Texas Model Optical Bronchoscope Instruction Manual

Important general notes and instructions Make sure that this product is used only as intended and described in this instruction manual, by adequately trained and qualified medical personnel, Maintenance and repair must be carried out by authorized experts. Use the product only in the combinations and with the accessories and spare parts specified in this instruction manual. Use other combinations, accessories and replacement parts only if they are expressly intended for the planned appli­ cation and if the performance characteristics and safety requirements are met. The product must not be altered in any way. Reprocess the product in accordance with the manual before every use and before return shipment to protect the pa­ tient, user and third parties. This manual is an integral part of the product and must be stored in such a way that it is accessible at any time during its entire life cycle. This manual must be passed on to any subsequent owner or user. Immediately on receipt, check the product and its accessories for completeness and possible damage. Should the shipment give rise to complaints, please inform the manufacturer or supplier immediately. Subject to technical changes! Due to ongoing developments the illustrations and technical data may deviate slightly.

Safety instructions and levels of danger Symbol

Level of danger

WARNING!

Failure to observe can result in death or serious injury.

CAUTION!

Failure to observe can result in slight injury or damage to the product.

IMPORTANT!

Failure to observe can result in damage to the product or surroundings.

NOTE!

User tips for optimum device use and other useful information.

0

GERMANY RICHARD WOLF GmbH 75438 Knittlingen Pforzheimerstr. 32 Telephone: +49 70 43 35-0 Telefax: +49 70 43 35-4300 MANUFACTURER [email protected] www.richard-wolf.com

USA RICHARD WOLF Medical Instruments Corporation 353 Corporate Woods Parkway Vernon Hills, Illinois 60061 Toll Free: 001 (800) 323 - 9653 Phone: 001 (847) 913 - 1113 Fax: 001 (847) 913 - 1488 [email protected] www.richardwolfusa.com

UK RICHARD WOLF UK Ltd. Waterside Way Wimbledon SW17 0HB Telephone: + 44 20 89 44 74 47 Telefax: + 44 20 89 44 13 11 [email protected] www.richardwolf.uk.com

BELGIUM / NETHERLANDS N.V. Endoscopie RICHARD WOLF Belgium S.A. Industriezone Drongen Landegemstraat 6 9031 Gent Drongen Telephone: +32 92 80 81 00 Telefax: +32 92 82 92 16 [email protected] www.richard-wolf.be

FRANCE RICHARD WOLF France S.A.R.L. Rue Daniel Berger Z.A.C. La Neuvillette F-51100 Reims Telephone: +33 3 26 87 02 89 Telefax: +33 3 26 87 60 33

AUSTRIA RICHARD WOLF Austria Ges.m.b.H. Wilhelminenstraße 93 a A-1160 Vienna Telephone: +43 14 05 51 51 Telefax: +43 14 05 51 51 45

[email protected]

[email protected] www.richard-wolf.com

Marketing Office U.A.E RICHARD WOLF Middle East P.O. Box 500283 AL Thuraya Tower 1 9th Floor, Room 904, Dubai Telephone: + 9 71 43 68 19 20 Telefax: + 9 71 43 68 61 12 [email protected] www.richard-wolf.com

INDIA RICHARD WOLF India Private Ltd. JMD Pacific Square No. 211 A, Second Floor Behind 32nd Milestone Gurgaon - 122 001 National Capitol Region Telephone: + 91 12 44 31 57 00 Telefax: + 91 12 44 31 57 05 [email protected] www.richard-wolf.com

GA-G130

Contents 1 1.1 1.2 1.3

Technical description... Optical bronchoscope model Texas [ A ]... Bronchoscope model Texas [ B ]... Accessories...

1 1 1 2

2 2.1 2.2 2.3

Intended use... Optical bronchoscope model Texas [ A ]... Bronchoscope model Texas [ B ]... Accessories...

2 2 3 3

3

Indications and field of use...

4

4 4.1 4.2

Contraindications and side effects... Contraindications... Side effects...

