ESG-300 ELECTROSURGICAL GENERATOR Instructions for Use July 2020

Contents 1 Using this document...5 1.1 User instructions...5 1.2 Conventions throughout this document...5 1.3 Safety-related information in this document...5 2 Safety information...7 2.1 Intended purpose...7 2.2 Contact...8 2.3 General safety notes...8 3 Product description...13 3.1 Scope of delivery...13 3.2 Product functions...13 3.3 Features...13 3.4 Operating elements on the hardware...15 3.5 Operating elements of the touchscreen...17 3.6 Symbols...23 3.7 Warranty...25 4 Installation...26 4.1 Safety notes for installation...26 4.2 General inspection...26 4.3 Placement of the electrosurgical generator...26 4.4 Connecting the APU‑300...27 4.5 Connecting the electrosurgical generator to the mains electricity...27 4.6 Connecting the foot switch...29 5 Basic settings...30 5.1 Operation of the touchscreen...30 5.2 User-defined settings and procedures...30 5.3 Volume control of activation tones...32 5.4 Brightness control...32 5.5 Languages...33 5.6 Touch Tone...33 5.7 Default Settings...33 5.8 Argon supply setup...34 6 Using the ESG‑300 with a neutral electrode...35 6.1 Safety notes for neutral electrode use...35 6.2 Split type and non-split type neutral electrodes and CQM...36 6.3 Conditions of the CQM indicator...36 6.4 Connection to the electrosurgical generator...37 6.5 Verifying the CQM indicator...38 7 Before use...39 7.1 Safety notes for before use...39 7.2 Inspection...39 7.3 Power settings...41 7.4 Tissue effects depending on the power level and effect level...46 8 Use...48 8.1 Safety notes for use...48

8.2 Description of the output sockets...49 8.3 Connecting HF instruments...50 8.4 Selection of appropriate power settings...50 8.5 Selection of user-defined settings or procedures...51 8.6 Activation of HF output...52 8.7 The alarm system...53 8.8 Troubleshooting...56 8.9 Overview of error messages...59 9 After use...69 9.1 Safety notes for after use...69 9.2 Disconnection...69 10 Reprocessing...70 10.1 Safety notes for reprocessing...70 10.2 General information for reprocessing...70 10.3 Cleaning...70 10.4 Disinfection...71 10.5 Other HF equipment...71 11 Maintenance, repair and shipment...72 11.1 Maintenance...72 11.2 Repair...72 11.3 Shipment...73 12 Storage and disposal...74 12.1 Storage...74 12.2 Disposal...74 13 Ordering information...75 14 Compatible equipment...76 14.1 System chart...76 14.2 Compatible neutral electrodes...77 15 Technical data...78 15.1 Specifications for the ESG‑300...78 15.2 Ambient conditions for operation, storage and transport...78 15.3 Plug requirements ...79 15.4 Resistance range for CQM...79 15.5 Specifications for cables...79 16 Electromagnetic compatibility...80 17 Additional information...84 17.1 Alarm system...84 17.2 Activation tone information...85 17.3 Mode characteristics according to IEC 60601-2-2...86 17.4 Characteristics of High Power Cut Support (HPCS)...87 17.5 Output characteristic diagrams...87 18 Glossary...104 19 Index...108

Using this document

1 Using this document This chapter provides a general information on how to use these instructions for use.

1.1 User instructions Before use, thoroughly read these instructions for use and the instructions for use of all other products that will be used during the procedure. If the required instructions for use are missing, immediately contact an Olympus representative. Keep the instructions for use in a safe, accessible location.

1.2 Conventions throughout this document This is the safety alert symbol. It is used to alert the user to potential physical injury hazards. Observe all safety messages that follow this symbol to avoid possible injury. This symbol indicates additional helpful information. 1. A numeration indicates a sequence of actions. 2. 3. ● Bullet points indicate individual actions or different options for action. – Dashes indicate the listing of data, options or objects. – – 1) Numbers with right parenthesis name elements in illustrations. 2) 3) […] Bracketed terms refer to elements in the graphical user interface or keys. Elements in the graphical user interface can be: - buttons - menu items - dialog elements

1.3 Safety-related information in this document For safe and efficient use of this product it is important to read the complete instructions for use. The safety related information of these instructions for use is not only described in this chapter. All information and instructions in this document are to ensure a safe and efficient use. Safety information are described in 3 categories: ‒ General safety notes ‒ Specific safety notes ‒ Safety messages

