diego___pk_diego_system_owners_manual_rev_ac.pdf
Page 1
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 2
diego ® &
PK diego ® System
OWNER’S MANUAL
Page 2
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 5
Diego® & PK diego®
System Owner’s Manual
Manufactured by/Customer Service USA:
Gyrus ACMI, Inc.
136 Turnpike Road
Southborough, MA 01772
USA
Tel:
901 373 0200
800-773-4301
Fax: 901 373 0220
800-757-2942
Authorized European Representative:
Gyrus Medical Ltd.
Fortran Road
St. Mellons
Cardiff
CF3 OLT
United Kingdom
Tel: +44 (0) 29 2077 6300
Fax: +44 (0) 29 2077 6301
CAUTION: Federal Law (USA) restricts this device to sale by or on the order of a Physician.
Page 3
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 6
DIEGO® SYSTEM
TABLE OF CONTENTS
Page
Warnings and Cautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
System Description. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Indicated Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
System Layout. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
System Description. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
System Set Up Instructions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Blade and Burr Set-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Suction/Irrigation Set-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Cleaning and Sterilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Sterilization Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Otologic Handpieces & Burrs Cleaning & Sterilization . . . . . . . . . . . . . . . . . . . . . . . . 21
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Repairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Warranty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
i
Page 4
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 7
PK DIEGO® SYSTEM
TABLE OF CONTENTS
Page
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
System Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
PK Diego® Blade Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
System Layout. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
System Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
Using PK Diego® . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
Troubleshooting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44
Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Error and Fault Codes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Yearly Checklist for Technical Personnel . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Warnings and Cautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
ii
Page 5
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 8
Warnings and Cautions
• Federal law restricts this device to sale by or on the order of a physician.
• When unplugging the unit, do not pull on the power cord itself. This may damage wiring inside the
cord. Pull the connector housing only.
• When disconnecting the handpiece, do not pull the cord itself. This may cause damage to the internal
wiring. Pull on the connector housing only.
• Do not clean by ultrasonic means! Use of ultrasonic cleaning equipment may damage the
handpiece and will void the product warranty.
• Always remove blade/burr before sterilization of the handpiece.
• To provide adequate cooling, where appropriate, for the blade/burr, to prevent accumulation of
unwanted materials in the surgical site, and to prevent abnormal wear of the cutting surfaces, be
certain to periodically irrigate the surgical site and the tip of the blade/burr and ensure that suction
(at least 127mm hg vacuum) is flowing whenever the instrument is running.
• Set pump flow so that irrigation is seen at the surgical site. (The flow of irrigating solution must exceed
the level of suction.)
• Avoid the use of chemical cleaning agents that might damage the silicone used in this instrument.
Use a non-residue type cleaner, preferably isopropyl alcohol, or a solution of 10% mild detergent
and 90% water.
• Do not autoclave the handpiece unless it is thoroughly clean.
• Follow cleaning instructions and use recommended brushes.
• Visually inspect to ensure that no tissue, fluid, or blood has contacted the inner surfaces.
• Mains disconnect device is unplugging cord. Position system so unplugging power cord is easily
accessible.
• The handpieces listed in this manual are for use with Gyrus ACMI, Inc. - ENT Division blade and burr
attachments only.
• Do not use sterile packaged items (blades, burrs, suction/irrigation tubing, trigger switch) if package
seal is torn or broken.
• Do not attempt to disassemble the handpiece. Failure to observe this caution will void the product
warranty.
• To mount the Diego controller to an IV pole, use the following height parameters. When the top of
the IV pole is set to 72 inches, the top of the controller should not exceed 40 inches. When the top
of the IV pole is set to 68-1/2 inches, the top of the controller should not exceed 58-1/2 inches.
• Diego passed IEC 601-1-2 testing; however, do not place the Diego controller in direct contact with
electrosurgery equipment or near any equipment that may emit electromagnetic fields or radio
frequency. If interference is encountered, move/locate devices farther apart from each other.
• To avoid risk of electrical shock, the equipment must be connected to a supply mains with protected
earth.
