BBraun
Atraumatic & retraction grasping forceps
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Aesculap® 1
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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 Atraumatic & retraction grasping forceps 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 Atraumatische und Retraktionsfasszangen Mode d’emploi/Description technique Grip-pinces atraumatiques et de rétraction Instrucciones de manejo/Descripción técnica Pinzas atraumáticas y de retracción Istruzioni per l’uso/Descrizione tecnica Pinza da presa atraumatica per retrazione Instruções de utilização/Descrição técnica Pinça atraumática & de retração Gebruiksaanwijzing/Technische beschrijving Atraumatische & retractie paktang Brugsanvisning/Teknisk beskrivelse Atraumatiske gribetænger & gribetænger med retraktion Bruksanvisning/Teknisk beskrivning Atraumatisk och sammandragande grippincett Käyttöohje/Tekninen kuvaus Atraumaattiset ja retraktiotartuntapihdit Lietošanas instrukcijas/tehniskais apraksts Netraumējošas un retrakcijas tveršanas knaibles Naudojimo instrukcija/techninis aprašas Netraumuojantis retrakcinis griebtuvas Инструкция по примению/Техническое описание Захватывающий атравматический зажим для ретракции Návod k použití/Technický popis Atraumatické a extrakční kleště Instrukcja użytkowania/Opis techniczny Nieurazowe i wysuwane kleszcze chwytające Návod na použitie/Technický opis Atraumatické a retrakčné uchopovacie kliešte Használati útmutató/Műszaki leírás Atraumatikus és visszahúzó fogócsipesz Navodila za uporabo/Tehnični opis Atravmatske in retrakcijske prijemalne klešče Upute za uporabu/Tehnički opis Hvataljke s atraumatskim i retrakcijskim čeljustima Manual de utilizare/Descriere tehnică Pensă apucătoare extractoare şi atraumatică Упътване за употреба/Техническо описание Форцепс за aтравматично и издърпващо хващане Kullanım Kılavuzu/Teknik açiklama Atravmatik ve retraksiyon kavrama forsepsi Οδηγίες χρήσης/Τεχνική περιγραφή Ατραυματικές λαβίδες σύλληψης και λαβίδες σύλληψης και ανάσυρσης
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 TA010213
2020-07
V6
Change No. 62452
4
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Aesculap Atraumatic & retraction grasping forceps Legend 1 2 3 4
General safety instructions
Note Adhere to national statutory regulations, national and international standards and directives, and local, clinical hygiene instructions for sterile processing.
Note Mechanical reprocessing should be favored over manual cleaning as it gives better and more reliable results.
About this document
Note General risk factors associated with surgical procedures are not described in these instructions for use.
1.1
Validated reprocessing procedure
3.1
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.
Lubrication points Luer lock connector Sliding lock Star wheel
1.
3.
Scope
These instructions for use apply for the following products:
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.
Art. no.
Designation
PL230R
AdTec® Sovereign atraumatic grasping forceps Ø 5mm length 360 mm
3.2
PL231R
AdTec® Sovereign atraumatic grasping forceps Ø 5mm length 420 mm
PL232R
AdTec® Sovereign atraumatic grasping forceps, rotatable, Ø 5mm length 360 mm
PL233R
AdTec® Sovereign atraumatic grasping forceps, rotatable, Ø 5mm length 420 mm
PL234R
AdTec® Retraction grasping forceps Ø 5mm length 360 mm
PL235R
AdTec® Retraction grasping forceps, rotatable, Ø 5mm length 360 mm
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.ak-i.org, link to "AKI-Brochures", "Red brochure".
► For article-specific instructions for use as well as information on material compatibility and lifetime 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: 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.
3.3
2.
Clinical use
2.1
Areas of use and limitations of use
2.1.1
Intended use
General information
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 opportunity to recognize a product that is no longer functional, see Inspection.
The Atraumatic & retraction grasping forceps are used for grasping tissues in minimally invasive surgery.
3.4
2.1.2
► 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.
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.
2.1.3
Contraindications
3.5
Preparations at the place of use
Preparing for cleaning
► Open up product with hinges. ► Remove the sealing cap from the Luer lock connector.
No known contraindications.
3.6
Cleaning/Disinfection
2.2
Safety information
3.6.1
Product-specific safety information on the reprocessing method
2.2.1
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.
2.2.2
Sterility
Damage to or destruction of the product due to inappropriate cleaning/disinfecting agents and/or excessive temperatures! ► Following the manufacturer's instructions, use cleaning and disinfecting agents – that are approved for use e.g. on aluminum, plastic materials, and high-grade steel, – that do not attack softeners (e.g., in silicone). ► Observe specifications regarding concentration, temperature and exposure time. ► Do not exceed the maximum allowable disinfection temperature of 95 °C. For products with plasma layers (e.g. Noir instruments), the layer is attacked or removed when special cleaning procedures with the addition of oxidizing chemicals (e.g. hydrogen peroxide H2O2) are used. ► Do not use oxidizing chemicals for cleaning. ► Use suitable cleaning/disinfecting agents if the product is disposed of in a wet condition. To prevent foaming and
degradation of the efficacy of the process chemicals: prior to mechanical cleaning and disinfection, rinse the product thoroughly with running water
3.6.2
Validated cleaning and disinfection procedure
Validated procedure
Specific requirements
Reference
Manual cleaning with ultrasound and immersion disinfection
■ Suitable cleaning brush ■ Disposable syringe 20 ml ■ To flush the product: Use a
Chapter Manual cleaning/disinfection and subsection:
flushing nozzle or flushing sleeve.
