BBraun
AdTec needle holder
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Aesculap® 1
3
4
Aesculap Endoscopic Technology
en USA
de fr es it pt nl da sv fi lv lt ru cs pl sk hu sl hr ro bg tr el
Instructions for use/Technical description AdTec® needle holder Note for U.S. users This Instructions for Use is NOT intended for United States users. Please discard. The Instructions for Use for United States users can be obtained by visiting our website at www.aesculapusa.com. If you wish to obtain a paper copy of the Instructions for Use, you may request one by contacting your local Aesculap representative or Aesculap's customer service at 1-800-282-9000. A paper copy will be provided to you upon request at no additional cost. Gebrauchsanweisung/Technische Beschreibung AdTec® Nadelhalter Mode d’emploi/Description technique Porte-aiguille AdTec® Instrucciones de manejo/Descripción técnica Portagujas AdTec® Istruzioni per l’uso/Descrizione tecnica Portaghi AdTec® Instruções de utilização/Descrição técnica Porta-agulhas AdTec® Gebruiksaanwijzing/Technische beschrijving AdTec® naaldhouder Brugsanvisning/Teknisk beskrivelse AdTec® nåleholder Bruksanvisning/Teknisk beskrivning AdTec® nålförare Käyttöohje/Tekninen kuvaus AdTec® Neulapidike Lietošanas instrukcijas/tehniskais apraksts AdTec® adatas turētājs Naudojimo instrukcija/techninis aprašas AdTec® adatos laikiklis Инструкция по примению/Техническое описание Иглодержатель AdTec® Návod k použití/Technický popis AdTec® jehelec Instrukcja użytkowania/Opis techniczny Igłotrzymacz AdTec® Návod na použitie/Technický opis Držiak klinca AdTec® Használati útmutató/Műszaki leírás AdTec® Tűtartó Navodila za uporabo/Tehnični opis Držalo za iglo AdTec® Upute za uporabu/Tehnički opis AdTec® držač igle Manual de utilizare/Descriere tehnică AdTec® - pensă de ac Упътване за употреба/Техническо описание Иглодържач AdTec® Kullanım Kılavuzu/Teknik açiklama AdTec® İğne tutucu Οδηγίες χρήσης/Τεχνική περιγραφή Βελονοκάτοχο AdTec®
Aesculap AG | Am Aesculap-Platz | 78532 Tuttlingen | Germany Phone +49 (0) 7461 95-0 | Fax +49 (0) 7461 95-26 00 | www.aesculap.com Aesculap® – a B. Braun brand TA011172
2020-07
V6
Change No. 61604
2
2
2.3.2
en ®
Aesculap AdTec® needle holder Legend 1 2 3 4
Jaw piece Lubrication points Luer lock connector for cleaning channel Screw handle
1.
About this document
Note General risk factors associated with surgical procedures are not described in these instructions for use.
1.1
Scope
2.3.3
Sterility
The product is delivered in an unsterile condition. ► Clean the new product after removing its transport packaging and prior to its initial sterilization.
2.4
Application
WARNING Risk of injury and/or malfunction! ► Prior to each use, inspect the product for loose, bent, broken, cracked, worn, or fractured components. ► Always carry out a function test prior to each use of the product.
2.4.1
These instructions for use apply for the following products:
Product
Product-specific safety information ► To prevent damage at the working end: carefully insert the product through the working channel (e.g. trocar). ► Only use the product under vision. ► Improper loading (lateral forces, bending, torsion, etc.) should be avoided. ► Clamp and affix only needles in the jaw parts using needle holders.
Closing the jaw piece
► To close jaw piece 1 and grasp objects without engaging the lock on handle 4, slightly compress the handle.
2.4.2
Engaging the lock
Art. no.
Designation
PL404R
DUROGRIP NEEDLE HOLDER STRAIGHT.D:5/370MM
PL405R
DUROGRIP NEEDLE HOLDER LEFT CURVE.D:5/370MM
PL406R
INSERTION DEV. FOR PRESSURE PLATE FOR CIRC. STAPLER
PL407R
DUROGRIP NEEDLE HOLDER STRAIGHT.D:5/310MM
Note After releasing the lock, the handle must be opened half-way at least before the lock can be engaged again.