• Grounding reliability can only be achieved when this equipment is connected to an
equivalent receptacle marked “HOSPITAL ONLY” or “HOSPITAL GRADE”
• Neuromuscular stimulation of tissue may occur
• No modification of this equipment is allowed.
Diego® System Manual
1
Page 6
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 9
System Description
The Diego Powered Dissector & Drill System from Gyrus ACMI, Inc. - ENT Division is
comprised of a console, optional powered handpieces, footswitch, tubing set and
hospital grade power cord.
Console –Provides power and functionality to the specified Diego and Otologic
handpieces. In addition, a peristaltic irrigation pump is integrated into the controller
unit to facilitate local irrigation.
Footswitch – The footpedal’s loop style base allows for easy “no-look” identification, orientation and movement under the table. Lights are incorporated on the
pedal for easy orientation in a darkened operating room. Footswitch allows the
user to operate the Diego handpiece in the traditional way. Diego also provides
the option of handpiece actuation.
Handpiece – The handpiece accepts a range of one-time use cutting blades, and
tissue removal and drilling burrs. The handpiece's shape takes into account the
comfortable neutral hand position and is designed to reduce "cord drag" to
optimize balance and reduce fatigue.
The handpiece includes a proprietary fluid control design that retards contact of
bodily fluids from soiling the inner surfaces of Diego. The handpiece also allows
the user to aim the cutting window of the blade circumferentially with minimal
arm motion. Diego uses Diego blades and burrs from Gyrus ACMI, Inc. - ENT
Division.
Otologic handpiece styles are available in addition to Diego, including the Stapes
drill, and Viper Straight or Angled handpieces. All are lightweight and designed to
provide balanced power.
One-Time-Use Tubing Set – The disposable tubing set combines suction and
irrigation tubing into one component. The tubing set snaps into place, and works
in tandem with the fluid control design to speed set-up and cleaning. The tubing
set is discarded at the end of the procedure. The Viper high-speed drill uses a
separate tubing set that does not include suction.
Under normal conditions, blades and burrs may come in contact with the patient.
PK blades are type BF applied parts.
Diego® System Manual
2
Page 7
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 10
Indicated Use
The Diego Powered Dissector System
The Diego Powered Dissector System’s intended use is the cutting and removal of bone and
tissue in general ENT, Head & Neck, and Otoneurologic procedures. Sinus applications would
embody Ethmoidectomy, Sphenoethmoidectomy, Polypectomy, Septoplasty, and procedures
such as the removal of septal spurs, Antrostomy, Frontal Sinus Trephination and irrigation, Frontal
Sinus Drill-out, Endoscopic DCR and Trans-sphenoidal procedures. Nasopharyngeal/Laryngeal
procedures would comprise Adenoidectomy, Laryngeal lesion de-bulking, laryngeal
polypectomy, tracheal procedures and tonsillectomy. Head & Neck procedures would
encompass soft tissue shaving, Rhinoplasty (narrowing of the bony vault and revision of the
bony pyramid), removal of fatty (adipose) tissue (Lipodebridement) in the maxillary and
mandibular regions of the face, and acoustic neuroma removal. Otology procedures would
include Mastoidectomy and Mastoidotomy. Additionally, an irrigation pump is integrated into
the controller unit to provide irrigant to the surgical site in conjunction with the procedures.
Diego Handpiece
The Diego handpiece is intended for general nose, throat, and head & neck procedures. All
Powered Dissector handpieces are intended to be used with the Gyrus ACMI, Inc. - ENT
Division disposable sinus Powered Dissector blades and burrs. The equipment can be used in
endoscopic or traditional methods of surgery. This equipment is not intended for use in
Arthroscopy.
Stapes/Viper Handpiece
The Stapes and Viper Handpieces are for use in otologic and otoneurologic procedures only.
All Stapes and Viper handpieces are intended for use with Gyrus ACMI, Inc. - ENT Division burrs
only.
Transport and Storage Conditions
Parameter
Ambient Temperature Range
Relative Humidity Range (Non-condensing)
Atmospheric Pressure Range
From
0º C
30%
500 hPa
Power Ratings
100 - 120/220 - 240 V AC, 50/60 Hz, 2 A.
