More and more hospitals are rationalising their indirect
processes to work on a more cost-effective basis. One way
of doing this is to centralise certain hospital processes.
When operations are carried out, all the re-usable
materials, such as instruments, need to be cleaned,
disinfected and sterilised. More and more hospitals in
European countries centralise these activities in a
so-called Central Sterilisation Area (CSA). Here, all the
different instruments from the various operating theatres
are connected (dismantled), washed, disinfected,
(assembled), packed, sterilised (stored) and transported
back to the operating theatres. This is a very labour-
intensive process. Before invasive surgery, instruments
were relatively simple (and inexpensive), therefore easy to
handle and easy to process (in CSAs). Now, a lot of
advanced surgical instruments needs special care and
attention. This takes extra time due to dismantling and
reassembling. These refined and expensive instruments are
also more sensitive (resulting in damage and wastage) so
handling after surgery should be kept to a minimum.
because every different supplier has his own
specifications, a higher level of knowledge for CSA
personnel is also needed. Some instruments have their own
sterilisation instructions and sterilisation boxes.
ROBOUW has recognised this growing problem and has started
to develop a solution in the form of generic instrument
cassettes for several different (routine) operations. In
these partly open (metal wire) cassettes, all relevant
instruments can be placed, stored and presented in the most
logical configuration for operating theatre personnel. The
cassettes are ideal for transportation to and from the CSA.
Because of their open structure, the cassettes can be
placed directly in the washing machine. After washing the
whole cassette is wrapped in special, non-woven material
and placed in the sterilisation chamber. After
sterilisation, the cassette is ready for transport and use
in the operating theatre. Because of cassette use, many
steps in the process are skipped or turn out to be far less
intensive, which decreases mistakes, damage, wastage, the
use of packing material, labour and overall processing
time. The overall level of sterilisation increases due to
fewer contamination risks.
After having developed and successfully sold up to 42 types
of cassette, ROBOUW was confronted with requests for
cassettes especially for endoscopic instruments. About 40%
of current operations in the NETHERLANDS is carried out
with invasive surgery which uses endoscopic instruments.
These instruments consist of small hollow tubes with
complex mechanical (and sometimes electrical and optical)
constructions. This high operation percentage, the
European trend of converting to centrally organised
sterilisation departments in hospitals, growing expert
(more uniform European medical legislation), the need to
complete the range of sterilisation cassettes and, of
course - the stated demand, made ROBOUW decide to develop
such an endoscopic cassette.
Keywords: endoscopic, cassette, sterilisation.