Certain models of arthroscopic shavers for orthopedic surgery have been found to retain pieces of tissue, even after they've been cleaned according to manufacturers' directions, says the U.S. Food and Drug Administration.

This contamination compromises the sterilization process and endangers public health, the agency says. It and the products' manufacturers are conducting safety reviews of the instruments and are urging surgical facilities that use these devices to:

Magnetically controlled surgical instruments could give laparoscopic surgeons greater maneuverability and a fuller range of motion, say researchers at the University of Texas Southwestern Medical Center and UT Arlington in Dallas, who've been developing the groundbreaking technology.

Surgeons using the Magnetic Anchoring and Guidance System move small magnetic handpieces outside of a patient's abdomen to manipulate specially designed instruments inside their body cavity.

"A laparoscopic incision represents a fixed access point that has a limited working envelope that is conical in shape. We are working to develop the technology to move around more freely," says Jeffrey Cadeddu, MD, a professor of urology and radiology and the director of the Clinical Center for Minimally Invasive Treatment of Urologic Cancer at the University of Texas Southwestern. "The magnetic maneuverability affords a much greater range of motion inside the abdominal cavity, allowing the surgical team to more easily position instruments in their optimum locations."

He explains that the magnetic system lets surgeons spread retractors, cautery devices and cameras throughout the abdominal cavity, reducing the clutter of instruments around trocars and potentially reducing the number of entry points needed to perform laparoscopic surgery.

The creators of MAGS have partnered with Ethicon Endo-Surgery to work toward the system's commercial release, something Dr. Cadeddu is hoping to see in the next 12 to 18 months. "We've been working on this technology for 8 years," he says. "It's close."

Daniel Cook

After comparing the results of a pair of portal drilling methods for anterior cruciate ligament reconstruction, researchers have reported that the most commonly employed technique might not be the most effective.

"The goal in repairing the ACL is to recreate normal anatomy," says Asheesh Bedi, MD, a fellow in sports medicine and shoulder surgery at the Hospital for Special Surgery in New York City. "The anatomy was better reproduced with the anteromedial portal drilling technique compared to the transtibial technique."

Dr. Bedi and colleagues compared frontal approach anteromedical drilling to the more frequently used lateral approach of transtibial drilling on 10 well-matched cadaver knees. During this research, they found an additional drawback to the more common method. "In preparing the femoral tunnel using the transtibial technique, the tibial tunnel is inadvertently re-reamed as much as 30% and can lead to significant time-zero tunnel expansion," says Dr. Bedi.

The study's results were reported at the American Orthopedic Society for Sports Medicine's annual meeting in Keystone. Colo., this month.

Kent Steinriede

Bladder scans non-invasively measure patients' bladder volume and determine whether catheterization is truly necessary. Do you use a bladder scanning device in your facility? Go to our Web site to let us know and see real-time results.

If you do use one and would like to share a pearl on how you've incorporated it into your routine, please e-mail Dan O'Connor, who will include your tip in a feature article to be published in the September issue of Outpatient Surgery Magazine.

Last week's InstaPoll asked whether a standard safety protocol to prevent wrong-site surgeries and other errors would work in your state. Most (59%) of our 44 respondents thought that every surgical facility in their state could embrace the idea. About 1 in 5 (21%) couldn't imagine their states' hospitals and ASCs getting together on this. Another 20% weren't sure.

All 12 hospitals and 21 surgery centers in Rhode Island have recently agreed to adopt uniform surgical procedures, and in 2005, New Hampshire became the first state in which every hospital and participating ambulatory surgical center voluntarily adopted a surgical safety checklist based on the work of the World Health Organization.

Dan O'Connor