Users Manual
92 Pages
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ArthroCare® Atlas™ System i User’s Manual
Table of Contents by Language ArthroCare Atlas System User’s Manual – English... 1 Manuel de l’opérateur du système Atlas ArthroCare – Français... 31 Gebrauchsanweisung für ArthroCare System Atlas – Deutsch... 61
ii ArthroCare® Atlas™ System User’s Manual
ArthroCare® Atlas™ System 1 User’s Manual
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ArthroCare® Atlas™ System User’s Manual
2 ArthroCare® Atlas™ System User’s Manual
ArthroCare® Atlas™ System 3 User’s Manual
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This equipment has been tested and found to comply with the limits for medical devices to IEC 60601-1-2:1994. These limits are designed to provide reasonable protection against harmful interference in a typical medical installation. This equipment generates, uses, and can radiate radiofrequency energy and, if not installed and used in accordance with the instructions, may cause harmful interference to other devices in the vicinity. If this equipment does cause harmful interference to other devices, which can be verified by turning the equipment off and on, the user is encouraged to try to correct the interference by one or more of the following measures: • Reorient or relocate the receiving device, • Increase the separation between the affected equipment and the Controller, • Connect the affected equipment to an outlet or circuit different from that to which the Controller is connected, or • Consult the manufacturer or field service technician for help.
4 ArthroCare® Atlas™ System User’s Manual
ArthroCare® Atlas™ System 5 User’s Manual
Description, Indications for Use, and Contraindications...7 Description...7 Indications for Use...7 Contraindications...7 System Overview...8 Connection Diagram...8 Principle of Operation...9 Warnings, Precautions, and Adverse Events...10 Warnings...10 Precautions...10 Adverse events...11 Controls, Indicators, and Alarms...12 Controls & Indicators...12 Alarms...13 Diagram of Controls, Indicators, and Alarms...14 Unpacking, Assembly, and System Check...15 Unpacking...15 Assembly and System Check...15 Instructions for Use...16 Operator Training Requirements...16 General System Operation...16 Voltage Outputs...17 System Preparation and Care...18 System Preparation...18 Wand Selection...19 System Shut Down...19 System Storage and Transport...19 Equipment Disposal...19
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Table of Contents
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Cleaning and Sterilization...20 Controller...20 Foot Control...20 Wand...21 Patient Cable...21 Maintenance and Troubleshooting...22 Maintenance...22 Fuse Replacement...22 Troubleshooting Guide...22 Product Specifications...24 Technical Specifications...24 Controller Output Graphs...25 Controller Classification and Safety Verification...28 Classification...28 Safety Verification...28 Customer Service...29 Warranty Information...29 Product Complaints...29 Symbols Key...30
ArthroCare® Atlas™ System 7 User’s Manual
Description The ArthroCare® Atlas™ System is a bipolar, radiofrequency (RF) electrosurgical system designed for use in arthroscopic and orthopedic procedures. The System consists of the following components: 1) a bipolar radiofrequency controller; 2) a reusable, non-sterile Power Cord; 3) a reusable, non-sterile Foot Control; 4) a reusable, non-sterile Patient Cable; and 5) a disposable, sterile ArthroWand or Microdebrider Wand. An optional reusable non-sterile Hand Control is also available for use with the System. The Controller is the voltage source that delivers RF energy to the treatment site via a reusable Patient Cable and sterile Wand, or an Integrated Cable Wand (ICW), a sterile Wand/Cable combination. The reusable Patient Cable is supplied non-sterile and is designed for sterilization prior to use. The sterile disposable Wand is available in various single or multi-electrode configurations and is supplied separately. It may have a Cable component incorporated into its design to replace the Patient Cable, The Controller is activated by either a reusable Foot Control or an optional reusable Hand Control.
Indications for Use The ArthroCare Atlas System is indicated for resection, ablation, and coagulation of soft tissue and hemostasis of blood vessels in arthroscopic and orthopedic procedures.
Contraindications The ArthroCare Atlas System is contraindicated in any procedures where a conductive solution is not used. The System is also contraindicated for patients who have cardiac pacemakers or other electronic implants without specific instructions from the manufacturer of the cardiac pacemaker or implant. Please refer to the Wand Instructions for Use for a more comprehensive list of contraindications regarding specific procedures.
