task of covering before, during, and after surgery action. The absence of SOP (Standart OperationalProcedure) makes every action only based on the experience and habits of each surgical operator. The purpose of this study is to determine the performance of nurses in implementing instrument management tools in a kind of herniotomic herniospheric instrument operation management at central surgical installation of Kanjuruhan Kepanjen Hospital. The research design used is descriptive observative. A population of 30 nurses at a central surgical installation. The number of samples used in this study is 10 nurses of instrument according to the inclusion criteria in charge. In operating room for herniotomic hernioraphy (HTHR) surgery. Sampling technique used is Total Sampling. Taking data by observation with check list. The result of research on the performance of nurse instrument in implementing the management of Herniotomic Herniospheric operation tool before and during the 100% surgical action not yet comply with the SOP (Standart OperationalProcedure), the performance of the instrument nurse after surgery is 100% appropriated. Further research recommendations are expected to continue research on the performance of nurse instruments on others types of operations for all nurses assigned to operating rooms.

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30

Burger, J., W. Piotrowski, S. Ambrosetti, M. Kreenn, A. Pfenniger, A. Stahel, S. Olsen, S. Ferguson, M. Loeffel, and L. Nolte. "Smart surgical instrument for spinal interventions." Journal of Biomechanics 39 (January 2006): S207—S208. http://dx.doi.org/10.1016/s0021-9290(06)83756-5.

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31

Santos-Carreras, Laura, Monika Hagen, Roger Gassert, and Hannes Bleuler. "Survey on Surgical Instrument Handle Design." Surgical Innovation 19, no. 1 (August 25, 2011): 50–59. http://dx.doi.org/10.1177/1553350611413611.

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32

Heibeyn, Jan, Nils König, Nadine Domnik, Matthias Schweizer, Max Kinzius, Armin Janß, and Klaus Radermacher. "Design and Evaluation of a Novel Instrument Gripper for Handling of Surgical Instruments." Current Directions in Biomedical Engineering 7, no. 1 (August 1, 2021): 1–5. http://dx.doi.org/10.1515/cdbme-2021-1001.

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Abstract Introduction: Contaminated surgical instruments are manually prepared for cleaning and disinfection in the reprocessing unit for medical devices (RUMED). Manual labour exposes staff to the risk of infection and is particularly stressful at peak times due to the large volume of instruments. Partial automation of processes by a robot could provide a solution but requires a gripper that can handle the variety of surgical instruments. This paper describes the development and first evaluation of an instrument gripper. Methods: First, an analysis of gripping geometries on basic surgical instruments is carried out. Based on the identified common features and a review of the state of the art of gripper technology, the SteriRob gripper concept is developed. The concept is compared with a force closure gripper in a series of tests using seven criteria. Results: Both gripping approaches investigated can be used for handling surgical instruments in a pick-and-place process. However, the SteriRob gripper can transmit significantly higher acting forces and torques. In addition, the gripping process is more robust against deviations from the expected instrument position. Conclusion: Overall, it has been shown that the developed instrument gripper is suitable for about 60% of reusable surgical instruments due to the focus on horizontal cylindrical geometries. Because of the large possible force transmission, this gripping approach is particularly suitable for tasks in which the robot assists with cleaning processes.

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33

Yoon, Seungwon, Corinna C. Zygourakis, Joshua Seaman, Min Zhu, A. Karim Ahmed, Tamara Kliot, Sheila Antrum, and Andrew N. Goldberg. "Implementation and Impact of a Hospital-Wide Instrument Set Review: Early Experiences at a Multisite Tertiary Care Academic Institution." American Journal of Medical Quality 34, no. 1 (June 25, 2018): 67–73. http://dx.doi.org/10.1177/1062860618783261.