4 4 4

5 5.1 5.2 5.3 5.3.1 5.3.2 5.3.3

Combinations... Optical bronchoscope model Texas [ A ]... Bronchoscope model Texas [ B ]... Overview of permissible combinations... Optical bronchoscope model Texas [ A ]... Bronchoscope model Texas [ B ]... Optical bronchoscope model Texas [ A ] / Bronchoscope model Texas [ B ] with accessories...

4 4 5 5 5 6

6 6.1 6.1.1 6.2 6.2.1 6.3

Illustration... 8 Optical brochoscope model Texas [ A ]... 8 Legend and identification... 9 Bronchoscope model Texas [ B ]... 10 Legend and identification... 11 Symbol... 12

7 7.1 7.1.1 7.1.2

Application... 13 Preparation - Optical brochoscope model Texas [ A ]... 13 Telescope element (1.0)... 13 Connect the telescope element (1.0) to the bronchoscope tube / tracheoscope tube (4.0)... 14 Inserting laser fiber in laser guide tube (6.0)... 14 Preparation - Bronchoscope Model Texas [ B ]... 15 Head for Texas bronchoscope (7.0) - Variant 1... 15 Head for Texas bronchoscope (8.0) - Variant 2... 15 Connecting the head for Texas bronchoscope (7.0) (8.0) to bronchoscope tube / tracheoscope tube (4.0)... 16 Connecting the telescope adapter (10.0) to the head for Texas bronchoscope (7.0) (8.0) (option)... 16 Inserting the bronchoscope telescope (11.0) into the telescope adapter (10.0) (option) 17 Connecting accessories (option)... 17 Ventilation in the case of closed systems... 17 Jet ventilation... 18 Connecting the nozzle for jet ventilation (2.0) to a jet ventilator with Luer connector . . 19 Remove Luer connector (adapter element) (3.0) and nozzle for jet ventilation (2.0). . 19 Install the proximal lighting insert (9.0) in head for Texas bronchoscope (8.0)... 20 Connecting the telescope element (1.0) / head for Texas bronchoscope (7.0) (8.0) to the system components... 20

7.1.3 7.2 7.2.1 7.2.2 7.2.3 7.2.4 7.2.5 7.2.6 7.3 7.4 7.4.1 7.4.2 7.4.3 7.5

GA-G130

7

I

7.6 7.7 7.7.1 7.7.2 7.7.3 7.7.4 7.8 7.9

Telescope element (1.0) - rinsing / cleaning the lens window... Additional notes and instructions for use... Light... Electrical current... Image quality... Irrigation fluid... HF applications... Laser application...

21 22 22 22 23 23 24 25

8 8.1 8.2 8.2.1

Checks... Visual check... Function check... Telescope element (1.0) / head for Texas bronchoscope (7.0) (8.0)...

26 26 26 27

9 9.1 9.2 9.3

Reprocessing and maintenance... Reprocessing procedure... Optical bronchoscope model Texas [ A ], bronchoscope model Texas [ B ]... Laser guide tube (6.0), telescope adapter (10.0)...

29 29 30 36

10 10.1 10.2 10.3 10.4

Technical data and order data... Bronchoscope tube / tracheoscope tube (4.0)... Optical brochoscope model Texas [ A ]... Bronchoscope model Texas [ B ]... Telescope adapter (10.0) and bronchoscope telescope (11.0)...

39 39 40 40 41

11 11.1 11.2

Spare parts and accessories... 41 Replacement parts... 41 Accessories... 42

12 12.1

Operating, storage, transport and shipping conditions... 43 Disposal of product, packaging material and accessories... 43

13

Literature... 44

II

GA-G130

1

Technical description

1.1

Optical bronchoscope model Texas [ A ]