Diego® System Manual
3
To
50º C
90%
1060 hPa
Page 8
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 11
System Layout
Diego Powered Dissector Console
70339000
Front Panel
1
2
3
4
5
6
8
9
7
10
11
12
13
1. Power On/Standby Switch
2. Maximum Handpiece RPM Display
3. Handpiece Speed Adjustment
Control Switches
5. Actual Handpiece RPM Display
4. Active Handpiece Selection Switches
7. Footswitch Operating Mode
Switches (constant & variable)
9. Irrigating Pump Flow Rate Control
Switches / Display
11. Footswitch Input Connector
13. Irrigation Tubing
Diego® System Manual
6. Handpiece Operating Mode Switches
(forward, reverse, oscillate)
8. Irrigating Pump On/Off Switch
10. Irrigating Pump Prime Switch
12. Handpiece Input Connectors
4
Page 9
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 12
System Layout (cont.)
Diego Powered Dissector Console
70339000
Rear Panel
1
2
3
1. IV Attachment Clamp
2. Grounding Post
3. Power Input Connector
Diego® System Manual
5
Page 10
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 13
System Layout (cont.)
Diego Powered Dissector Handpiece
70338010
70339001
6
3
2
1
4
5
1. Blade/Burr Engagement Collet
2. Nose Cone (revolving action)
3. Housing
4. Strain relief boot
5. Power Cord
6. Dual Lumen Suction & Irrigation Tubing
Set, disposable (with snap-on connector)
Diego® System Manual
6
Page 11
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 14
System Layout (cont.)
Diego Powered Dissector Footswitch
70338011
1
2
3
1. Mode Change Button
2. Lighted Footpedal
3. Toe Loop
Diego® System Manual
7
Page 12
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 15
System Description
Maximum Handpiece RPM Display
This is a 5 segment, LED display to indicate the maximum attainable RPM of the active handpiece.
Actual Handpiece RPM Display
This is a 5 segment, LED display to indicate the actual RPM of the active handpiece.
Handpiece Speed Limit Adjustment Control Switches
The plus and minus button controls—located on the front of the console on either side of the
maximum speed display—allow the user to set the upper speed limit in either constant or variable
mode.
Handpiece Operating Mode Switches
The Diego Powered Dissector & Drill System operates the Diego Powered Dissector handpiece, Gyrus
ACMI, Inc. - ENT Division Viper straight and angled drills, and the Gyrus ACMI, Inc. - ENT Division Stapes
drill. Switches are provided on the front panel to control the mode of the active handpiece. If the
handpiece does not support a mode, the switch shall not allow selection of that mode. The following
modes are available:
Powered Dissector
Drill(s)
Oscillate, Forward & Reverse
Forward & Reverse
Active Handpiece Selection Switches
An LED display indicates which handpiece is active, as determined by the selector switches.
Footswitch Operating Mode Switches
Changes the footswitch function from constant to variable.
Irrigating Pump
The irrigation pump is a rotary type, peristaltic pump designed to drive irrigating solution to the surgical
site via the Powered Dissector blade/burr or Viper mastoid drill handpiece. The irrigating pump is located
on the side of the unit.
Irrigating Pump On/Off Switch
The irrigation pump can be turned on/off by the power switch located on the front of the console as
indicated by the LED light.
Diego® System Manual
8
Page 13
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 16
Irrigating Pump Prime Switch
To facilitate easy setup of the irrigation pump, a prime switch is provided that allows
continuous pump operation to fill all tubing and/or handpiece with irrigant.
Irrigating Pump Flow Rate Control Switches/Display
The flow rate of the pump is displayed on the front panel of the controller using a vertical
bar-graph type display. The flow rate of the pump can be adjusted by pressing the (+)
increase or (-) decrease switches located on the front panel. The pump is on the side
of the unit.
Diego® System Manual
9
Page 14
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 17
System Set-Up Instructions
System Components
Description
Console & Power Cord
Diego Handpiece
Cat. No.