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Using this document

1.3.1 General safety notes General safety notes are located at the beginning of the instructions for use. They address safety issues that apply to the general use and handling of the product. 1.3.2 Specific safety notes Specific safety notes are located at the beginning of a chapter or section. They address safety issues that are specific to the information and actions described in the chapter or section. 1.3.3 Safety messages Safety messages focus on unexpected incidents that can occur during the intended use. They are placed in the context of such risks and actions. The safety messages are highlighted by a signal word. DANGER Indicates a hazardous situation which, if not avoided, will result in death or serious injury. WARNING Indicates a potentially hazardous situation which, if not avoided, can result in death or serious injury. CAUTION Indicates a potentially hazardous situation which, if not avoided, can result in minor or moderate injury.

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Safety information

2 Safety information This chapter provides general safety information for using the product. The safety information includes: ‒ Intended purpose ‒ Manufacturer information ‒ General safety notes

2.1 Intended purpose 2.1.1 Intended use and indications The electrosurgical generator, in conjunction with electrosurgical accessories and ancillary equipment, is intended for cutting and coagulating tissue in open surgery, laparoscopic surgery and endoscopic surgery. For monopolar argon plasma coagulation (MAPC) of tissue, the electrosurgical generator is intended to be used with a compatible Olympus argon plasma coagulation unit to deliver ionized argon gas. Do not use the product for any other purpose. 2.1.2 Relative contraindications Relative contraindications of electrosurgical interventions: ‒ If electrosurgery could have a negative effect on the state of the patient. ‒ Patients with implanted electronic devices (e.g. pacemakers or cardioverter-defibrillators) ‒ Patients with a weakened immune system ‒ Patients with blood coagulation disorders. 2.1.3 Patient target group Not dedicated to a specific patient population. Patient target groups are defined by the individual applicator used with the device. 2.1.4 Intended users Medical use Only for use by a qualified physician or medical personnel under the supervision of a physician. Only for use in an adequate medical environment. These instructions for use do not explain or discuss clinical procedures. Reprocessing Reprocessing of reusable products may only be performed by qualified hygiene personnel. Repair Repair of the product may only be performed by trained qualified servicing personnel that has been authorized by Olympus. Otherwise, Olympus cannot be held responsible for the safety and performance of the product.

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Safety information

Commissioning The electrosurgical generator must be properly installed and commissioned by trained qualified personnel that has been authorized by Olympus. Regular safety check The regular safety check must only be performed by a qualified electrician with sufficient experience in maintaining medical electrical devices. The regular safety check must only be performed in a technical laboratory with appropriate equipment. 2.1.5 Clinical benefits Clinical benefits depend on the applied part used with the device.

2.2 Contact 2.2.1 Manufacturer Olympus Winter & Ibe GmbH Kuehnstr. 61 22045 Hamburg Germany Country-specific information Refer to the contact information for customers included in the scope of delivery for countryspecific information. 2.2.2 Incident reporting European Union If a serious incident occurs with the device, report it to the manufacturer and the relevant national authority. Eurasian Economic Union If an undesirable event occurs with the device, report it to the manufacturer or the authorized representative. Other regions If a serious incident occurs with the device, report it to the manufacturer and/or the relevant national authority according to national legislation.

2.3 General safety notes The following safety information address points that apply to the general handling and use of the product. This information is to be supplemented by the information given in each chapter of this document. Read all instructions for use thoroughly Before use, read this instructions for use and the instructions for use for all other equipment which will be used during the procedure.