The "Optical bronchoscope model Texas" [ A ] and the "bronchoscope model Texas" [ B ] are rigid universal bronchoscopes consisting of a telescope or head, access and working instruments. The scopes comprise the instruments described in the following: Telescope element Telescope outer tube with integrated light guide, optical system, irrigation and insufflation channel with interface to Texas bronchoscope tube / tracheoscope tube with lateral irrigation and insufflation connector and distal irrigation nozzle for telescope rinsing with angled eyepiece with eyecup for connection to objective lenses with cold-light connector at a right angle for connection to fiber light cables with ventilation fitting for connection to all known ventilation and anasthetic systems with stopcock for lateral exhalation with proximal connection cone for accessories with sealing ring Protection sleeve with protection tube and connecting element with Texas bronchoscope tube / tracheoscope tubes with telescope guide tube with graduation with ventilation slots with distal monitoring windows (not 82520.0842) with interface to telescope element laser guide tube with laser guide sheath and insertion channel with grip with spring collet

1.2

Bronchoscope model Texas [ B ] Head for Texas bronchoscope with distal light guide or obturator in case of variant with light guide: with cold-light connector for the connection of a fiber light cable with sealing cap in the case of the obturator variant: stub for proximal lighting insert with sealing cap with plug with working channel with interface to Texas bronchoscope tube / tracheoscope tube with expiration adaptor with ventilation fitting connecting to all known ventilation and anasthetic systems with proximal mounting cone for accessories

GA-G130

1

Texas bronchoscope tube / tracheoscope tubes with telescope guide tube with scale with ventilation slots with distal monitoring windows (not 82520.0842) with interface for head for Texas bronchoscope Telescope adapter with distal cone for connection to the head for Texas bronchoscope / tracheoscope with spacer tube with proximal automatic snap-lock to attach a telescope Bronchoscope telescope

1.3

Accessories Nozzle for jet ventilation with twist-lock mechanism with Luer connector (used only for jet ventilation) with identification: AIR on Luer connector with O rings Adjustable magnifier Universal sealing cap with sealing cap Sealing cap with telescope sealing cap Sealing cap with window Sealing cap for lateral expiration adapter Sealing plug for stub for proximal lighting insert

2

Intended use is used for endoscopic visualization of the tracheobronchial respiratory tract via the natural passage (oral).

2.1

Optical bronchoscope model Texas [ A ] The telescope element is attached to the Texas bronchoscope tube or tracheo­ scope tube. In conjunction with the telescope element, the bronchoscope tube / tracheo­ scope tube represents the port to the area to be examined or treated and al­ lows the introduction of auxiliary instruments. The inner diameter allows the conduction of gasses necessary for the patient's artifical respiration. Via the ventilation stub of the telescope element used in combination, the bron­ choscope tube / tracheoscope tube can be connected to all known ventilation and anesthesia systems. The area to be treated is illuminated via the cold-light connector on the tele­ scope element. The tracheoscopes are used in the trachea down to the bifurcation. Make sure you take into account the patient's anatomy. For bronchoscope tube / tracheoscpe tube with biopsy channel for breathing gas analysis: the gas to be analyzed is obtained from the patient's central respiratory tract via the tracheoscope tube by applying the bypass principle. M = identification on Luer connector Laser guide tube serves to guide laser fibers.

2

GA-G130

2.2

Bronchoscope model Texas [ B ] The head for Texas bronchoscope is attached to the Texas bronchoscope tube or tracheoscope tube. In conjunction with the head for Texas bronchoscope, the bronchoscope tube / tracheoscope tube represents the access port to the examination / treatment area and allows the introduction of auxiliary instruments. The inner diameter allows the conduction of gasses necessary for the patient's artifical respiration. Via the ventilation stub of the head for Texas bronchoscope, used in combination, the bronchoscope tube / tracheoscope tube can be connected to all known venti­ lation and anesthesia systems. The area to be treated is illuminated via the cold-light connector or the illumina­ tion insert on the head for Texas bronchoscope. The tracheoscopes are used in the trachea down to the tracheal bifurcation. Make sure you take into account the patient's anatomy. In case of the bronchoscope tube / tracheoscope tube with sampling channel for breathing gas analysis: the gas to be analyzed is obtained from the patient's central respiratory tract via the tracheoscope tube applying the bypass principle. M = identification on Luer connector Telescope adapter is used to fasten the endoscope to the head of the Texas bronchoscope tube / tracheoscope tube. Bronchoscope telescope is used for endoscopic visualization of the tracheobronchial respiratory tract via the natural passage (oral). These products are exclusively intended for use by specialized medical personnel and must only be used by medically qualified and adequately instructed persons.