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Description, Indications for Use, and Contraindications
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System Overview Connection Diagram
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5
1. Controller 2. Power Cord 3. Foot Control 4. Ablation Pedal 5. Coagulation Pedal 6. Set Point Adjustment Button 7. Patient Cable 8. Controller Connector 9a. Patient Cable Connector 9b. Cable Connector with Gray Plug
9c. Cable Connector with Black Plug 10. Wand 11. Shaft 12. Return Electrode 13. Active Electrode Tip 14. Suction Tube (optional on Wand Style) 15. Irrigant Tube (optional on Wand Style) 16. Handle 17. Integrated Cable Wand (ICW)
ArthroCare® Atlas™ System 9 User’s Manual
The ArthroCare Atlas Controller is designed to deliver RF energy to the electrode elements located at the distal end of the sterile single-use Wands. Current flows between the active electrodes elements and the return electrode element, both elements or poles located on the Wand itself in a bipolar configuration, providing a localized energy field. The result of this arrangement is controlled energy delivery with minimal collateral tissue damage. The ArthroCare Atlas System works by passing RF energy through a conductive solution (such as normal saline or Ringer’s lactate) in close proximity to or in contact with the tissue to be treated. The conductive solution forms a thin layer between the active and return electrode elements. In the ablation mode, when sufficient energy is applied, the conductive solution is converted into a vapor layer (plasma) containing energized charged particles. When the highenergy charged particles come in contact with tissue, they cause its disintegration through molecular dissociation. This mode of operation results in relatively low treatment site temperatures when compared to conventional electrosurgical and monopolar RF systems, thus yielding limited collateral thermal damage to the surrounding untreated tissue. The system can also function when a lower voltage is applied between the active and return electrode(s). In this case, the electrical field is below the threshold required to create a plasma layer and resistive tissue heating occurs. This mode is useful when a greater thermal effect is needed, i.e. for coagulation of blood vessel. The appropriate voltage setting will depend on the design of Wand used, tissue type, and desired tissue effect.
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Principle of Operation
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Warnings, Precautions, and Adverse Events The following is a list of Warnings and Precautions that apply to the general operation of the ArthroCare Atlas System. For specific warnings and precautions, please refer to the Wand and the Patient Cable Instructions for Use.
WARNINGS • Failure to follow all applicable instructions may result in serious surgical consequences. • Fire Hazard: DO NOT place active accessories near or in contact with flammable materials (such as gauze or surgical drapes). • Electrosurgical accessories, which are activated or hot from use, can cause a fire. • Accessory tips may remain hot enough to cause burns after the electrosurgical current is deactivated. • Inadvertent activation or movement of Wands outside the field of vision may result in injury to the patient. • Localized burns to the patient or physician may result from electrosurgical current carried through other instruments and conductive objects. • Electrosurgical current may be generated in conductive objects by direct contact with the active electrode or by the active or return electrode being in close proximity to a conductive object. • If excessive heating or physical forces cause damage to the Wand tip, foreign body fragments may result, possibly requiring extended surgery for removal. • DO NOT use the ArthroCare Atlas System with non-conductive media (e.g. sterile water, dextrose, air, gas, glycine, etc.). Use only conductive media such as normal saline or Ringer’s lactate. • Electric Shock Hazard: DO NOT connect wet accessories to the Controller. • Controller failure could result in an unintended increase in output power.
PRECAUTIONS • Prior to initial use, ensure that all package inserts, warnings, precautions, and Instructions for Use are read and understood. • Safe and effective electrosurgery is dependent not only on equipment design, but also, to a large extent, on factors under the user’s control. Only persons having adequate training and familiarity with orthopedic surgery should perform procedures with the ArthroCare Atlas System. • Consult medical literature relative to techniques, complications, and hazards prior to performance of any procedure. • Evaluate patients for predisposing medical problems that may be aggravated by the stress of surgery. • A thorough understanding of the principles and techniques involved in electrosurgical procedures is essential to avoid shock and burn hazards to both patient and medical personnel and damage to the device and other medical instruments. Ensure that insulation or Controller grounding is not compromised. • When instruments and accessories from different manufacturers are employed together in a procedure, verify compatibility prior to initiation of the procedure. • When not in use, remove the Wand from the surgical site and place away from metallic objects. Wands should remain separated from other electrosurgical equipment to avoid inadvertent electrical coupling between devices. Inadvertent activation may cause injury to patient and/or user or equipment damage. • DO NOT wrap Patient Cable around metal objects. Wrapping cords around metal objects may induce currents that could lead to shocks, fires, or injury to the patient or surgical personnel.