PL408R
DUROGRIP NEEDLE HOLDER LEFT CURVE.D:5/310MM
3.
Validated reprocessing procedure
PL409R
ASSISTANT DUROGRIP NEEDLE HOLDER STRAIGHT 2X3Z.D:5/310MM
3.1
General safety information
PL413R
DUROGRIP NEEDLE HOLDER RIGHT CURVE.D:5/310MM
PL414R
NEEDLE HOLDER WITH NEEDLE ALIGHTMENT.D:5/310MM
Note Adhere to national statutory regulations, national and international standards and directives, and local, clinical hygiene instructions for sterile processing.
PL415R
DUROGRIP NEEDLE HOLDER RIGHT CURVE.D:5/370MM
PL416R
DUROGRIP NEEDLE HOLDER STRAIGHT.D:5/420MM
PL417R
DUROGRIP NEEDLE HOLDER LEFT CURVE.D:5/420MM
PL418R
DUROGRIP NEEDLE HOLDER STRAIGHT.D:3.5/290MM
PL419R
DUROGRIP NEEDLE HOLDER STRAIGHT.D:3.5/200MM
► To lock handle 4 and jaw piece 1, fully compress the handle until the lock engages automatically with a click.
The instrument is locked now.
2.4.3
Releasing the lock
► Fully compress handle 4 until the lock is released automatically with a click.
► For article specific instructions for use and material compatibility and lifetime information, see B. Braun eIFU at
eifu.bbraun.com
1.2
Safety messages
Safety messages make clear the dangers to patient, user and/or product that could arise during the use of the product. Safety messages are labeled as follows: DANGER Shows a possible threat of danger. If not avoided, death or severe injuries may result. WARNING Indicates a possible threat of danger. If not avoided, minor or moderate injury may result. CAUTION Indicates a possible threat of material damage. If not avoided, the product may be damaged.
2.
Clinical use
2.1
Available sizes
The deliverable AdTec® needle holders are described in the C00411 brochure and at www.endoscopy-catalog.com.
2.2
Areas of use and limitations of use
2.2.1
Intended use
AdTec® needle holders are used for grasping and suturing in laparoscopic operations using trocars. The applier forceps PL406R is used for fixating the counter-pressure plate of a circular stapler.
2.2.2
Indications
Note The manufacturer is not responsible for any use of the product against the specified indications and/or the described applications. For indications, see Intended use.
2.2.3
Contraindications
No known contraindications. Applies to PL406R: Do not use with any indications other than named application areas.
2.3
Safety information
2.3.1
Clinical user
General safety information To prevent damage caused by improper setup or operation, and to not compromise the manufacturer warranty and liability: ► Use the product only according to these instructions for use. ► Follow the safety and maintenance instructions. ► Ensure that the product and its accessories are operated and used only by persons with the requisite training, knowledge and experience. ► Store any new or unused products in a dry, clean, and safe place. ► Prior to use, check that the product is in good working order. ► Keep the instructions for use accessible for the user. Note The user is obligated to report all severe events in connection with the product to the manufacturer and the responsible authorities of the state in which the user is located. Notes on surgical procedures It is the user's responsibility to ensure that the surgical procedure is performed correctly. Appropriate clinical training as well as a theoretical and practical proficiency of all the required operating techniques, including the use of this product, are prerequisites for the successful use of this product. The user is required to obtain information from the manufacturer if there is an unclear preoperative situation regarding the use of the product.
Note For patients with Creutzfeldt-Jakob disease (CJD), suspected CJD or possible variants of CJD, observe the relevant national regulations concerning the reprocessing of products. Note Mechanical reprocessing should be favored over manual cleaning as it gives better and more reliable results. Note Successful processing of this medical device can only be ensured if the processing method is first validated. The operator/sterile processing technician is responsible for this. Note If there is no final sterilization, then a virucidal disinfectant must be used. Note For up-to-date information about reprocessing and material compatibility, see B. Braun eIFU at eifu.bbraun.com The validated steam sterilization procedure was carried out in the Aesculap sterile container system.