2.3

Accessories NOTE! The possible combinations of the accessories listed below with the „Optical bron­ choscope model Texas“ [ A ] or the „bronchoscope model Texas“ [ B ] are listed in section 5.3.3. Nozzle for jet ventilation is used for jet ventilation of the patient via the bronchoscope tube / tracheo­ scope tube Adjustable magnifier provides a magnified view of the treatment area. Universal sealing cap with sealing cap proximal attachment with the following positions: Protection with glass window Seal with rubber cap free passage Sealing cap with telescope sealing cap is used as a proximal closure in conjunction with the telescope or head for Texas bronchoscope and instrument Sealing cap with window provides a proximal closure in conjunction with the telescope or head for Texas bronchoscope and instrument Sealing cap for lateral expiration adapter serves to close the lateral expiration adapter Sealing plug for stub for proximal lighting insert serves to close the stub for proximal lighting insert

GA-G130

3

3

Indications and field of use

This product is used for examination, diagnosis and therapy of pathological changes in the area of the tracheobronchial respiratory tracts in conjunction with endoscopic accessories.

NOTE! We recommend reading relevant literature for the planned application. see also section 13 "Literature"

4

Contraindications and side effects

4.1

Contraindications. CJD - Creutzfeldt Jakob Disease or a vCJD - Variant of the Creutzfeldt-Jakob Disease BSE - Bovine Spongiform Encephalopathy; so-called mad cow disease (e.g. Creutzfeldt-Jakob Disease) TSE - Transmissible Spongiform Encephalopathy On the basis of the patient's general condition the doctor in charge must decide whether the planned use is possible or not. Follow the laws and regulations valid in your country. For further notes and instructions please refer to the latest medical literature and guidelines. Contraindications directly related to the product are presently unknown.

4.2

Side effects

5

Combinations

5.1

Optical bronchoscope model Texas [ A ]

No side effects are to be expected if the system is used as intended.

The "Optical bronchoscope model Texas“ [ A ] is used in conjunction with: Light projectors and fiber light cables anasthetic respiration systems or respiration apparatus (with controlled / sup­ porting ventilation or jet ventilation) using the necessary accessories Nozzle for jet ventilation Pumps for suction and irrigation HF surgical devices Laser guide tube Laser light cables with diameters up to max. 600 µm (corresponding to an outside diameter of 0.8 mm) conventional disposable syringes Endoscopic accessories For this, see section 5.3.3 Auxiliary instruments, such as Forceps and cytology brushes Electrodes Suction tubes Coagulation suction tubes Biopsy cannulas Resectors / Remover Stent Loading System

4

GA-G130

5.2

Bronchoscope model Texas [ B ] The "Bronchoscope model Texas“ [ B ] is used in conjunction with: Light projectors and fiber light cables Anasthetic respiration systems or respiration apparatus (with controlled / sup­ porting ventilation or jet ventilation) using the necessary accessories Nozzle for jet ventilation Pumps for suction and irrigation HF surgical devices Endoscopic accessories such as For this, see section 5.3.3 Auxiliary instruments, such as Forceps and cytology brushes Electrodes Suction tubes Coagulation suction tubes Biopsy cannulas

CAUTION! Do not combine products incorrectly! Injuries of the patient, user or others as well as damage to the product are possible. The different products can only be used together if their intended uses and rele­ vant technical data (such as working length, diameter, peak voltage, etc.) are the same. Follow the instruction manuals of the products used in combination with this product. Instrument set for shaver-aided tissue resection in the tracheobronchial space GA-G134 Stent loading system BB-G134

5.3

Overview of permissible combinations

5.3.1

Optical bronchoscope model Texas [ A ]