ArthroCare® Atlas™ System 11 User’s Manual
ADVERSE EVENTS As a consequence of electrosurgery, damage to surrounding tissue through iatrogenic injury could occur.
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• Use caution when using Wand tips to probe or manipulate tissue. Forceful contact between Wand tips and tissue or other instruments may result in damage to the instrument. • DO NOT use the Wand as a lever to enlarge surgical site or gain access to tissue. • DO NOT allow fluid to contact any electrical connectors on the Wands, Controller, or Cables during use. • Maintain the lowest Controller Set Point necessary to achieve the desired tissue effect. • Confirm proper activation of the Wand if a Controller Set Point is chosen outside of the selected, default settings. • DO NOT allow patient contact with grounded conductive objects, such as a surgical table frame or an instrument table, to avoid risk of shock. Grounding pads should not be used. • DO NOT contact metal objects with an activated Wand. • Observe fire precautions at all times. Sparking and heating associated with electrosurgery may be an ignition source. • DO NOT use flammable agents for cleaning and disinfection of the Controller or Cables. • As with other electrosurgical units, electrodes and Cables can provide paths for high frequency current. Position the cables to avoid contact with the patient or other electrical leads. • High frequency (HF) electrosurgical equipment such as the ArthroCare Atlas System may adversely affect the operation of other electronic equipment. • Electrodes should remain separated from other electrosurgical equipment to avoid inadvertent electrical coupling between devices. • Monitoring electrodes should be positioned as far as possible from the surgical electrodes when HF surgical equipment and physiological monitoring equipment are used simultaneously on a patient. Monitoring electrodes are not recommended. • Monitoring equipment incorporating high frequency current-limiting devices is recommended. • DO NOT remove the cover of the Controller. Refer servicing to qualified personnel. • DO NOT obstruct the exhaust fan (located at rear of Controller). • DO NOT touch the Controller’s fan and/or speaker while touching the patient. • Before each use, check that all Controller indicator lights and audio signals are functional. Make sure that the power cable plug is properly connected to the Controller receptacle. • To avoid risk of fire, only replace the Controller fuses with the same type and rating. • The ArthroCare Atlas System is designed to be operated exclusively as a unit. Only use accessories provided by ArthroCare.
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Controls, Indicators, and Alarms Controls & Indicators The Atlas Controller incorporates the following controls and indicators: FRONT PANEL 1. On/Off Switch This switch turns the AC power on and off. When the switch is on, green numbers will be visible in the Set Point Display Window. This display may remain active for up to 5 seconds following power turn-off. 2. Warning Indicator A red indicator illuminates and an audible alarm when a Controller-specific failure or malfunction occurs. 3. Foot Control / Hand Control Connected Indicator A green Foot Control / Hand Control Connector Indicator will illuminate when a Foot Control or Hand Control is properly connected. 4. Coagulation Activation Indicator A blue indicator will illuminate when the Foot Control/Hand Control Coagulation function is depressed with a Wand attached. 5. Wand Connected Indicator A green Wand Connector Indicator will illuminate when the Patient Cable and the Wand are properly connected. For an ICW, the Indicator will illuminate when the Wand cable connector end is properly connected to the Controller. 6. Set Point Adjustment Increment and Decrement Arrow buttons control the Ablation Set Point. This output level can also be adjusted from the Ablation Set Point Adjustment function on the Foot Control or the Hand Control. Refer to the Instructions for Use section of this manual for the corresponding voltage levels for each setting. 7. Set Point Display Window This display indicates the output level. A nominal setting will automatically be displayed when the System is powered up with a Wand attached or when a new Wand is connected. When the Controller is turned on, and prior to connection of a Wand, this display will show 0. 8. Ablation Activation Indicator A yellow indicator will illuminate when the Foot Control/Hand Control Ablation function is depressed with a Wand attached.
