Current practices and problems in the reuse of single-use devices in Japan.

Along with the popularization of endoscopic surgeries, the reuse of disposable single-use devices (SUDs), which may cause various risks, has become a considerable issue globally. We conducted the survey by questionnaires for the operating room (OR) head nurses to obtain hospital-based answer. First survey was done for three months in 2000 by sending the questionnaires to 2,224 hospitals. The second survey was done in 2003. In addition, for trocars and endoscopic clips, we carried out laboratory functional tests for the reuse of these reprocessed devices. As a total, 94.4% of hospitals reused SUDs routinely. The second survey showed significant decrease in the frequency of reuse to 86.2% as a whole. In the sample study, gross inspection showed the existence of contamination with debris. In-vitro sample study on in-hospital reprocessed instruments also demonstrated damaged endoscopic clips with impaired holding power. This study has demonstrated a still high frequency of reuse of SUDs in endoscopic surgeries in Japan. Although financial background may be the main reason, what is necessary to promote the single use of SUDs are multidisciplinary and composite approaches including an effort to lower the product price in parallel with the establishment of regulation and education programs.