DESIGNATION

TELESCOPE ELEMENT

TEXAS

MODEL

ILLUSTRATIONS

PRODUCT NO. BRONCHOSCOPE TUBE SIZE 6

82520.0641

BRONCHOSCOPE TUBE SIZE 8

82520.0841

BRONCHOSCOPE TUBE SIZE 8

82520.0842

BRONCHOSCOPE TUBE SIZE 10

82520.1041

TRACHEOSCOPE TUBE SIZE 12

82520.1241

TRACHEOSCOPE TUBE SIZE 14

82520.1441

TRACHEOSCOPE TUBE SIZE 8

825210830

TRACHEOSCOPE TUBE SIZE 10

825211030

TRACHEOSCOPE TUBE SIZE 12

825211230

TRACHEOSCOPE TUBE SIZE 14

825211430 Description of symbols:

GA-G130

=

combinable

=

not combinable

5

5.3.2

Bronchoscope model Texas [ B ]

DESIGNATION

HEAD FOR TEXAS BRONCHOSCOPE

TELESCOPE ADAPTER

ILLUSTRATIONS

Example: Identification 12 x 415

8252060301

8252050301

8465.30

8252040301

with proximal illumination 825101200

PRODUCT NO.

with distal illumination 825101100

825101xxx

with tele­ scope 8465.30

with tele­ scope 8465.30

Example: Identification

TEXAS

MODEL

12 x 415

BRONCHOSCOPE TUBE SIZE 6

82520.0641

10 x 415

BRONCHOSCOPE TUBE SIZE 8

82520.0841

12 x 415

BRONCHOSCOPE TUBE SIZE 8

82520.0842

12 x 415

BRONCHOSCOPE TUBE SIZE 10

82520.1041

14 x 420

TRACHEOSCOPE TUBE SIZE 12

82520.1241

16 x 420

TRACHEOSCOPE TUBE SIZE 14

82520.1441

18 x 425

TRACHEOSCOPE TUBE SIZE 8

825210830

12 x 405

TRACHEOSCOPE TUBE SIZE 10

825211030

14 x 405

TRACHEOSCOPE TUBE SIZE 12

825211230

16 x 403

TRACHEOSCOPE TUBE SIZE 14

825211430

18 x 405 Description of symbols:

6

=

combinable

=

with telescope 82514.431

not combinable

GA-G130

Optical bronchoscope model Texas [ A ] / Bronchoscope model Texas [ B ] with accessories

Sealing plug

Proximal lighting inmsert

Nozzle for jet ventilation

Universal lock cap

Sealing cap with monitoring window 8205.12

8020.15

Sealing cap with telescope sealing cap 8020.18 8021.18

Sealing cap

Adjustable telescope magnifier

ACCESSORIES

4205.20

DESIGNATION

8205.13

5.3.3

TELESCOPE 17° W 4.4mm H 2mm WL 314mm TEXAS

82510.1400

HEAD FOR TEXAS BRONCHOSCOPE

825101100

HEAD FOR TEXAS BRONCHOSCOPE

825101200 Description of symbols:

GA-G130

=

combinable

=

not combinable

8256.99

8217.12

PRODUCT NO.

8238.502

ILLUSTRA­ TIONS

7

6

Illustration

6.1

Optical brochoscope model Texas [ A ] 1.11.1

W

1.11.2 1.11.3 1.11.4

1.1

1.0

1.11.5

1.2 1.3

1.8

1.7

1.5.2 1.5.3

1.6

25

*

1.5.1 1.5

1.4

1.9 1.12.1

1.10

X

2.1 2.2 2.3

Z 4.10

4.11 4.12 4.1 4.2

1.11 1.12

W X

1.12.2

Y

1.10.1

1.14 1.13 #

Y 4.3

4.4

4.6

4.5

4.7

4.9 4.8

2.0

#

4.0

Z

3.1

3.0

#

5.0

5.1

#

5.2

6.0 6.1 6.5

6.4 6.3 # 6.2

Fig. 1

8

GA-G130

6.1.1

Legend and identification Item

Designation

Item

Designation

1.0

Telescope element

4.0

Bronchoscope / tracheoscope tube

1.1

Light exit

4.1

Viewing window

1.2

Objective window

4.2

Tube insertion part

1.3

Irrigation nozzle for lens cleaning

4.3

Ventilation slots

1.4

Telescope outer tube

4.4

Outer tube

1.5

Irrigation and insufflation connector

4.5

Scale

4.6

Identification: Outside diameter of tube x total length (with telescope element) [mm]