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A multidisciplinary team of nurses, sterile processing technicians, and surgeons reviewed 609 otolaryngology–head and neck surgery (OHNS) surgical instrument sets at the study institution’s 3 hospitals. Implementation of the 4-phase instrument review resulted in decreased OHNS surgical instrument set types from 261 to 234 sets, and a decreased number of instruments in these sets from 18 952 to 17 084. The instrument set review resulted in an estimated savings of $35 665 in sterile processing costs for the OHNS department. Instrument review applied to all 10 surgical specialties at the institution would result in an estimated annual savings of $425 378. Through effective leadership, multidisciplinary participation of all key stakeholders, and a systematic approach, this study demonstrates that a hospital-wide quality improvement intervention for instrument set optimization can be successfully performed in a large, multisite tertiary care academic hospital.

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34

Mhlaba, Julie M., Emily W. Stockert, Martin Coronel, and Alexander J. Langerman. "Surgical instrumentation: the true cost of instrument trays and a potential strategy for optimization." Journal of Hospital Administration 4, no. 6 (September 22, 2015): 82. http://dx.doi.org/10.5430/jha.v4n6p82.

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Objective: Operating rooms (OR) generate a large portion of hospital revenue and waste. Consequently, improving efficiency and reducing waste is a high priority. Our objective was to quantify waste associated with opened but unused instruments from trays and to compare this with the cost of individually wrapping instruments.Methods: Data was collected from June to November of 2013 in a 550-bed hospital in the United States. We recorded the instrument usage of two commonly-used trays for ten cases each. The time to decontaminate and reassemble instrument trays and peel packs was measured, and the cost to reprocess one instrument was calculated.Results: Average utilization was 14% for the Plastic Soft Tissue Tray and 29% for the Major Laparotomy Tray. Of 98 instruments in the Plastics tray (n = 10), 0% was used in all cases observed and 59% were used in no observed cases. Of 110 instruments in the Major Tray (n = 10), 0% was used in all cases observed and 25% were used in no observed cases. Average cost to reprocess one instrument was $0.34-$0.47 in a tray and $0.81-$0.84 in a peel pack, or individually-wrapped instrument.Conclusions: We estimate that the cost of peel packing an instrument is roughly two times the cost of tray packing. Therefore, it becomes more cost effective from a processing standpoint to package an instrument in a peel pack when there is less than a 42%-56% probability of use depending on instrument type. This study demonstrates an opportunity for reorganization of instrument delivery that could result in a significant cost-savings and waste reduction.

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35

Muscarella, Lawrence F. "Instrument Design and Cross-Infection." AORN Journal 67, no. 3 (March 1998): 552–56. http://dx.doi.org/10.1016/s0001-2092(06)62824-x.

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36

Schall, Bridget. "Sponge, Needle, and Instrument Counts." AORN Journal 54, no. 3 (September 1991): 482. http://dx.doi.org/10.1016/s0001-2092(07)66767-2.

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37

Deardorf, Marie A. "Increasing multipuncture laparoscopic instrument longevity." AORN Journal 54, no. 2 (August 1991): 357–60. http://dx.doi.org/10.1016/s0001-2092(07)69300-4.

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38

Spruce, Lisa. "Back to Basics: Instrument Cleaning." AORN Journal 105, no. 3 (February 27, 2017): 292–99. http://dx.doi.org/10.1016/j.aorn.2017.01.001.

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39

Kim, Jungsuk, Kyeongjin Kim, Sun-Ho Choe, and Hojong Choi. "Development of an Accurate Resonant Frequency Controlled Wire Ultrasound Surgical Instrument." Sensors 20, no. 11 (May 28, 2020): 3059. http://dx.doi.org/10.3390/s20113059.