ArthroCare® Atlas™ System 13 User’s Manual
BACK PANEL 14. Tone Volume Control The Tone Volume Control regulates tone volume. To increase volume, turn the knob clockwise. To reduce volume, turn the knob counterclockwise. 15. Non-Ionizing Radiation Symbol This symbol indicates that this equipment intentionally emits RF energy during activation. 16. Fuse Rating Symbol This symbol indicates that only fuses with the appropriate rating should be used. Check the Controller back label for the appropriate fuse rating. See Maintenance and Troubleshooting section for fuse replacement instructions. 17. Power Cord Receptacle / Fuse Holder The Controller Power Cord plugs into this receptacle. The fuse holder is behind the receptacle. 18. Equipotential Ground Symbol This symbol identifies the conductor that is used to bond the equipment to earth ground. 19. CE Mark - European Certification Symbol This indicates compliance with the European Commission Medical Device Directive (93/42/EEC). 20. Attention Symbol This symbol alerts the user to read and understand this manual and accompanying instructions before operating the equipment. 21. Auxiliary Input For manufacturer use only.
Alarms 1. Intermittent dual tone: 2. Intermittent monotone:
current limit alarm or overload connection fault alarm (Patient Cable, Wand, Integrated Cable Wand, Over Temperature Condition, Over Power Condition)
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9. Foot Control / Hand Control Receptacle The Foot Control / Hand Control plugs into the tan receptacle located on the front of the Controller. 10. Symbol for Defibrillator-Proof Type BF Equipment This equipment provides a degree of protection against electric shock to TYPE BF applied parts as defined in IEC 601-1, it also has an F type applied part capable of withstanding the effects of defibrillator discharge. 11. Black Cable Receptacle The Cable Receptacle with the black ring will accept ICWs with black mating end. 12. Tan Cable Receptacle The Cable Receptacle with the tan ring will accept the reusable Patient Cable and ICWs with gray mating end. 13. Sliding Door This door slides left and right and allows access to either the Black Cable Receptacle or the Tan Cable Receptacle.
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Diagram of Controls, Indicators, and Alarms
ArthroCare® Atlas™ System 15 User’s Manual
Unpacking Verify that all items have been received and are not damaged. Damage should be reported at once to the Customer Service Department. Save all containers and packaging material; they will be required if it is necessary to return the equipment.
Assembly and System Check 1. Connect the Power Cord to the receptacle on the rear panel of the Controller. Connect the other end of the Power Cord to the electrical outlet. If it is necessary to use a Power Cord other than the one supplied with the System, the additional Power Cord should comply with appropriate electrical standards and be suitable for hospital use. 2. Turn the On/Off Switch on the front panel of the Controller to the ‘On’ position. The Set Point Display should indicate a setting of ‘0’. All other indicator lights should be off. 3. Attach the Foot Control or Hand Control to the tan receptacle on the front of the Controller. The Foot Control / Hand Control Connector Indicator on the front panel of the Controller should illuminate. 4. Depress the Ablation function on the Foot Control or the Hand Control. The red Warning Indicator on the front panel of the Controller should illuminate and the Controller should emit an intermittent monotone alarm. The yellow Ablation Activation Indicator on the front panel should be off. 5. Attach the Patient Cable to the left cable receptacle of the two cable receptacles on the lower left of the Controller. The Patient Cable and Wand indicators should not illuminate. No alarms should sound. 6. Attach an ArthroWand to the Patient Cable. The green Wand Indicator should illuminate. CAUTION: DO NOT contact metal objects with an activated Wand. CAUTION: DO NOT place active accessories near or in contact with flammable materials (such as gauze or surgical drapes). CAUTION: Electrosurgical accessories, which are activated or hot from use, can cause a fire. CAUTION: Accessory tips may remain hot enough to cause burns after the electrosurgical current is deactivated. CAUTION: Localized burns to the patient or physician may result from electrosurgical current carried through other instruments and conductive objects. 7. Taking care not to touch the Wand end, depress the Ablation (yellow) pedal of the Foot Control. The yellow Ablation Activation Indicator should illuminate. If the Controller does not function as described above, please contact Customer Service immediately.
