{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T12:29:23Z","timestamp":1776774563412,"version":"3.51.2"},"reference-count":18,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:00:00Z","timestamp":1712188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>In recent decades, minimally invasive surgery has become the favoured surgical technique, with increasing utilisation of robotic surgery to enhance patient outcomes. However, the design complexity of surgical robotic instruments can pose challenges in maintaining adequate cleaning, disinfection and sterilisation\u2014particularly of the device\u2019s interior. In our hospital, robotic instruments are reused for a maximum of ten successive patients, following the manufacturer\u2019s guidelines. To the best of our knowledge, neither the manufacturer nor ISO standards have specified any methods to determine the sterility of robotic instruments after cleaning, disinfection and sterilisation procedures. In a small pilot study, we used a locally developed protocol to evaluate the sterility of 20 da Vinci SI robotic instruments, with the aim of determining whether the recommended cleaning, disinfection and sterilisation process is adequate to achieve safe usage in subsequent patients. None of the 20 instruments showed viable micro-organisms, therefore the robotic instruments were considered sterile, and suitable for re-use. We recommend our protocol to other hospitals, to be used as an essential control element in the assessment of their unique reprocessing technique for robotic instruments.<\/jats:p>","DOI":"10.1371\/journal.pone.0300355","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T17:30:05Z","timestamp":1712251805000},"page":"e0300355","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of microbial occurrence in reusable robotic instruments for minimally invasive surgery: A pilot study"],"prefix":"10.1371","volume":"19","author":[{"given":"Roy J.","family":"Pelzer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wil C.","family":"van der Zwet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike M. E. G.","family":"Eggen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley","family":"Beard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul H. M.","family":"Savelkoul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1961-9589","authenticated-orcid":true,"given":"Jeanne A. M. C.","family":"Dirks","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,4,4]]},"reference":[{"issue":"4","key":"pone.0300355.ref001","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s11701-021-01327-z","article-title":"Mandate to evaluate robotic surgery implementation: a 12-year retrospective analysis of impact and future implications.","volume":"16","author":"A Gomolin","year":"2022","journal-title":"Journal of robotic surgery."},{"issue":"10","key":"pone.0300355.ref002","doi-asserted-by":"crossref","first-page":"2550","DOI":"10.1007\/s00268-016-3543-9","article-title":"30 Years of Robotic Surgery.","volume":"40","author":"T Leal Ghezzi","year":"2016","journal-title":"World journal of surgery"},{"issue":"10","key":"pone.0300355.ref003","doi-asserted-by":"crossref","first-page":"4330","DOI":"10.1007\/s00464-016-4752-x","article-title":"Robotic surgery: disruptive innovation or unfulfilled promise? A systematic review and meta-analysis of the first 30 years","volume":"30","author":"A Tan","year":"2016","journal-title":"Surgical endoscopy."},{"key":"pone.0300355.ref004","author":"Inc. IS","year":"2023","journal-title":"About da Vinci Systems: procedures."},{"issue":"1","key":"pone.0300355.ref005","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1055\/s-2004-814113","article-title":"Minimally invasive surgery","volume":"36","author":"TN Robinson","year":"2004","journal-title":"Endoscopy"},{"key":"pone.0300355.ref006","first-page":"195","article-title":"A method for testing the cleaning of MIS robotic instruments.","volume":"21","author":"M Wehrl","year":"2013"},{"issue":"4","key":"pone.0300355.ref007","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.jhin.2016.04.009","article-title":"Novel concept of cleanliness of instruments for robotic surgery","volume":"93","author":"Y Saito","year":"2016","journal-title":"The Journal of hospital infection"},{"issue":"2","key":"pone.0300355.ref008","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1017\/ice.2016.249","article-title":"Challenging Residual Contamination of Instruments for Robotic Surgery in Japan.","volume":"38","author":"Y Saito","year":"2017","journal-title":"Infection control and hospital epidemiology"},{"key":"pone.0300355.ref009","author":"W. Behrends","year":"2020","journal-title":"Surgical robots must also be hygienic healthcare-in-europe.com"},{"key":"pone.0300355.ref010","unstructured":"Intuitive Surgical I. Bijlagen bij de instructies voor het opnieuw voor gebruik gereed maken van de da Vinci S en Si. https:\/\/acrobat.adobe.com\/link\/review?uri=urn%3Aaaid%3Ascds%3AUS%3A768953fc-eac7-3483-bd7a-04d723a4d3a82018."},{"key":"pone.0300355.ref011","author":"Getinge","year":"2023","journal-title":"Why you need an ultrasonic to clean robotic instruments"},{"key":"pone.0300355.ref012","author":"W Michels","year":"2017","journal-title":"Standardization of precleaning and automated reprocessing of robotic instruments Key words \u2022 Robotic instruments \u2022 ultrasound treatment \u2022 washer-disinfector \u2022 residual protein \u2022 haemoglobin test \u2022 cauterisation instruments."},{"issue":"12","key":"pone.0300355.ref013","doi-asserted-by":"crossref","first-page":"3305","DOI":"10.21037\/gs-21-814","article-title":"Multicenter comparative study of three \"non-destructive\" methods of detecting the cleanliness of the da Vinci surgical robotic instrument.","volume":"10","author":"A Chen","year":"2021","journal-title":"Gland surgery"},{"issue":"1","key":"pone.0300355.ref014","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1186\/s13756-021-00981-0","article-title":"The correlation between ATP measurement and microbial contamination of inanimate surfaces.","volume":"10","author":"A van Arkel","year":"2021","journal-title":"Antimicrobial resistance and infection control."},{"issue":"2","key":"pone.0300355.ref015","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.surg.2023.04.024","article-title":"Evaluation of cleaning process efficacy of instruments for robotic surgery using the adenosine triphosphate test","volume":"174","author":"ME Dolci","year":"2023","journal-title":"Surgery"},{"issue":"1","key":"pone.0300355.ref016","doi-asserted-by":"crossref","first-page":"e53","DOI":"10.1016\/j.jhin.2018.11.001","article-title":"Complex design of surgical instruments as barrier for cleaning effectiveness, favouring biofilm formation","volume":"103","author":"LKO Lopes","year":"2019","journal-title":"The Journal of hospital infection"},{"key":"pone.0300355.ref017","article-title":"Decontamination of a Robot used to Reprocess Reusable Surgical Instruments","author":"J Heibeyn","year":"2023","journal-title":"Journal of Hospital Infection"},{"issue":"3","key":"pone.0300355.ref018","doi-asserted-by":"crossref","first-page":"e142","DOI":"10.1016\/j.jhin.2018.08.004","article-title":"The validity of adenosine triphosphate measurement in detecting endoscope contamination","volume":"100","author":"CE McCafferty","year":"2018","journal-title":"The Journal of hospital infection"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0300355","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T17:30:15Z","timestamp":1712251815000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0300355"}},"subtitle":[],"editor":[{"given":"Naga Raju","family":"Maddela","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,4,4]]},"references-count":18,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0300355","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,4]]}}}