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Our developed wire ultrasound surgical instrument comprises a bolt-clamped Langevin ultrasonic transducer (BLUT) fabricated by PMN-PZT single crystal material due to high mechanical quality factor and electromechanical coupling coefficient, a waveguide in the handheld instrument, and a generator instrument. To ensure high performance of wire ultrasound surgical instruments, the BLUT should vibrate at an accurate frequency because the BLUT’s frequency influences hemostasis and the effects of incisions on blood vessels and tissues. Therefore, we implemented a BLUT with a waveguide in the handheld instrument using a developed assembly jig process with impedance and network analyzers that can accurately control the compression force using a digital torque wrench. A generator instrument having a main control circuit with a low error rate, that is, an output frequency error rate within ±0.5% and an output voltage error rate within ±1.6%, was developed to generate the accurate frequency of the BLUT in the handheld instrument. In addition, a matching circuit between the BLUT and generator instrument with a network analyzer was developed to transfer displacement vibration efficiently from the handheld instrument to the end of the waveguide. Using the matching circuit, the measured S-parameter value of the generator instrument using a network analyzer was −24.3 dB at the resonant frequency. Thus, our proposed scheme can improve the vibration amplitude and accuracy of frequency control of the wire ultrasound surgical instrument due to developed PMN-PZT material and assembly jig process.

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40

Fogg, Dorothy M. "Count sheets in instrument sets, color-coding instruments, and warming sterile solutions in microwave ovens discouraged." AORN Journal 48, no. 6 (December 1988): 1174–76. http://dx.doi.org/10.1016/s0001-2092(07)69786-5.

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41

Tybjerg, Karin. "Sharp and telling." Journal of the History of Collections 31, no. 3 (October 22, 2018): 547–62. http://dx.doi.org/10.1093/jhc/fhy036.

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Abstract Surgical instrument collections have been used in a multitude of ways – as tools, taxonomies, teaching aids, representation, historical highlights and public displays – and they provide a key to understanding the shifting relations between surgery, medical museums and medical history. Tracing the uses of the surgical instrument collections from the Royal Danish Academy of Surgery and the Medical Historical Museum at the University of Copenhagen reveals a network of disciplinary and institutional changes from the late nineteenth to early twenty-first century. The history of the collections maps relations between scientific and cultural historical collections and between medicine and history. In the same way as surgical instruments have connected the surgeon’s hand to the patients’ body, the surgical instrument collections connect together the public, medical practice and history.

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42

Armstrong, William B., Amir M. Karamzadeh, Roger L. Crumley, Timothy F. Kelley, Ryan P. Jackson, and Brian J. F. Wong. "A novel laryngoscope instrument stabilizer for operative microlaryngoscopy." Otolaryngology–Head and Neck Surgery 132, no. 3 (March 2005): 471–77. http://dx.doi.org/10.1016/j.otohns.2004.10.012.

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OBJECTIVE: To evaluate and optimize the design of a removable and inexpensive internal stabilization device to reduce the effect of intention tremor during laryngeal microsurgery. STUDY DESIGN AND SETTING: In this laboratory investigation, stabilizers were designed and constructed to allow a nonobstructing view of the surgical field, permit simple insertion and removal, and accommodate microsurgical instruments. Prototype stabilizers were tested by using a Dedo laryngoscope, a measurement grid, and video recording equipment, which recorded instrument tremor within the magnified operative field for later analysis. Physicians also rated instrument stability, mobility, visualization, and ease of use on a survey form. RESULTS: Instrument tremor was reduced approximately 90%, with little obstruction of view of the surgical field. Instrument range of motion was reduced but improved rapidly as the stabilizer bar was moved further from the tip of the laryngoscope. CONCLUSIONS: Use of a stabilization device in the laryngoscope lumen reduces instrument tremor and has the potential to improve surgical performance during laryngeal microsurgery. EBM rating: B-3.

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Brophy, T., PD Srodon, C. Briggs, P. Barry, J. Steatham, and MJ Birch. "Quality of Surgical Instruments." Annals of The Royal College of Surgeons of England 88, no. 4 (July 2006): 390–93. http://dx.doi.org/10.1308/003588406x98621.