The product is delivered in an unsterile condition. ► Clean the new product after removing its transport packaging and prior to its initial sterilization.
■ Keep working ends open for
2.3
■ When cleaning instruments
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.
cleaning. with movable hinges, ensure that these are in an open position and, if applicable, move the hinge while cleaning.
■ Drying phase: Use a lint-free cloth or medical compressed air
WARNING Risk of injury when using the product beyond the field of view! ► Apply the product only under visual control.
2.3.1
Engaging the sliding lock
► Close the handle. ► Slide the sliding lock 3 in the direction indicated by the arrow until you feel noticeable resistance.
2.3.2
Releasing the sliding lock
► Compress the handle. ► Slide the sliding lock 3 in the opposite direction of the arrow.
■ Chapter Manual cleaning with ultrasound and immersion disinfection
Validated procedure
Specific requirements
Reference
Manual pre-cleaning with brush and subsequent mechanical alkaline cleaning and thermal disinfection
■ Suitable cleaning brush ■ Disposable syringe 20 ml ■ Connect components with
Chapter Mechanical cleaning/disinfection with manual pre-cleaning and subsection:
■ Chapter Manual pre-cleaning
lumens and channels directly to the rinsing port of the injector carriage.
with a brush
■ Chapter Mechanical alkaline cleaning and thermal disinfecting
■ To flush the product (Luer-lock and working channel): Use a flushing nozzle or flushing sleeve
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. 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.
■ Keep working ends open for cleaning.
■ Place the product on a tray that
3.8.2
Mechanical alkaline cleaning and thermal disinfecting
Machine type: single-chamber cleaning/disinfection device without ultrasound
is suitable for cleaning (avoid rinsing blind spots).
Phase
■ Place the product on the tray with all product links and joints open.
3.7
► Note the information on appropriate cleaning brushes and disposable syringes, see Validated cleaning and dis-
Manual cleaning/disinfection
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:
► Prior to manual disinfecting, allow water to drip off for a sufficient length of time to prevent dilution of the dis-
– pH = 13 – <5 % anionic surfactant
infecting solution. ► After manual cleaning/disinfection, check visible surfaces visually for residues. ► Repeat the cleaning/disinfection process if necessary.
■ working solution 0.5% – pH = 11*
3.7.1
Manual cleaning with ultrasound and immersion disinfection
Phase
Step
T [°C/°F]
t [min]
Conc. [%]
Water quality
Chemical
III
Intermediate rinse
>10/50
1
FD-W
-
IV
Thermal disinfecting
90/194
5
FD–W
-
V
Drying
-
-
-
According to the program for cleaning and disinfection device
I
Ultrasonic cleaning
RT (cold)
>15
2
D–W
Aldehyde-free, phenol-free, and QUAT-free concentrate, pH ~ 9*
II
Intermediate rinse
RT (cold)
1
-
D–W
-
D–W: FD–W:
III
Disinfection
RT (cold)
5
2
D–W
Aldehyde-free, phenol-free, and QUAT-free concentrate, pH ~ 9*
► Check visible surfaces for residues after mechanical cleaning/disinfecting.
IV
Final rinse
RT (cold)
1
-
FD-W
-
RT
-
V
Drying
Drinking water Fully desalinated water (demineralized, low microbiological contamination: drinking water quality at least) *Recommended: BBraun Helimatic Cleaner alcaline
3.9
Inspection
► Allow the product to cool down to room temperature. ► Dry the product if it is wet or damp.
-
-
-
3.9.1 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.
Visual inspection
► Ensure that all soiling has been removed. In particular, pay attention to mating surfaces, hinges, shafts, recessed
areas, drill grooves and the sides of the teeth on rasps. ► If the product is dirty: repeat the cleaning and disinfection process. ► Check the product for damage, e.g. insulation or corroded, loose, bent, broken, cracked, worn or severely
scratched and fractured components. ► Check the product for missing or faded labels. ► Check the products with long, slim shapes (in particular rotating instruments) for deformities. ► Check the product for damage to the spiral element. ► Check the cutting edges for continuity, sharpness, nicks and other damage. ► 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) 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). ► 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
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.
► Store products with ratchet locks fully opened or locked no further than in the first notch. ► Close the locks so that the jaw tips just touch each other. ► 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.
Phase V ► Dry the product in the drying phase with suitable equipment (e.g. cloth, compressed air), see Validated cleaning and disinfection procedure.
3.11 Steam sterilization
3.8
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.
3.8.1
Manual pre-cleaning with a brush
Phase
Step
T [°C/°F]
t [min]
Conc. [%]
Water quality
Chemical
Note To avoid breakage due to stress crack corrosion, sterilize the instruments with the lock fully open or locked no further than on the first ratchet tooth. ► 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.
I
Disinfecting cleaning
RT (cold)
>15
2
D–W
Aldehyde-free, phenol-free, and QUAT-free concentrate, pH ~ 9*
II
Rinsing
RT (cold)
1
-
D–W
-
D–W: Drinking water RT: Room temperature *Recommended: BBraun Stabimed fresh
4.
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.
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. WARNING Risk of injury due to sharp-edged and/or pointed products! ► When disposing of or recycling the product, ensure that the packaging prevents injury by the product. Note The user institution is obliged to reprocess the product before its disposal, see Validated reprocessing procedure. TA010213
2020-07
V6
Change No. 62452