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Safety information

An insufficient understanding of the safety information in these instructions for use can result in death, serious injury, or equipment damage. Repair and product modifications Unauthorized repairs and product modification can cause injury to the patient and the user. Repairs may only be performed by qualified servicing personnel that has been authorized by Olympus. Refer to the section “11.2 Repair” on page 72 for more details. 2.3.1 Risks regarding implants WARNING Malfunction of pacemakers and defibrillators Using HF equipment on patients with implanted electronic devices, e.g. cardiac pacemakers or cardioverter defibrillators, can cause failure of the implanted electronic device. Failure of the implanted electronic device will affect the heart and can result in cardiac arrest. ‒ Before the HF procedure, confirm its safety with a cardiologist or the manufacturer of the implanted electronic device. ‒ For monopolar procedures, position the neutral electrode so that the current pathway does not pass through or near the implanted electronic device and its lead system. ‒ Do not apply the HF instrument in close proximity to the implanted electronic device. Other electrically conductive implants All electrically conductive implants present a hazard due to concentration or re-direction of HF currents. Qualified advice should be obtained before the electrosurgical procedure. 2.3.2 Risks regarding accessories WARNING Incompatible equipment Using incompatible equipment can lead to injury of the patient and/or the user as well as damage to the product. ‒ Only use this electrosurgical generator with compatible equipment. ‒ Refer to the chapter “14 Compatible equipment” on page 76. WARNING Damaged equipment and accessories The use of damaged equipment, of equipment with improper functioning or the reuse of single use products can cause electric shock, mechanical injury, infection and thermal injury to the patient and the user. ‒ Before each use, observe the instructions in the section “7.2 Inspection” on page 39. ‒ Do not use damaged equipment or equipment with improper functioning. ‒ Do not reuse used accessories that are intended for single use. ‒ Replace damaged equipment or equipment with improper functioning. WARNING Mechanical injuries by snares Mechanical stress at the treatment site when using a snare can result in bleeding and perforation to the patient. ‒ Select a wire diameter of the snare that is appropriate for the target tissue. ‒ As long as HF output is not activated, only close the snare loosely around the target tissue. ‒ Before closing the snare for cutting, make sure to activate the HF output.

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Safety information

CAUTION Risk of sparkover There is a risk of sparkover leading to electrical injury, thermal injury and/or unintended nerve stimulation. ‒ Check the maximum rated voltage of the other HF equipment. ‒ Make sure that the maximum output voltage of the electrosurgical generator does not exceed the lowest maximum rated voltage of any of the HF equipment used during the procedure. 2.3.3 Risks regarding electric shock WARNING Grounding failure There is a risk of electric shock if the housing of the electrosurgical generator is not grounded. ‒ Only connect the power cable to a properly grounded fixed socket outlet. ‒ Do not use an adapter for an incompatible grounded fixed socket outlet as it can impair safe operation of the electrosurgical generator. 2.3.4 Risks regarding burns WARNING Power levels The selected power level should be as low as possible for the intended purpose. If the power level initially is set too high, then the HF instrument’s insulation can be damaged. This can result in burns to the patient and the user. However, the RFCoag mode presents an unacceptable risk when used with power levels that are too low. The risk of excessive thermal effects rises if the power level is too low when using these modes. ‒ For appropriate power levels, refer to the chapter “7.3 Power settings” on page 41. ‒ Before the procedure, perform basic testing with the electrosurgical generator. WARNING Unintended tissue contact When the HF output of the electrosurgical generator is active, then unintended contact between tissue and the active part of the HF instrument can cause burns to the patient, the user and the medical personnel. ‒ Store temporarily unused HF instruments in an electrically insulated container. ‒ Do not place unused HF instruments on the patient. CAUTION Unintended current flow and HF leakage current Unintended current flow and HF leakage current can cause thermal injury to the patient. The patient must be insulated against all electrically conductive parts. ‒ Ground the operating table. ‒ Make sure that the patient does not come in contact with metal parts, e.g. the operating table. ‒ Place the patient on a dry, electrically insulating surface. ‒ Make sure that the patient’s clothes are dry. ‒ Prevent any contact between different skin surfaces (arms, legs) of the patient. Place dry gauze between the body and arms and between the legs to prevent such contact. ‒ Prevent any skin contact between the patient and the user. ‒ Remove any metallic items from the patient, e.g. wristwatches, jewelry.