3.2
General information
Dried or affixed surgical residues can make cleaning more difficult or ineffective and lead to corrosion. Therefore the time interval between application and processing should not exceed 6 h; also, neither fixating pre-cleaning temperatures >45 °C nor fixating disinfecting agents (active ingredient: aldehydes/alcohols) should be used. Excessive measures of neutralizing agents or basic cleaners may result in a chemical attack and/or to fading and the laser marking becoming unreadable visually or by machine for stainless steel. Residues containing chlorine or chlorides e.g. in surgical residues, medicines, saline solutions and in the service water used for cleaning, disinfection and sterilization will cause corrosion damage (pitting, stress corrosion) and result in the destruction of stainless steel products. These must be removed by rinsing thoroughly with demineralized water and then drying. Additional drying, if necessary. Only process chemicals that have been tested and approved (e.g. VAH or FDA approval or CE mark) and which are compatible with the product’s materials according to the chemical manufacturers’ recommendations may be used for processing the product. All the chemical manufacturer's application specifications must be strictly observed. Failure to do so can result in the following problems: ■ Optical changes of materials, e.g. fading or discoloration of titanium or aluminum. For aluminum, the application/process solution only needs to be of pH >8 to cause visible surface changes. ■ Material damage such as corrosion, cracks, fracturing, premature aging or swelling. ► Do not use metal cleaning brushes or other abrasives that would damage the product surfaces and could cause corrosion. ► Further detailed advice on hygienically safe and material-/value-preserving reprocessing can be found at www.a-k-i.org, link to "AKI-Brochures", "Red brochure".
3.3
Reusable products
Influences of the reprocessing which lead to damage to the product are not known. A careful visual and functional inspection before the next use is the best option to determine if a product is no longer functional, see Inspection.
3.4
Preparations at the place of use
► If applicable, rinse non-visible surfaces preferably with deionized water, with a disposable syringe for example. ► Remove any visible surgical residues to the extent possible with a damp, lint-free cloth. ► Transport the dry product in a sealed waste container for cleaning and disinfection within 6 hours.
3.5
Preparing for cleaning
► Open up instruments with hinges. ► Remove the sealing cap from the Luer lock connector.
3.6
Cleaning/Disinfection
3.6.1
Product-specific safety information on the reprocessing method
Damage to or destruction of the product due to inappropriate cleaning/disinfecting agents and/or excessive temperatures! ► Use cleaning agents and disinfectants according to the manufacturer's instructions. ► Observe specifications regarding concentration, temperature and exposure time. ► Do not exceed the maximum allowable disinfection temperature of 95 °C.
3.6.2
3.8.1
Manual pre-cleaning with a brush
Validated procedure
Validated cleaning and disinfection procedure Specific requirements
Reference
Phase
Step
t [min]
Conc. [%]
Water quality
Chemical
Manual cleaning with ultrasound and immersion disinfection
■ Suitable cleaning brush ■ Single use syringe 20 ml ■ Keep working ends open for
T [°C/°F]
Chapter Manual cleaning/disinfection and subsection:
I
Disinfectant cleaning
RT (cold)
>15
2
D–W
Aldehyde-free, phenol-free, and QUAT-free concentrate, pH ~ 9*
II
Rinsing
RT (cold)
1
-
D–W
-
■ Chapter Manual cleaning with ultrasound and immersion disinfection
cleaning.
■ When cleaning instruments with movable hinges, ensure that these are in an open position and, if applicable, move the hinge while cleaning.
D–W: Drinking water RT: Room temperature *Recommended: BBraun Stabimed fresh
■ Drying phase: Use a lint-free cloth or medical compressed air Manual pre-cleaning with brush and subsequent mechanical alkaline cleaning and thermal disinfection
■ Single use syringe 20 ml ■ Place the product on a tray that is suitable for cleaning (avoid rinsing blind spots).
■ Connect components with lumens and channels directly to the rinsing port of the injector carriage.
► Note the information on appropriate cleaning brushes and disposable syringes, see Validated cleaning and dis-
Chapter Mechanical cleaning/disinfection with manual pre-cleaning and subsection:
■ Chapter Manual pre-cleaning with a brush
■ Chapter Mechanical alkaline cleaning and thermal disinfecting
■ Place the product on the tray with all product links and joints open.