70339000
70338010
70339001
Otology Drill Handpieces
Synergy Viper Straight
Synergy Viper Angled
Synergy Stapes
Footswitch
Accessories
Diego System Bifurcated Suction/Irrigation Tubing
Irrigation Bag Spike Assembly for Mastoid Drill
Handpiece Cleaning Kit
Powered Dissector
Mastoid and Stapes Drill
70338009
70325512
Power Cord for use in the U.K.
Power Cord for use in Continental Europe
Power Cord for use in Australia
70231054
70231055
70231056
70338030
70338031
70338032
70338011
70338003
70338007
A visual inspection should be completed prior to each use of the system. Examine the
handpiece power cord for damage, such as nicks and cuts. DO NOT USE THE
HANDPIECE IF THE POWER CORD IS DAMAGED.
Verify the blade or burr is in good condition. DO NOT USE A BLADE OR BURR IF IT IS
NOT IN PROPER WORKING ORDER. Test the chucking mechanism by engaging and
removing a blade/burr several times.
Verify that the system is operating properly by connecting the handpiece and footswitch
and then running the system in the appropriate modes.
Diego® System Manual
10
Page 15
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 18
Console
Step 1
a) Connect the power cord into the port on the back of the console and into the appropriate
power outlet.
b) Press the Power On/Standby switch. All displays will turn on, then go off. The Power light
will remain illuminated.
Step 2
Connect the desired handpiece. The handpiece default mode illuminates, and the button for
the selected handpiece (1 or 2) illuminates. NOTE: Maximum RPM shows the default
handpiece setting. Actual RPM shows 0.
Step 3
Connect the footpedal into the plug labeled as follows. The footpedal lights on both the
console and footswitch illuminate. NOTE: If the handpiece is not first connected, only
footswitch lights illuminate.
Step 4
a) The irrigating pump flow rate control display illuminates flow display defaults. NOTE:
When using the Stapes drill handpiece, the pump is not available.
b) You may now adjust the flow by pressing the + or - buttons. (See icons below.)
(To ensure irrigation of the surgical site, the flow of irrigating solution must exceed the
level of suction.)
c) Prime the pump by pressing the PRIME button. The flow display will show this.
Footswitch
The Diego single-pedal footswitch (Catalog No. 70338011) allows for operation in both
variable and constant modes, depending on the console setting. Footswitch lights will illuminate
when the footswitch is connected.
Handpiece(s)
Active Handpiece
Handpieces can be connected to the controller by aligning the indicator mark on the plug with
the corresponding indicator mark on the console input port and pushing until it clicks. Switches
provided on the front panel select the active handpiece. Pressing the switches changes the
active handpiece to the other connected handpiece.
Diego® System Manual
11
Page 16
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 19
Handpiece(s) (Cont.)
IT IS VERY IMPORTANT THAT THE INDICATOR MARKINGS ARE PROPERLY ALIGNED. If
the alignment is incorrect, you will not be able to connect the handpiece with the console and
the handpiece will not operate.
70339001
SPEED (Maximum RPM)
Forward & Reverse Mode
Oscillate Mode
Diego® System Manual
Stapes
Viper
70338032
70338030
70338031
15,000
12,000
5,000
Table 1–Supported Handpieces
12
44,000
-
Page 17
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 20
Blade and
Burr Set-up
(Powered Dissector)
The Diego Handpiece (Sold separately from console)
The Diego Powered Dissector handpiece (Catalog No. 70338010, 70339001) is a lightweight
and powerful handpiece specifically designed for use with the Diego console, and performs to
the parameters listed in Table 1. In order to operate the handpiece, chuck a single use
disposable blade/burr into the chucking mechanism (one of 8 available positions). Diego
includes a revolving blade chucking feature, allowing the user to orient the blade window
manually. Once securely chucked, the user can manually orient the blade window orientation
by rotating the nose cone left or right.
Powered Dissector Blades and Burrs
Diego Powered Dissector blades/burrs are provided sterile and are single-use disposable instruments. Their hubs are designed to fit only the Gyrus ACMI, Inc. - ENT Division Diego Powered
Dissector handpieces. There are various patterns, including straight, curved, smooth blades,
serrated blades, and burrs.