1.5.1

Irrigation and Insufflation channel (internal in 1.4)

1.5.2

Tube connector (outside)

4.7

Locking collar

1.5.3

Luer connector (inside)

4.8

Twist-lock

1.6

Rubber cap

4.9

Identification: Inside diameter (insert capacity) of the instrument channel [mm]

1.7

Adapter, light cable to endoscope (en­ doscope-mounted)

4.10

Telescope guide tube

1.8

Eyepiece with eyecup

4.11

Identification: not locked (open) tube with telescope element unlocked

1.9

Working channel

4.12

Identification: locked (not open) tube is locked to the telescope element

1.10

Connection cone

5.0

Protection sleeve

1.10.1 Groove

5.1

Protection tube

1.11

5.2

Adapter element

1.11.1 Stopcock housing

6.0

Laser guide tube

1.11.2 Recess

6.1

Insertion channel

1.11.3 Pin

6.2

Spring collet

1.11.4 Stopcock plug

6.3

Identification: Capacity for laser fiber up to max. 600 µm

Insert capacity identification 1.11.5 - stopcock plug - stopcock housing

6.4

Handle is

1.12

6.5

Laser guide shaft

1.12.2 Marking - position of nose

*

Serial no.

1.13

Guide pins

#

Product no.

1.14

Sealing ring

2.0

Nozzle for jet ventilation

2.1

Twist-lock

2.2

O-ring

2.3

Marking

3.0

Luer connector (adapter element)

3.1

O-ring

Stopcock for lateral exhalation

Ventilation connector

(corresponding to an outside diameter of 0.8 mm)

1.12.1 Nose (inside)

GA-G130

9

6.2

Bronchoscope model Texas [ B ]

3.0

Y

Z

Z

4.0

Y

2.0

X

7.4

#

7.4.1

10.6 10.8 10.2 10.1 10.4.2 10.7

7.5.1

7.5 7.6

7.3

10.4

10.4.1

# 12.1

12.2

10.3

8.4.1

X

7.1

X 8.5.2

7.1.1

8.0

8.7 8.8

8.3 8.2

8.1.1

8.5.1

8.5

# 8.6

8.1

12.5

9.0 12.3

7.0

12.5

7.2 8.4

12.0

X 7.5.2

7.7 7.8

10.0

10.5

#

#

12.6

9.1

12.4 13.1

13.0

5.0

#

13.2

11.0 Fig. 2

10

GA-G130

6.2.1

Legend and identification Item

Designation

2.0

Nozzle for jet ventilation

3.0

Luer connector (adapter element)

4.0

Bronchoscope / tracheoscope tube

5.0

Protection sleeve

7.0

Head for Texas bronchoscope

Item

Designation

Items see section 6.1

with distal illumination

10.0

Telescope adapter

7.1

Light guide rod, outer tube

10.1

Marking - position of nose

7.1.1

Light exit

10.2

Nose (inside)

7.2

Adapter

10.3

Conical adapter

7.3

Working channel

10.4

Automatic snap-in lock

7.4

Connection cone

10.4.1 Tab

7.4.1

Groove

10.4.2 Spring sleeve

7.5

Ventilation connector

10.5

Nose

7.5.1

Nose (inside)

10.6

Model no. of suitable bronchoscope tele­ scope

7.5.2

Marking - position of nose

10.7

Spacer tube

7.6

Lateral expiration adapter

10.8

Model no. of head for Texas bronchoscope and identification of size of the combinable bronchoscope tubes / tracheoscope tubes

