ArticleJournal of robotic surgery2026
The effect of lean management on the efficiency and quality of domestic robotic surgical instrument cleaning.
Article in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
This study aimed to evaluate the impact of a lean management-based optimisation process on the cleaning efficiency and quality of domestically produced robotic surgical instruments. This study was conducted at the Fourth Hospital of Hebei Medical University between 4 April 2023 and 4 August 2025. In total, 296 batches of instruments were consecutively included and allocated into 2 groups based on the intervention timeline: a control group (n = 150) receiving the traditional cleaning protocol and an observation group (n = 146) receiving the optimised process. The intervention featured systematic reorganisation, including real-time instrument recovery, refined classification, enhanced ultrasonic cleaning, and an intelligent inventory system. Cleaning efficiency was measured as the average time for 5 key reprocessing stages. Cleaning quality was assessed using light-source magnifier inspection, protein residue assay, and adenosine triphosphate (ATP) biofluorescence detection. The lean management intervention led to improvements across the following outcomes: in terms of efficiency, the observation group demonstrated a 26% reduction in average cleaning time (2.23 ± 0.51 h vs. 3.00 ± 0.82 h, P < 0.001), with significant time savings also evident in the recovery, classification, disinfection, and distribution processes (all P < 0.001). Regarding quality, the optimised process resulted in significantly higher pass rates. Superior results were also consistently observed for wrist-type instruments and accessories across the light-source and protein residue assessments (all P < 0.05). Furthermore, instrument cleanliness scores at functional ends, joints, and surfaces were all significantly higher in the observation group (all P < 0.001). Process optimisation guided by lean management principles enhances both the operational efficiency and cleaning quality of domestic robotic instrument reprocessing. This lean management optimisation model establishes unified standardised reprocessing procedures for domestic robotic surgical instruments, effectively shortens overall reprocessing time, reduces unnecessary resource waste and operational costs, and demonstrates considerable potential for clinical application to improve workflow, elevate cleaning quality, and ensure patient safety.
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