Powered Dissector Blade and Burr Engagement
A Powered Dissector blade or burr may be positioned in each of 24 different positions on
Diego. The window position may be changed intraoperatively by rotating the nose cone.
To engage the Powered Dissector blades/burrs:
1. Pull the sliding collet back.
2. Rotate the hub until the key aligns on the chucking mechanism.
3. Insert the plastic driver hub of the blade/burr into the handpiece until it stops completely.
4. Release the collet and firmly push the blade/burr into the handpiece until the collet springs
back into its original position.
5. Pull slightly on the shaft of the blade/burr to verify engagement.
6. If the blade/burr pulls out, repeat steps 1-5.
To disengage the Powered Dissector blade/burr:
1. Pull the sliding collet back.
2. Pull the blade/burr out of the handpiece.
NOTE: Since the Powered Dissector blade/burr is a two-piece configuration, it is possible that
the inner component may remain in the handpiece when the outer component is removed.
If this happens, simply pull the inner component out. The chucking mechanism will not engage
the inner component alone.
The blades, burrs and tubing sets are one-time use disposable items. These items should be
replaced after each surgery. Disposal of these items should comply with local hospital regulations for disposable items.
Diego® System Manual
13
Page 18
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 21
Burr
Set-up
(Otologic Drills)
Viper Handpieces: (Sold separately from console)
There are 2 Viper handpieces: Angled (70338030) and Straight (70338031). The handpiece
power cord attaches through a custom strain relief for anti-rotation and anti-pullout, and attaches
to the console with a quick release connecor. Hybrid ceramic bearings are used for decreased
friction and corrosion resistance. The burr chucking mechanism features a locking ring with no
external button to eliminate accidental release of the burr. Each handpiece has replaceable
irrigation tubing that is secured to the power cord with quick release connectors. This tubing has
a male luer connector.
Stapes Handpiece: (Sold separately from console)
There is one stapes handpiece: (70338032) The handpiece power cord attaches through a
custom strain relief for anti-rotation and anti-pullout, and attaches to the console with a quick
release connector. The burr chucking mechanism incorporates a sliding collet. Hybrid ceramic
bearings are used for decreased friction and corrosion resistance. The shaft is bent at a 15º angle
to maximize visualization of the operative site.
Viper / Drill Burr Engagement:
THE VIPER HANDPIECES WILL WORK ONLY WITH THE VIPER/MASTOID BURRS. THE
STAPES HANDPIECE WILL WORK ONLY WITH THE STAPES BURRS.
NOTE: ALL VIPER/MASTOID BURRS COME STERILE AND ARE INTENDED FOR ONE USE
ONLY. STAPES BURRS ARE NON-STERILE AND CAN BE RE-USED, AFTER STERILIZATION.
The Viper drill has a burr locking ring for engaging and disengaging burrs. When this locking
mechanism is open the burrs will not engage. The locking ring must be closed in order to
engage the burrs.
Viper / Mastoid burrs are engaged as follows:
1.
2.
3.
4.
Lock the locking ring by rotating it forward until it stops turning.
Insert the notched end of the burr into the nosecone of the handpiece.
Rotate the burr back and forth, and pull in and out slightly until you hear and feel a click.
Tug slightly on the burr. If it does not pull out, it has engaged. If it pulls out, repeate the above
procedure. Another indicator of burr engagement is a ring around the shank of the burr. If
this ring is visible after burr insertion, the burr is not properly engaged.
5. If the burr still does not engage, pull it out of the nosecone, rotate the bur one-quarter turn,
and repeat the initial procedure again.
Diego® System Manual
14
Page 19
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 22
The stapes handpiece has a sliding collet burr engagement mechanism. This grooved collet is
located just behind the angled shaft of the nosecone. Engage the Stapes Burrs as follows:
1.
2.
3.
4.
Pull back on the sliding collet.
Hold the collet in place and insert the burr into the nosecone.
Release the sliding collet.
Gently tug outward on the burr. If it does not pull out, the burr has engaged. If it does pull
out, repeat the burr engagement procedure.