7.7

Guide pins

11.0

Bronchoscope telescope

7.8

Sealing ring

12.0

Accessories

with proximal illumination

12.1

Adjustable magnifier

8.1

Rod

12.2

8.1.1

Rod with obturator (distal)

12.3

8.0

8.2

(Variant 1)

Head for Texas bronchoscope (Variant 2)

Stub

for proximal lighting insert

12.4

Universal sealing cap with sealing cap

Sealing cap with window

Sealing cap

with telescope sealing cap

8.3

Working channel

12.5

Sealing cap

8.4

Connection cone

12.6

Sealing plug

8.4.1

Groove

13.0

Sealing caps (spare parts)

8.5

Ventilation connector

13.1

Sealing caps for telescopes

8.5.1

Nose (inside)

13.2

Sealing cap without bore

8.5.2

Marking - position of nose

8.6

Lateral expiration adapter

#

Product no.

8.7

Guide pins

8.8

Sealing ring

9.0

Proximal lighting insert

9.1

Adapter

GA-G130

11

6.3

Symbol Symbol

Designation Attention, Caution

Follow instructions for use

Follow the instruction manual

REF

Order number

LOT

Lot designation

SN

Serial no. not locked (open)

locked (not open) Identification in conformity with Medical Product Directive 93/42/EEC, only valid if the product and/or the packaging is marked with this identification. Products of category IIa and above, as well as sterile products or products with measuring function of category I, are additionally marked with the code no. of the notified body (0124).

12

GA-G130

7

Application CAUTION! The products have only limited strength! Excessive force will cause damage, impair the function and therefore endanger the patient. Immediately before and after each use, check the products for damage, loose parts and completeness. Make sure that no missing parts remain in the patient. Do not use the products if they are damaged or incomplete or have loose parts. WARNING! Insufficient patient ventilation! Tracheoscope tubes 82521 do not have lateral distal openings! If not used as intended, there is the danger of insufficient ventilation. Use tracheoscope tubes only in accordance with their intended use. WARNING! Do not insert the bronchoscope tube / tracheoscope tube (4.0) without the tele­ scope element (1.0) without the head for Texas bronchoscope (7.0) (8.0)! This may cause inadvertent tissue damage. Insert the bronchoscope tube / tracheoscope tube (4.0) only with the telescope element (1.0) attached or with the head for Texas bronchoscope (7.0) (8.0) at­ tached under endoscopic view or with video assistance transorally into the trachea. CAUTION! Danger of kinking! The following instrument parts have only limited strength: Telescope outer tube (1.4) - telescope element (1.0) Light rod outer tube (7.1) - head for Texas bronchoscope (7.0) Rod with obturator (8.1.1) - head for Texas bronchoscope (8.0) Do not apply bending forces to the telescope element (1.0) / head for Texas bron­ choscope (7.0) (8.0) during assembly or disassembly. NOTE! The adapters (1.7) (7.2) (9.1) can be unscrewed and replaced by suitable adapters in order to connect fiber lightcables made by other manufacturers. For order information please refer to the latest catalog sheets.

7.1

Preparation - Optical brochoscope model Texas [ A ] Check assembly: Sections 9.2 (page 34) and 9.3 (page 37) Carry out a check: see sections 8 and 8.1

7.1.1

5.0

Telescope element (1.0)

1. 7 1.6

1.5.2

Fig. 3 Remove the protection sleeve (5.0) axially from the telescope element (1.0). Place the rubber cap (1.6) onto the tube connector (1.5.2). Screw on the "light cable to endoscope" adapter (1.7).

25

1.0

Fig. 3

GA-G130

13

7.1.2

Connect the telescope element (1.0) to the bronchoscope tube / tracheoscope tube (4.0) Fig. 4 Turn the locking collar (4.7) to the position. Insert the telescope element (1.0) into the telescope guide tube (4.10) of the bronchoscope tube / tracheoscope tube (4.0). The guide pins (1.13) and the twist-lock mechanism (4.8) are aligned. The tip of the tube insertion part (4.2) and the eyepiece (1.8) must be aligned. position. Turn the locking collar (4.7) to the Both components are locked together.