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Safety information

‒ Route all connecting cables so that they are not in direct contact with the patient. ‒ Route all connecting cables so that they are not in contact with other cables. Consider bipolar techniques For surgical procedures where the HF current could flow through parts of the body that have a relatively small cross sectional area, the use of bipolar techniques can be desirable to avoid unwanted tissue damage. 2.3.5 Risks regarding fire and explosion DANGER Flammable gas in the gastrointestinal tract Flammable gases within the intestines of the patient can cause fire or explosion when applying HF current. This will result in serious injury to the patient. Before the HF procedure, replace intestine gases by non-flammable gases. WARNING Flammable anaesthetics and gases If flammable gases, especially anaesthetics ignite, then they cause serious injuries to the patient, the user and the medical personnel. ‒ Take precautionary measures to keep away flammable gases from the site of intervention. ‒ Do not use flammable anaesthetics. WARNING Flammable materials Sparks that occur during normal operation of the HF equipment can ignite flammable materials, e.g. absorbent cotton or gauze and also body hair. This can result in serious injuries to the patient, the user and the medical personnel. ‒ Use soluble surgical lubricating jelly to cover hair close to the site of intervention. ‒ Do not apply materials like cotton or gauze simultaneously with the HF instrument to the site of intervention. Use non-flammable agents for cleaning and disinfection Non-flammable agents should be used for cleaning and disinfection wherever possible. If flammable agents are used, they should be allowed to evaporate before the application of HF surgery. There is a risk of pooling of flammable solutions under the patient or in body depressions such as the umbilicus, and in body cavities such as the vagina. Any fluid pooled in these areas should be mopped up before HF surgical equipment is used. 2.3.6 Procedural hazards and complications WARNING Impeded performance Coagulum or eschar that accumulates at the HF instrument can impede the performance of the electrosurgical generator. Increasing the power level can damage the electrosurgical generator and can result in injury to the patient. ‒ Carefully clean affected areas of the HF instrument. Refer to the instructions for use of the HF instrument. ‒ If necessary, replace the HF instrument.

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Safety information

WARNING Electrical stimulation of nerves and muscles Low frequency electrical currents or intense high frequency electrical currents can stimulate nerves and muscles which can result in violent spasms or muscle contractions of the patient. Low frequency electrical currents can be generated by a partial rectification of intense high frequency electrical current, in particular when there is a spark discharge to the tissue or to another metallic object. Intense high frequency electrical currents can occur at the beginning of an electrosurgical cut or when using high power levels. ‒ Use the lowest appropriate power level and effect level. Be aware that the RFCoag mode presents an unacceptable risk with power levels that are too low. ‒ For appropriate power levels, refer to the chapter “7.3 Power settings” on page 41. CAUTION Procedural hazards and complications If a malfunction of the electrosurgical generator occurs during the procedure, there is the risk that the procedure is interrupted, delayed or cannot be completed. ‒ Before starting the procedure, check that all equipment is connected properly. ‒ Observe the instructions in the chapter “7.2 Inspection” on page 39. ‒ Prepare a spare electrosurgical generator or an alternative procedure to avoid interruption due to an unexpected electrosurgical generator failure during the procedure. 2.3.7 User-related error prevention CAUTION Regular safety checks To maintain device performance and electrical safety, regular safety checks must be performed on the electrosurgical generator and the foot switch. Otherwise, malfunction of the devices can occur which can result in injury to the patient. ‒ Make sure that the regular safety check is performed annually. ‒ Observe the information in the section “11.1 Maintenance” on page 72. Observe national statutory regulations. 2.3.8 Risks regarding environmental conditions CAUTION The electrosurgical generator can disturb other equipment The electrosurgical generator complies with the standards as described in the chapter “16 Electromagnetic compatibility” on page 80. However, during activation of the elctrosurigal generator, high frequency signals or spark discharge noise can disturb neighboring electrical equipment. Malfunction of the devices can occur, e.g. the monitor of endoscopic imaging equipment can freeze or black out, which can result in injury to the patient. ‒ Follow the instructions regarding electromagnetic ambient conditions given in the chapter “16 Electromagnetic compatibility” on page 80. ‒ Make sure that electrosurgical generator is not used adjacent to or stacked with equipment that is not part of this electrosurgical generator or system. ‒ Before use, thoroughly confirm the compatibility of all equipment. ‒ Do not use the electrosurgical generator in conjunction with: ‒ Electrical equipment for which the safety against leakage current is not confirmed. ‒ Electrosurgical equipment for which the safety in combined use is not confirmed. ‒ Do not loop cables. ‒ Do not bundle cables together with cables belonging to other medical equipment.

