Hospitals using unsafe devices for keyhole ops

The first ever UK audit of laparoscopic operating theatres found 28 per cent were using obsolete equipment and, in some cases, instruments that may cause harm.

Some 19 per cent – including hospitals in Yorkshire – were using old-style reusable surgical instruments which carry extra risks for patients, the Association of Laparoscopic Surgeons of Great Britain & Ireland (ALSGBI) research found.

These 'Trocars' are sharp and made of metal, which increases the risk of accidentally puncturing organs or spreading infection. The association now recommends the use of blunt, disposable Trocars.

Just over one in 10 hospitals (11 per cent) were operating with the highest standard of equipment for carrying out safe, advanced laparoscopic (also known as keyhole) surgery, the audit found.

Some 3 per cent were not using modern technologies such as ultrasound in their operations and almost one in four hospitals did not have a maintenance contract to replace broken tools.

The National Audit of Theatre Equipment 2010 includes details from 474 hospitals in the UK, where staff were asked about the age, standard and type of equipment used and how it was powered and maintained.

Hospitals were graded bronze, silver or gold depending on the equipment they used.

The report found 61 per cent of hospitals were operating with silver standard equipment, 11 per cent with the best gold standard and 28 per cent with poor bronze equipment.

Regionally, Sheffield Children's Hospital and the privately-run Nuffield Hospital in Leeds were found to be gold standard but hospitals in Bridlington, Calderdale, Harrogate, York, Scarborough and the Northern General in Sheffield were all rated only bronze.

In addition, the Northern General, Sheffield's Royal Hallamshire, Airedale General and Calderdale hospitals were found to be using outdated and potentially dangerous sharp metal trocars.

Keyhole surgery is used for almost all gastrointestinal and abdominal operations and is less painful for patients, leading to speedier recovery and smaller scars.

In recent years, surgeons have been using high definition camera equipment, which offers better images, to perform complex surgery and can lead to shorter operations.

Mike Parker, past president of the association, said: "The view from the original laparoscopic cameras was like squinting through a goldfish bowl.

"In comparison, high definition equipment has revolutionised practice.

"It is unbelievable that some surgeons are still having to use equipment which limits the operations they can perform safely.

"We hope the result of this audit encourages surgeons and management to discuss upgrading their equipment to improve standards and to reassure patients that the best service is being provided."

Last month, officials from the Care Quality Commission warned of "serious concerns" about standards at the NHS trust covering Scarborough and Bridlington hospitals, mainly related to staffing shortages and the quality of its infrastructure which has a 6m maintenance backlog.

Last night a spokesman for the hospitals said the report was out of date and did not reflect the current situation. He said: "All our laparoscopic equipment has been replaced in the last 12 months so we now have the most up-to-date equipment in place."

A Calderdale Hospital spokesman said: "All the laparoscopic general surgeons are compliant with the advice to use blunt Trocars for insertion of the laproscope. All laparoscopic surgery is subject to vigorous audit and clinical governance procedures.

"Equipment is regularly updated in line with recommendations."

Paul Skinner, clinical director for surgical services at Sheffield Teaching Hospitals NHS Foundation Trust – which covers the Northern General and Royal Hallamshire – said: "Patient safety is our top priority and patients can be reassured that we have excellent surgical outcomes. We spend more than 6m a year on replacement medical equipment and patient safety is a key factor in prioritising the investments."

No-one was available for comment at Harrogate, York or Airedale General.