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This study will address the gap in coblator wands by comparing the performance of reprocessed coblator wands with new wands in terms of efficiency and technical issues. As part of the evaluation, the investigator team will conduct the technical performance of the life cycle assessment of reprocessed versus new coblation wands based on the methodology described in the literature (see References) in studies of laryngoscopes.
Reprocessed operating room tools offer surgeons an opportunity to use equipment that have been inferenced to incur lower hospital and environmental costs. Tools that are "disposable" are collected by reprocessing companies that then refurbish and sterilize the instrument and sell it back to the hospital at a reduced cost. Advocates argue that they may serve as a means of controlling increasing healthcare costs and further, because few if any new raw materials are needed for the reprocessing, environmental costs are also hypothesized to be reduced. However, the use of reprocessed tools has demonstrated variable results in clinical performance across different surgical domains. Comparable performance of reprocessed orthopedic drill bits to new ones in terms of force, heat, and usability has been demonstrated (see References). It has been shown that blinded surgeons could not distinguish between new and reprocessed arthroscopic shavers and found equivalent sharpness on engineering tests. In contrast, it has been found that reprocessed laparoscopic trocars had more imperfections and higher leak rates (see References) reported more abnormalities in reprocessed harmonic scalpels with poorer tissue handling outcomes. There remains a lack of consensus about the reliability of reprocessed surgical tools, including coblator wands.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| New Coblator Ablation Wands | Active Comparator |
| |
| Reprocessed Coblator Ablation Wands | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| New Coblator Ablation Wands | Device | New, unused coblator ablation wands from Arthrocare |
|
| Measure | Description | Time Frame |
|---|---|---|
| Surgeon Comfort | The primary outcome for this study is surgeon comfort in terms of using the new or reprocessed coblator wand again based on data collected from the post-procedure surveys. Surgeon comfort will be assessed as a dichotomous (yes/no) measure following the procedure. The number of instances for which the surgeon is comfortable using the new or reprocessed coblator wand will be summarized by study arm using descriptive statistics. | Following the procedure, up to 4 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hannah Collins | Contact | 914-705-3215 | hannah.collins@einsteinmed.edu | |
| Salma Ahsanuddin, MD | Contact | sahsanuddi@montefiore.org |
| Name | Affiliation | Role |
|---|---|---|
| John Bent, MD | Montefiore Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Children's Hosptial at Montefiore | The Bronx | New York | 10467 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28166171 | Background | Myers R, Kim H, Hsieh AH, O'Toole RV, Sciadini MF. When Should We Change Drill Bits? A Mechanical Comparison of New, Reprocessed, and Damaged Bits. J Orthop Trauma. 2017 May;31(5):281-286. doi: 10.1097/BOT.0000000000000812. | |
| 24683649 | Background | Ledonio CG, Arendt EA, Adams JE, Matz J, Boers A, Miller K, Lester BR. Reprocessed arthroscopic shavers: evaluation of sharpness and function in a cadaver model. Orthopedics. 2014 Jan;37(1):e1-9. doi: 10.3928/01477447-20131219-09. |
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| Reprocessed Medline Coblator Ablation Wands | Device | Reprocessed coblator ablation wands from Medline |
|
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| 21036630 | Background | Mues AC, Haramis G, Casazza C, Okhunov Z, Badani KK, Landman J. Prospective randomized single-blinded in vitro and ex vivo evaluation of new and reprocessed laparoscopic trocars. J Am Coll Surg. 2010 Dec;211(6):738-43. doi: 10.1016/j.jamcollsurg.2010.08.003. Epub 2010 Oct 30. |
| 16698349 | Background | Weld KJ, Dryer S, Hruby G, Ames CD, Venkatesh R, Matthews BD, Landman J. Comparison of mechanical and in vivo performance of new and reprocessed harmonic scalpels. Urology. 2006 May;67(5):898-903. doi: 10.1016/j.urology.2005.11.027. |
| 23924492 | Background | Jin T, Huang W, Jiang K, Xiong JJ, Xue P, Javed MA, Yang XN, Xia Q. Urinary trypsinogen-2 for diagnosing acute pancreatitis: a meta-analysis. Hepatobiliary Pancreat Dis Int. 2013 Aug;12(4):355-62. doi: 10.1016/s1499-3872(13)60056-9. |