3.7
Phase II ► Rinse/flush the product thoroughly (all accessible surfaces) under running water. ► Mobilize non-rigid components, such as set screws, joints, etc. during rinsing.
Manual cleaning/disinfection
► Prior to manual disinfecting, allow water to drip off for a sufficient length of time to prevent dilution of the dis-
infecting solution. ► After manual cleaning/disinfection, check visible surfaces visually for residues. ► Repeat the cleaning/disinfection process if necessary.
Manual cleaning with ultrasound and immersion disinfection
Phase
Step
Ultrasonic cleaning
3.8.2
T [°C/°F]
t [min]
Conc. [%]
Water quality
Chemical
RT (cold)
>15
2
D–W
Aldehyde-free, phenol-free, and QUAT-free concentrate, pH ~ 9*
RT (cold)
1
Mechanical alkaline cleaning and thermal disinfecting
Machine type: single-chamber cleaning/disinfection device without ultrasound Phase
3.7.1
I
infection procedure. Phase I ► Fully immerse the product in the cleaning/disinfectant for at least 15 min. Ensure that all accessible surfaces are moistened. ► Clean the product with a suitable cleaning brush in the solution until all discernible residues have been removed from the surface. ► If applicable, brush through non-visible surfaces with an appropriate cleaning brush for at least 1 min. ► Mobilize non-rigid components, such as set screws, links, etc. during cleaning. ► Thoroughly rinse through these components with the cleaning disinfectant solution (at least five times), using a disposable syringe.
Step
T [°C/°F]
t [min]
Water quality
Chemical
I
Prerinse
<25/77
3
D–W
-
II
Cleaning
55/131
10
FD-W
■ Concentrate, alkaline: – pH ~ 13 – <5 % anionic surfactant
■ working solution 0.5% – pH = 11*
II
Intermediate rinse
III
IV
V
Disinfection
Final rinse
Drying
RT (cold)
5
RT (cold)
1
RT
-
-
2
-
D–W
D–W
FD-W
-
Aldehyde-free, phenol-free, and QUAT-free concentrate, pH ~ 9*
Intermediate rinse
>10/50
1
FD-W
-
IV
Thermal disinfecting
90/194
5
FD-W
-
V
Drying
-
-
-
In accordance with the program for the cleaning and disinfecting machine
D–W: FD–W:
-
-
-
D–W: FD–W:
Drinking water Fully desalinated water (demineralized, low microbiological contamination: drinking water quality at least) RT: Room temperature *Recommended: BBraun Stabimed fresh ► Note the information on appropriate cleaning brushes and disposable syringes, see Validated cleaning and dis-
infection procedure. Phase I ► Clean the product in an ultrasonic cleaning bath (frequency 35 kHz) for at least 15 min. Ensure that all accessible surfaces are immersed and acoustic shadows are avoided. ► Clean the product with a suitable cleaning brush in the solution until all discernible residues have been removed from the surface. ► If applicable, brush through non-visible surfaces with an appropriate cleaning brush for at least 1 min. ► Mobilize non-rigid components, such as set screws, links, etc. during cleaning. ► Thoroughly rinse through these components with the cleaning disinfectant solution (at least five times), using a disposable syringe. Phase II ► Rinse/flush the product thoroughly (all accessible surfaces) under running water. ► Mobilize non-rigid components, such as set screws, joints, etc. during rinsing. ► Drain any remaining water fully. Phase III ► Fully immerse the product in the disinfectant solution. ► Mobilize non-rigid components, such as set screws, joints, etc. during rinsing. ► Rinse lumens at least five times at the beginning of the exposure time with an appropriate disposable syringe. Ensure that all accessible surfaces are moistened. Phase IV ► Rinse/flush the product thoroughly (all accessible surfaces) under running water. ► Mobilize non-rigid components, such as set screws, joints, etc. during final rinse. ► Rinse lumens with an appropriate disposable syringe at least five times. ► Drain any remaining water fully. Phase V ► Dry the product in the drying phase with suitable equipment (e.g. cloth, compressed air), see Validated cleaning and disinfection procedure.