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Product description

3 Product description This chapter provides a general overview of the product and its functions. This includes the following information: ‒ Scope of delivery ‒ Product functions ‒ Features ‒ Explanations of operating elements ‒ Explanation of symbols ‒ Warranty information

3.1 Scope of delivery Before use, check that all items are available. Contact an Olympus representative or an authorized service center if any items are missing or damaged. Content: ‒ Electrosurgical generator ESG‑300 ‒ Instructions for use ‒ Contact information for customers

3.2 Product functions The electrosurgical generator ESG‑300 is designed to be used for the following electrosurgical applications: ‒ Bipolar electrosurgical cutting and coagulation. ‒ Monopolar electrosurgical cutting and coagulation, which requires a neutral electrode. ‒ In combination with the compatible argon plasma coagulation unit APU‑300, monopolar argon plasma coagulation, which also requires a neutral electrode. The ESG‑300 is equipped with several cutting and coagulation modes which are mainly designed for procedures in the gastrointestinal tract and in the respiratory tract. All settings of the device are done via the touchscreen on the front panel. The ESG‑300 is activated either via a compatible double pedal foot switch or via a hand switch at the connected HF instrument. The ESG‑300 is connected to the local power supply. The ESG‑300 can be mounted on the compatible TC‑E300 Energy Cart. Details on the hardware and software, on the correct handling and use of the device are described in the following chapters.

3.3 Features The electrosurgical generator is equipped with the following features: ‒ Contact Quality Monitor (CQM) ‒ High Power Cut Support (HPCS) ‒ Fast Spark Monitor (FSM) ‒ Resistance Controlled Automatic Power (RCAP) ‒ Automatic end of procedure detection (Autostop)

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Product description

3.3.1 CQM – Contact Quality Monitoring for the neutral electrode When using split type neutral electrodes for monopolar electrosurgery, the ESG‑300 is able to detect unintended detachment of the neutral electrode from the patient. The indicator for the contact quality monitor (CQM) shines green while the contact between the split type neutral electrode and the skin of the patient is within an acceptable resistance range. If the contact between the split type neutral electrode and the patient’s skin is insufficient, then an alarm tone sounds, a warning message is displayed and the CQM indicator shines red. Using non-split type neutral electrodes is not as safe as using split type ones, because CQM is not able to detect any detachment of non-split type neutral electrodes from the patient. For detailed information on the safe and correct use of neutral electrodes refer to the chapter “6 Using the ESG‑300 with a neutral electrode” on page 35. 3.3.2 HPCS – High Power Cut Support This feature optimizes the start of the cutting procedure by applying high power to the tissue to support immediate spark ignition and to reduce the risk of mechanical cutting. 3.3.3 FSM – Fast Spark Monitor This feature ensures smooth and reproducible cutting although the tissue characteristics are varying, e.g. in muscle and fat. 3.3.4 RCAP – Resistance Controlled Automatic Power RCAP is a feature that supports the bipolar mode RFCoag. Deep tissue coagulation without significant desiccation is achieved with RCAP. Depending on the momentary tissue status, RCAP determines the maximum power uptake of the tissue and automatically adjusts the electrosurgical generator. For this process the geometry of the used bipolar applicator and also the individual tissue characteristics, e.g. blood perfusion, are considered. Therefore, premature tissue desiccation is effectively avoided and it is not necessary o to manually adapt the power settings. 3.3.5 Autostop – Automatic end of procedure detection for AutoCoag Autostop is a feature that supports the bipolar mode AutoCoag. When coagulating tissue the electrical resistance of the tissue increases. Tissue resistance is continuously measured by the electrosurgical generator so that it is able to detect when coagulation is completed. As soon as a limited value of tissue resistance is exceeded, the electrosurgical generator automatically stops the HF output. Autostop is indicated by 3 short beeps.

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Product description

3.4 Operating elements on the hardware 3.4.1 The front panel

ESG-300

BIPOLAR

MONOPOLAR

NEUTRAL

F

1) *BIPOLAR output socket To connect a bipolar HF instrument. 2) *MONOPOLAR output socket To connect a monopolar HF instrument. 3) Touchscreen To display the status of connected accessories. To show and modify settings. 4) *Neutral electrode socket To connect a neutral electrode. 5) UDI (unique device identifier) 6) Power switch To switch the electrosurgical generator on and off. *Applied part according to standard IEC 60601-1.