DO NOT OPERATE THE HANDPIECE IF THE BURR IS NOT PROPERLY ENGAGED. If the
burr is not properly engaged, the drill will not cut and the drive components may be damaged.
THE DRILL HANDPIECES ARE DESIGNED FOR USE ONLY WITH GYRUS ACMI BURRS.
No other burrs will engage or function with these handpieces.
ALL GYRUS ACMI CUTTING BURRS ARE DESIGNED TO CUT IN THE FORWARD
DIRECTION. The diamond burr functions equally well in forward or reverse.
Viper / Mastoid burrs are changed as follows:
1. Loosen the locking ring one-half to one full turn. IT IS RECOMMENDED THAT THE
CONSOLE BE TURNED OFF PRIOR TO BURR REMOVAL.
2. Remove the burr. BURRS, PARTICULARLY CUTTING BURRS, MAY BECOME VERY
HOT DURING USE. Exercise caution when removing burrs.
3. Lock the ring by rotating it forward until it stops turning.
4. Repeat the burr engagement procedure.
Stapes burrs are changed as follows:
1.
2.
3.
4.
Pull back on the sliding collet.
Remove the burr and hold the collet open.
Insert the new burr
Release the collet.
Diego® System Manual
15
Page 20
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 23
Suction/Irrigation Set-up
Suction/Irrigation Tubing Assembly Installation (Powered Dissector)
1. Inspect sterile package to assure that sterility has been maintained.
2. Remove tubing from package using appropriate sterile technique.
3. Center the tubing into the pump assembly located on the side of the console as
shown on page 4, then turn the knob. When the knob handle is at the 3 o’clock/9
o’clock position, the pump is closed and ready for use. THE TUBING SHOULD
NOT BE STRETCHED, NOR SHOULD THERE BE ANY SLACK.
4. Connect the spike end to a standard I.V. bag. Connect the integrated suction tube
to the suction canister. Push the tubing connector into the connection port on the
rear (proximal) end of the Diego handpiece until a palpable “click” is felt. Suction
and irrigation is now ready to use. No additional attachment to the blade is
necessary (To ensure irrigation of the surgical site, the flow of irrigating solution
must exceed the level of suction.)
Suction/Irrigation Tubing Assembly Installation (Otologic Drills)
Repeat steps 1 - 3
4. Connect the spike end to a standard I.V. bag. The Viper drill is provided with an
attached irrigation tube with male Luer lock. Connect the two irrigation lines by
inserting the male Luer lock into the female Luer lock and secure by twisting. (To
ensure irrigation of the surgical site, the flow of irrigating solution must exceed the
level of suction.)
Diego® System Manual
16
Page 21
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 24
Cleaning and Sterilization
Important Guidelines for Cleaning
Thorough cleaning and rinsing is vital to reprocessing reusable medical devices. Effective cleaning
must be carried out to achieve proper decontamination. All cleaning should be performed in a
manner designed to minimize exposure to bloodborne pathogens. Reusable medical devices
should be kept moist immediately after use until cleaning. Devices capable of disassembly must be
disassembled prior to cleaning. Thorough cleaning and rinsing should be carried out as soon as
possible. Manual cleaning with appropriate brushes should be done while the instrument is
being rinsed (if applicable). The purpose of cleaning and rinsing is to remove all adherent visible soil
and to reduce particulate matter, microorganisms and pyrogens. Furthermore, thorough rinsing is
necessary to remove any residual cleaning agents from the medical devices that could protect microorganisms from destruction and reduce the lethality of the sterilization process. Medical devices that will
be stored between cleaning and decontamination should be dried with low linting, non-abrasive soft
cloth to prevent microbial contamination that could result from wet instruments.
Console and Footswitch
Wipe the outside of the console and footswitch using a soft wipe and isopropyl alcohol.
Cleaning Agents and Equipment
Detergents
Proteolytic enzymatic detergents with a pH range between 6.0 and 8.0
should be used. These detergents have nonionic surfactants. Detergents
should be used at the concentration level recommended by the manufacturer. Note: Undiluted detergents and ones with pHs greater than 8.0
can strip the coloration from metal instruments.
