In vitro evaluation of integrity and sterilization of single-use argon beam plasma coagulation probes

Objective: Argon plasma coagulation probes (APC) are currently marketed in the United States as single-use items, and may constitute a significant per -procedure expense, It is unknown whether these probes can be sterilized af ter endoscopic use and if electrical integrity can be maintained after repr ocessing, Methods: Ten probes (2.3 mm diameter, 220 cm length) manufactured by ERBE Inc.? (Marietta, GA) were studied using the ERBE APC 300 at 60 wat ts, Baseline coagulation depth was measured by coagulating a piece of beefs teak for 60 s, Probes were contaminated with 10(6) Bacillus subtilis spores , cultured, and manually cleaned. Culturing involved introducing 10 cc ster ile water through the probes; water was filtered, plated onto blood agar, a nd incubated for 48 h, After ethylene oxide (ETO), the probes were cultured to determine sterilization, Finally, the per-procedure cost of each probe was assessed. Results: Ten of 10 probes completed 10 testing sessions. One probe split at the proximal end but remained functionally intact. Electrica l integrity remained intact for all 10 sessions. All probes grew too numero us to count colonies of B. subtilis after inoculation and no B, subtilis wa s detected after ETO sterilization, Assuming 10 uses clinically, a total pe r-procedure equipment cost would approximate $24.00, whereas per-procedure probe cost would equal $42.66 if only five uses were obtained in vivo. Conc lusions: The combination of manual cleaning and ETO sterilization consisten tly sterilized APC probes, Ninety percent of the probes showed no sign of p hysical deterioration and 100% maintained their electrical activity after 1 0 uses. APC probes can potentially be safely and effectively reused-up to 1 0 times, and a significant procedural savings is possible with reuse. (C) 1 999 by Am. Cell. of Gastroenterology.