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Product description

3.4.2 The rear panel

Type: REF: Line: Output:

SN:

LINK-IN

LINK-OUT

1) Volume control To adjust the volume of the activation tone. 2) Ventilation slots 3) Identification plate 4) Potential equalization connector To increase electrical safety by potential equalization. 5) Power socket For connection to the mains electricity. 6) Fuse holder Compartment for the replaceable fuses. 7) LINK-OUT socket To connect peripheral equipment via a communication cable with a 14-pin plug. 8) LINK-IN socket To connect the ESG‑300 with the compatible argon plasma coagulation unit APU‑300 via the communication cable MAJ-1871. 9) Foot switch socket To connect a compatible double pedal foot switch. 10) Threaded holes for mounting brackets To fix the housing of the ESG­‑300 to the housing of the compatible argon plasma coagulation unit APU‑300.

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Product description

3.4.3 The docking connector at the bottom

1) Docking connector To connect the compatible argon plasma coagulation unit APU‑300.

3.5 Operating elements of the touchscreen The electrosurgical generator is equipped with a user friendly touchscreen. The control buttons are activated by tapping the corresponding part on the screen with the finger tip. 3.5.1 The 3 home screens A home screen displays the current settings of the selected output socket, i.e. MONOPOLAR or BIPOLAR or ARGON.

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Product description

The home screen [Monopolar] and [Bipolar]

Buttons on the home screen 1) Mode name To selected a mode. 2) Plus and minus button To increase and decrease the level of power or argon gas flow. 3) Effect button To increase and decrease the effect. 4) Open To open user-defined settings and procedures. 5) Menu To open the screens [Edit Settings/Procedures], [Edit Preferences] and [Service Options]. 6) Output socket buttons [Argon], [Monopolar], [Bipolar] To display the current settings of the output socket.

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Product description

The home screen [Argon]

Indicators and displays on the home screen 1) CQM indicator for neutral electrodes Indicates the connection status of a neutral electrode. 2) Foot switch indicator Indicates which foot switch pedals are assigned to the currently selected output socket. 3) Procedure name Displays the selected user-defined procedure. If no procedure is selected, then this line is blank. 4) Communication indicator Indicates the connection status of the argon plasma coagulation unit APU‑300. 5) Setting name Displays the selected user-defined settings. If no setting is selected, then this line is blank. 6) Power level Displays the selected power level. 7) Effect level Displays the selected effect level. 8) Argon supply indicator Indicates the pressure level of the argon supply. 9) Name of the connected argon probe Automatically displays the name when a compatible argon probe is connected. 10) Flow rate for argon gas Displays the selected argon gas flow. 11) Output socket name Displays the name of the currently selected output socket. 3.5.2 The 4 buttons at the bottom At the bottom of the home screen, 4 buttons are displayed. The 2 buttons on the bottom left represent the output sockets. These 2 buttons are adapting automatically, depending on the currently selected output socket.

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Product description

‒ If the MONOPOLAR socket is selected, then the buttons [Bipolar] and [Argon] are displayed. ‒ If the ARGON socket is selected, then the buttons [Bipolar] and [Monopolar] are displayed. ‒ If the BIPOLAR socket is selected, then the buttons [Monopolar] and [Argon] are displayed. The 2 buttons on the bottom right, [Open] and [Menu], are always displayed on the home screen, independently from the select output socket. 3.5.3 [Select Cut Mode] and [Select Coag Mode] screens On the [Select Cut Mode] screen or the [Select Coag Mode] screen the required mode is selected. This screen is displayed when tapping the button with the mode name on the home screen.

1) Information button [i] To display a short description of the mode. 2) [Off] button To completely deactivate cutting or coagulation for the selected output socket. 3) [Return] button To return to the home screen. 4) Arrow buttons (Without function here.) 5) Mode buttons To select a mode for the corresponding output socket (MONOPOLAR, BIPOLAR or ARGON). 3.5.4 The 3 screens behind the [Menu] button When tapping the [Menu] button, it is possible to access the following 3 screens: ‒ [Edit Settings/Procedures] ‒ [Edit Preferences]

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Product description

‒ [Service Options] [Edit Settings/Procedures] screen

1) Pane for editing user-defined settings 2) Pane for editing user-defined procedures 3) [New] buttons To create a new user-defined setting or procedure. 4) [Modify] buttons To modify an existing user-defined setting or procedure. 5) [Delete] buttons To delete an existing user-defined setting or procedure. 6) [Return] button To return to the home screen. 7) Arrow buttons To browse through the 3 menu screens.

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