Water
The quality of water should be carefully considered for use in preparing
enzymatic detergents and for rinsing in the cleaning procedure. Water
hardness is a concern because deposits left on medical devices may result
in ineffective cleaning and decontamination. Deionized water can help
prevent discoloration and staining associated with mineral residues found
in tap water.
Sterile isopropyl
alcohol prep pads
Soft Cloths
Cleaning Brushes
Used for cleaning console and footswitch.
For drying handpiece.
Diego Powered Dissector Cleaning Kit (70338009) and the Synergy
Drill Cleaning Kit (70325512) are both available from Gyrus ACMI, Inc. ENT Division at 1-800-773-4301.
Diego® System Manual
17
Page 22
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 25
OBSERVE THE FOLLOWING CAUTIONS WHEN CLEANING THE
HANDPIECE:
• HANDPIECE SHOULD BE STERILIZED PRIOR TO FIRST USE.
• CLEAN THE HANDPIECE THOROUGHLY AFTER EVERY PROCEDURE. The
Powered Dissector and Drill handpiece are motorized equipment. The reliability
and performance of this equipment is highly dependent on proper care and
cleaning. Without proper cleaning, suction strength may be reduced resulting in
diminished cutting performance.
• DO NOT AUTOCLAVE THE HANDPIECE UNLESS IT HAS BEEN THOROUGHLY
CLEANED ACCORDING TO THE PROCEDURES OUTLINED BELOW. Debris left
in the handpiece will be much more difficult to clean and remove after heating in
an autoclave.
• USE WARM SOAPY WATER FOR CLEANING. Warm water is much more effective
at removing blood and tissue.
• DO NOT ALLOW FLUID, BLOOD, AND TISSUE TO DRY IN THE HANDPIECE
PRIOR TO CLEANING OR AUTOCLAVING.
• AVOID THE USE OF CHEMICAL CLEANING AGENTS, WHICH MIGHT DAMAGE
THE INSTRUMENT. USE A NON-RESIDUE CLEANER, PREFERABLY
ISOPROPYL ALCOHOL, OR A SOLUTION OF 10% MILD DETERGENT AND
90% WATER.
• DO NOT CLEAN USING CIDEX® OR ULTRASONIC WASHERS! ANY OF THESE
CLEANING METHODS MAY DAMAGE THE HANDPIECE AND WILL VOID THE
PRODUCT WARRANTY.
Diego® System Manual
18
Page 23
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 26
Diego Handpiece
Required Cleaning
Equipment:
Lukewarm water, a clean, soft towel, and sterile isopropyl alcohol
prep pads
Cleaning Procedure:
1. Wipe down the external surface of the hand piece with warm soapy
(enzymatic, biocidal, detergent) water.
2. Using a round, small diameter, soft bristle brush, moistened with the
soapy water, gently scrub the interior of the chucking mechanism, and
the through channel to loosen any soil. Take care not to scratch the
interior of the handpiece.
3. Holding the hand piece with the chuck end up, flush the interior of the
hand piece with running water, to remove loosened soil.
4. Flush the exterior of the hand piece with running water to remove
detergent and other soil.
5. Visibly inspect the exterior of the hand piece for any adherent soil.
6. Visibly inspect the interior, as far as possible, for adherent soil, paying
particular attention to the chucking mechanism and crevices in and
around the interior of the device.
7. Repeat if needed.
Sterilization
The Diego Powered Dissector handpiece is designed for sterilization by steam
autoclave.
ALWAYS REMOVE BLADES BEFORE STERILIZATION OF THE HANDPIECE.
IT IS CRITICAL TO PROPERLY CLEAN ALL REUSABLE DEVICES PRIOR TO
STERILIZATION.
Diego® System Manual
19
Page 24
Yes1
Yes2
Yes
Handpieces
Stapes Burrs
Yes
Yes2
Gravity
Wrapped
Yes
Yes1
Gravity
Unwrapped
Yes
No
EO
Yes
No
Chemical
Disinfectant
Yes
No
Chemical
Sterilant
No
No
Gas
Plasma3
Diego® System Manual
NOTES:
1. The flash cycle is not recommended as optimum sterilization method for the handpieces due to the lack of a vacuum drying cycle.