4.10

4.2

4.0

4.8

1.8

1.13

1.0

4.7

Fig. 4 Carry out a function check: see section 8.2 For disassembly proceed in reverse order. 7.1.3

Inserting laser fiber in laser guide tube (6.0)

CAUTION! Extended operating time and reduced user comfort if impermissible diameters are used or if the insertion channel (6.1) is blocked! Before use, check the laser fiber for easy insertion with open spring collet (6.2). Do not use laser fibers which are difficult to insert as these may become damaged during insertion. Use only laser fibers with a maximum size of 600 µm (corresponding to an outside diameter of 0.8 mm). Laser fibers with diameters greater than 600 µm are not permissible. WARNING! Danger of injury due to uncontrolled insertion of the laser fiber! Inadvertent tissue damage is possible if during insertion of the laser guide tube (6.0) into the bronchoscope tube / tracheoscope tube (4.0) the distal tip of the laser fiber projects distally from the laser guide sheath (6.5). Precisely position the laser guide tube (6.0) in the bronchoscope tube / tracheo­ scope tube (4.0) before you carefully position the distal tip of the laser fiber under visual control in axial direction (see section 7.9).

14

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Fig. 5 Slightly unscrew the spring collet (6.2) as indicated by the arrow (b). Insert a suitable laser fiber up to the distal end of the laser guide tube (6.0). Tighten the spring collet (6.2) in direction of arrow (a). The laser fiber is secured against axial offset. Reduced clamping forces of the spring collet (6.2) allow a controlled axial movement of the laser fiber.

6.0

6.5

(a)

(b)

6.2

Fig. 5

7.2

Preparation - Bronchoscope Model Texas [ B ] Check assembly: Sections 9.2 (page 34) and 9.3 (page 37) Carry out a check: see sections 8 and 8.1

7.2.1

Head for Texas bronchoscope (7.0) - Variant 1 Fig. 6

5.0

Remove the protection sleeve (5.0) axially from the head for Texas broncho­ scope (7.0). Tighten the adapter (7.2).

7.0

7.2 Fig. 6

7.2.2

Head for Texas bronchoscope (8.0) - Variant 2

5.0 8.0

Fig. 6 Remove the protection sleeve (5.0) axially from the head for Texas broncho­ scope (8.0). Tighten the adapter (9.1). Installing the proximal lighting insert (9.0). See section 7.4.3

9.0 Fig. 7

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9.1

15

7.2.3

Connecting the head for Texas bronchoscope (7.0) (8.0) to bronchoscope tube / tracheoscope tube (4.0) Fig. 8 Turn the locking collar (4.7) to the position. Insert the head for Texas bronchoscope (7.0) (8.0) in the telescope guide tube (4.10) of the bronchoscope tube / tracheoscope tube (4.0). The guide pins (7.7) (8.7) and the twist-lock mechanism (4.8) are aligned. The tip of the tube insertion part (4.2) and the cold-light connector (y) or stub (8.2), respectively, must be aligned. Turn the locking collar (4.7) to the position. Both components are locked together.

X

Y

4.7

4.8 1.8

4.10 7.7 8.7

4.0 7.1 8.1 Fig. 8

8.2

Y

(y)

4.2

X

Carry out a function check: see section 8.2 For disassembly proceed in reverse order. 7.2.4

Connecting the telescope adapter (10.0) to the head for Texas bronchoscope (7.0) (8.0) (option) Fig. 9 Hold the telescope adapter (10.0) in such a way that the marking (10.1) on the conical adapter (10.3) is aligned with the groove (7.4.1) (8.4.1) of the head for Texas bronchoscope (7.0) (8.0). Plug the conical adapter (10.3) firmly onto the cone (7.4) (8.4) of the head for Texas bronchoscope. The nose (10.2) engages in the groove (7.4.1) (8.4.1). Both components are firmly connected via the cone lock.

7.2

7.4.1

X 10.2 8.2

10.1 8.4.1

7.0 10.3

Fig. 9

16

X

8.0

10.0

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