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INTRODUCTION Many surgeons will have encountered the scissors that would not cut, and the artery clip that comes off in a deep difficult location, but it would be reasonable to assume that new instruments should be of assured quality. This study reports the surprising findings of a local quality control exercise for new instruments supplied to a single trust. MATERIALS AND METHODS Between January 2004 and June 2004, all batches of new surgical instruments ordered by the Central Sterile Supplies Department of St Bartholomew's and the Royal London Hospitals were assessed by three clinical engineers, with reference to British Standards (BS) requirements. RESULTS Of 4800 instruments examined, 15% had potential problems. These included 116 with machining burrs and debris in the teeth of the tissue-holding regions, 71 defects of ratcheted instruments, 34 scissors with deficient cutting action, and 35 tissue forceps protruding guide pins. In addition, 254 instruments did not have a visible manufacturer's mark. CONCLUSIONS This study demonstrates the value of local quality control for surgical instruments. This is of importance in an increasingly hazard-conscious environment, where there are concerns over instrument sterilisation, surgical glove puncture and the potential for transmission of blood-borne and prion diseases.

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Schaufler, Anna, Alfredo Illanes, Ivan Maldonado, Axel Boese, Roland Croner, and Michael Friebe. "Surgical Audio Guidance: Feasibility Check for Robotic Surgery Procedures." Current Directions in Biomedical Engineering 6, no. 3 (September 1, 2020): 571–74. http://dx.doi.org/10.1515/cdbme-2020-3146.

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AbstractIn robot-assisted procedures, the surgeon controls the surgical instruments from a remote console, while visually monitoring the procedure through the endoscope. There is no haptic feedback available to the surgeon, which impedes the assessment of diseased tissue and the detection of hidden structures beneath the tissue, such as vessels. Only visual clues are available to the surgeon to control the force applied to the tissue by the instruments, which poses a risk for iatrogenic injuries. Additional information on haptic interactions of the employed instruments and the treated tissue that is provided to the surgeon during robotic surgery could compensate for this deficit. Acoustic emissions (AE) from the instrument/tissue interactions, transmitted by the instrument are a potential source of this information. AE can be recorded by audio sensors that do not have to be integrated into the instruments, but that can be modularly attached to the outside of the instruments shaft or enclosure. The location of the sensor on a robotic system is essential for the applicability of the concept in real situations. While the signal strength of the acoustic emissions decreases with distance from the point of interaction, an installation close to the patient would require sterilization measures. The aim of this work is to investigate whether it is feasible to install the audio sensor in non-sterile areas far away from the patient and still be able to receive useful AE signals. To determine whether signals can be recorded at different potential mounting locations, instrument/tissue interactions with different textures were simulated in an experimental setup. The results showed that meaningful and valuable AE can be recorded in the non-sterile area of a robotic surgical system despite the expected signal losses.

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Mooney, Kristin L., Sondra Valdez, and Dena Peña. "Custom cradle trays: Secure instrument storage." AORN Journal 84, no. 1 (July 2006): 97–106. http://dx.doi.org/10.1016/s0001-2092(06)60101-4.

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Murphy, Ellen K. "Nonnegligence found in retained instrument case." AORN Journal 46, no. 5 (November 1987): 928–33. http://dx.doi.org/10.1016/s0001-2092(07)67416-x.

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Poulsen, Kari. "Best Practices for Streamlining Instrument Sets." AORN Journal 110, no. 4 (September 27, 2019): 366–71. http://dx.doi.org/10.1002/aorn.12822.

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Moss, Rose, Darin M. Prescott, and Joan M. Spear. "Instrument Manufacturing: Implications for Perioperative Teams." AORN Journal 112, no. 1 (June 29, 2020): 15–29. http://dx.doi.org/10.1002/aorn.13073.

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Hercules, Patricia Ann. "Instrument Readiness: A Patient Safety Issue." Perioperative Nursing Clinics 5, no. 1 (March 2010): 15–25. http://dx.doi.org/10.1016/j.cpen.2009.11.004.

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Mitchell, Sheila. "Placing count sheets in instrument trays." AORN Journal 90, no. 2 (August 2009): 280–81. http://dx.doi.org/10.1016/j.aorn.2009.07.017.

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