2. A 30-minute vacuum drying cycle must follow the steam autoclave cycle to remove moisture remaining inside the handpiece.
3. Gas plasma cycle refers to the STERRAD® Sterilization System.
Cycle Parameters
The following cycle parameters relate to the table above.
Handpieces
A 30-MINUTE VACUUM DRYING CYCLE MUST FOLLOW THE STEAM AUTOCLAVE CYCLE TO REMOVE MOISTURE
REMAINING INSIDE THE HANDPIECE.
Gravity Cycle: Full Cycle–15 minutes @ 270 -275ºF (132ºC)
Pre-vacuum Cycle, Flash: Full Cycle–3 minutes @ 270-275ºF (132ºC)
Pre-vacuum Cycle, Wrapped: Full Cycle–3 minutes @ 270-275ºF (132ºC)
*NOTE: May be processed at temperatures up to 278.6 °F (137 °C)
CAUTION: Do not quench the handpiece following sterilization as damage to the handpiece may occur.
Additional information on cleaning and sterilizing ENT devices may be obtained by contacting the Quality Assurance Department at
Gyrus ACMI, Inc. - ENT Division by telephone at 800-262-3540 or 901-373-0200 (USA).
A “No” indicates Gyrus ACMI, Inc. - ENT Division does not currently have the data to support the recommendation of the specified method of sterilization for the given category. It does not necessarily indicate the inability of the cycle to effectively sterilize this category of device.
Yes
Prevacuum
Unwrapped
Prevacuum
Wrapped
Device Type
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 27
Sterilization
Recommendations
20
Page 25
4434957 Diego manual - Rev AC-2_Diego Manual 2 7/17/12 9:53 AM Page 28
Otologic Handpieces and Burrs
Cleaning and Sterilization
Cleaning
CLEAN THE HANDPIECES THOROUGHLY PRIOR TO EVERY STERILIZATION CYCLE.
Blood and tissue not removed prior to sterilization may become dried and affixed to the interior
of the Handpiece. These deposits will detract from the Handpiece performance and life span.
The following is the recommended cleaning procedure for the Handpieces:
Disconnect the Irrigation Spike Assembly from the Handpiece Irrigation Tubing. Damaged or
discolored irrigation tubing should be replaced with part number 70921605. Flush the Irrigation
Tubing with a syringe filled with distilled water. Remove the remaining fluid from the Irrigation
Tubing. This can be done by placing the Irrigation Tubing in the Pump. Turn the pump on by
pressing the pump on/off switch, then flush the remaining fluid by using the primer button. The
remaining fluid can be forced out by inserting an empty syringe into the Handpiece Irrigation
Tubing and forcing 2-3 syringes of air through the tubing.
If you choose not to use the pump to flush out the extra irrigation fluid you may flush out the
fluid solely with the syringe.
ALWAYS DISCONNECT THE HANDPIECE(S) FROM THE CONSOLE AFTER FLUSHING,
BUT PRIOR TO CLEANING.
Remove the bur from the Handpiece and close the Locking Ring to the locked position. Using
a soft wipe and a mild, low-sudsing detergent or isopropyl alcohol, remove any blood and tissue
from the exterior of the Handpiece and tubing. Wipe debris from the Console at this time
following the same procedure.
DO NOT IMMERSE THE HANDPIECES IN LIQUID OR CLEAN BY ULTRASONIC MEANS!
DO NOT USE AUTOMATED WASHING-DISINFECTION SYSTEMS ON THE HANDPIECES.
The Handpieces contain electrical components that are not designed for immersion. Failure to
observe this caution can result in damage to the Handpieces and the warranty will be voided.
Fill a syringe from the Cleaning Kit (70325512) with isopropyl alcohol. Hold the handpiece
upside down (nosecone down) and insert the tip of the syringe into the Nosecone of the
inverted Handpiece. DO NOT FLUSH THE HANDPIECE UNLESS THE NOSECONE IS
POINTED DOWN.
Diego® System Manual
21