3.8
III
Mechanical cleaning/disinfection with manual pre-cleaning
Note The cleaning and disinfection device must be of tested and approved effectiveness (e.g. FDA approval or CE mark according to DIN EN ISO 15883). Note The cleaning and disinfection device used for processing must be serviced and checked at regular intervals.
Drinking water Fully desalinated water (demineralized, low microbiological contamination: drinking water quality at least) *Recommended: BBraun Helimatic Cleaner alkaline ► Check visible surfaces for residues after mechanical cleaning/disinfecting.
3.9
Inspection
► Allow the product to cool down to room temperature. ► Dry the product if it is wet or damp.
3.9.1
Visual inspection
► Ensure that all contamination has been removed. In particular, pay attention to mating surfaces, hinges, shafts,
recessed areas and drill grooves. ► If the product is dirty: repeat the cleaning and disinfection process. ► Check the product for damage, e.g. corroded, loose, bent, broken, cracked, worn or severely scratched and frac-
tured components. ► Check the product for missing or faded labels. ► Check the products with long, slim shapes (in particular rotating instruments) for deformities. ► Check the surfaces for rough spots. ► Check the product for burrs that could damage tissue or surgical gloves. ► Check the product for loose or missing parts. ► Immediately put aside damaged or inoperative products and send them to Aesculap Technical Service, see Tech-
nical service.
3.9.2
Functional test
CAUTION Damage (metal cold welding /friction corrosion) to the product caused by insufficient lubrication! ► Prior to function checks, lubricate moving parts (e.g. joints, pusher components and threaded rods) at the marked points with maintenance oil suitable for the respective sterilization process (e.g. for steam sterilization: STERILIT® I oil spray JG600 or STERILIT® I drip lubricator JG598). ► Prior to function checks, lubricate both locking parts at the labeled points with maintenance oil suitable for the respective sterilization process (e.g. for steam sterilization:JG600 STERILIT® I oil spray or JG598 STERILIT® I drip). ► Check that the product functions correctly. ► Check that all moving parts are working property (e.g. hinges, locks/latches, sliding parts etc.). ► Check for compatibility with associated products. ► Immediately put aside inoperative products and send them to Aesculap Technical Service, see Technical service.
3.10 Packaging ► Place the product in its holder or on a suitable tray. Ensure that sharp edges are covered. ► Package trays appropriately for the sterilization process (e.g. in Aesculap sterile containers). ► Ensure that the packaging provides sufficient protection against contamination of the product during storage.
3.11 Steam sterilization ► Check to ensure that the sterilizing agent will come into contact with all external and internal surfaces (e.g., by
opening any valves and faucets). ► Validated sterilization process
– Steam sterilization using fractional vacuum process – Steam sterilizer according to DIN EN 285 and validated according to DIN EN ISO 17665 – Sterilization using fractionated vacuum process at 134 °C/holding time 5 min ► If several devices are sterilized at the same time in the same steam sterilizer: Ensure that the maximum permitted load according to the manufacturers’ specifications is not exceeded.
3.12 Storage ► Store sterile products in germ-proof packaging, protected from dust, in a dry, dark, temperature-controlled area.
4.
Maintenance and Service
4.1
Technical service
CAUTION Modifications carried out on medical technical equipment may result in loss of guarantee/warranty rights and forfeiture of applicable licenses. ► Do not modify the product. ► For service and repairs, please contact your national B. Braun/Aesculap agency. Service addresses Aesculap Technischer Service Am Aesculap-Platz 78532 Tuttlingen / Germany Phone: +49 7461 95-1601 Fax: +49 7461 16-2887 E-Mail: [email protected] Other service addresses can be obtained from the address indicated above.
4.2
Accessories/Replacement Parts
Art. no.
Designation
EJ751251
Sealing cap for Luer Lock connector (pack of 20)
5.
Disposal
WARNING Risk of infection due to contaminated products! ► Adhere to national regulations when disposing of or recycling the product, its components and its packaging. TA011172
2020-07
V6
Change No. 61604