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Unpacking, Assembly, and System Check
16 ArthroCare® Atlas™ System User’s Manual
Instructions for Use Operator Training Requirements The operator should be experienced in electrosurgical techniques. It is recommended that the user remain current with advances in orthopedic procedures. Additional training on the use of the ArthroCare Atlas System from an ArthroCare representative is recommended.
General System Operation Wands are activated using either the Foot Control or the Hand Control. The Foot Control and the Hand Control have three functions as described below: Ablation Activation Pressing the Ablation Activation function operates the Controller’s normal ablation mode and will activate the Wand. Coagulation Activation Pressing the coagulation function will activate the Controller’s preset coagulation mode. And will activate the Wand for hemostasis of blood vessels. Ablation Set Point Adjustment Pressing the Ablation Set Point Adjustment function will adjust the Ablation voltage level on the Controller. Each time the Ablation Set Point Adjustment function is pressed, the Ablation voltage level increases by one level up to the maximum set point for each Wand style. Once the maximum level for the connected Wand has been reached, the System will cycle back to Set Point 1. NOTE:
The Foot Control and Hand Control cannot be used simultaneously.
ArthroCare® Atlas™ System 17 User’s Manual
The voltage outputs correspond to the Set Point Displays as listed in the Table below. Depending the particular Patient Cable in use, the display corresponds to the output voltage in open circuit as follows: Tan Patient Cable Receptacle Display Output Voltage (Vrms ±10%) 1 100 2 125 3 150 4 175 5 200 6 225 7 250 8 275 9 300 C 70
Black Patient Cable Receptacle Display Output Voltage (Vrms ±10%) 1 100 2 129 3 158 4 186 5 215 6 244 7 273 8 301 9 330 C 70
When the Controller is first powered on with no Wand attached, the Set Point Display digit ‘0’ appears on the front panel display as a default setting. If a Wand is attached at or after power-up, the Controller will adjust the Display and voltage output to nominal settings. These settings will usually provide the best effect in most situations. NOTE: If a Set Point is selected outside of the default range (between the initial Set Point and maximum Set Point), proper activation of the Wand should be confirmed. Once a Wand has been properly connected, the voltage level can be increased or decreased by pressing the voltage level adjustment button located on the front panel. Ablation level can also be adjusted by pressing the Ablation set point adjustment function on the Foot Control or the Hand Control. The ablation setting levels may be adjusted to levels throughout the appropriate range, depending on the maximum voltage permitted by the particular Wand in use.
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Voltage Outputs
18 ArthroCare® Atlas™ System User’s Manual
System Preparation and Care System Preparation 1. Prior to each use, inspect the ArthroCare Atlas System for possible damage to the Controller Casing and cables. 2. Insert the receptacle end of the Power Cord into the Power Cord Receptacle located at the rear of the Controller. Insert the plug end of the Power Cord into an appropriately grounded electrical outlet. Position the Controller so that the exhaust fan located in the rear of the Controller is unobstructed and directed away from the patient. 3. Press the On/Off Switch on the front panel of the Controller to the ‘On’ (I) position. The Voltage Output Level Display should indicate a setting of ‘0’. All other indicator lights should be off. 4. Connect the Foot Control or the Hand Control to the gray Foot Control / Hand Control Receptacle on the front of the Controller. The Foot Control / Hand Control Connected Indicator (green) on the Controller front panel will illuminate. 5. a. If using the reusable Patient Cable, ensure that the Patient Cable has been cleaned and sterilized and that the connectors are dry before use. Slide the sliding door to the right and connect the Patient Cable to the tan Receptacle on the front of the Controller. Connect the appropriate Wand to the other end of the Patient Cable. NOTE: If sliding door has been removed, contact Customer Service. b. If using an ICW with gray mating end, slide the sliding door to the right and connect the ICW to the tan Receptacle. c. If using an ICW with black mating end, slide the door to the left and connect the ICW to the black Cable Receptacle on the front of the Controller. NOTE: Refer to each Wand Instructions for Use for specific instructions regarding surgical preparation and procedures. 6. Set appropriate Set Point Display required to obtain desired effects.