At present, laparoscopic surgical treatment is carried out more and more widely. It is an effective minimally invasive treatment with less trauma, less pain, less interference with abdominal organs, and faster postoperative recovery. A complete set of laparoscopic system including cold light source, camera system, optical scopes, surgical instruments and pneumoperitoneum machine and other equipment"
2 System Composition and Working Principle
2.1 Cold light source
Cold light source for the laparoscopic system to provide illumination, because of the use of halogen or xenon bulb filled with high color temperature, energy distribution concentration, the proportion of blue radiation increased, the color of light cold, so called cold light. Therefore, it is called cold light source, now the cold light source more use of gas lamps, which is different from halogen lamps, there is no filament, is the use of discharge between the two poles to produce an arc and light-emitting, color temperature is higher (up to 6000 K), the service life is longer (up to 500h or so).
2.2 camera system
The camera system is generally composed of a camera control host, camera, coupler and connecting lines, of which the most central part is the camera on the optoelectronic coupling device, that is, the CCD (charge couple device). CCD's working principle is: the object to be photographed reflected light, spread to the lens, through the lens to focus on the CCD chip. CCD according to the intensity of light accumulation of the corresponding charge, and periodic discharge, resulting in an electrical signal on behalf of the picture, and then filtering, amplification and other processing, the output video signal to the monitor. Single CCD (also known as single-chip) camera system pixel is low, 3CCD (also known as tri-chip) camera system pixel is high, is the current mainstream products.
2.3 Pneumoperitoneum Machine
The pneumoperitoneum machine is connected to a cylinder of carbon dioxide gas, and gas is injected through the pneumoperitoneum needle to inflate the abdominal cavity, creating enough surgical space for the surgeon to operate and ensure that the surgery is safe and smooth. The pressure preset value is selected according to the actual situation during the operation. When the pressure in the abdominal cavity is lower or higher than the preset value, the pneumoperitoneum machine can automatically start or stop gas injection. The pneumoperitoneum machine has a safe airway module system including 3 sets of valves (regulating, drain and output valves) and multiple sensors (pressure, flow, fluid, temperature, etc.).
3 Troubleshooting and Routine Maintenance
3.1 Cold Light Source Troubleshooting and Maintenance
The Stryker X7000 Cold Light Source worked for a period of time with no light output, and the fault reappeared shortly after replacing the bulb. The bulb can be lit and work normally for a period of time, indicating that the cold light source parts of the connection is normal, there is no hardware failure. The light source has three fans inside the heat exhaust, inside the temperature control sensor. If the use of time and ventilation is not good, more than the upper limit of temperature control, the machine will stop working on its own, after a period of stagnation and then open the opportunity to normal. To the operating room site view, found that the cold light source exhaust port clogging, cleaning and use for a period of time, and then there is no such failure. Visible, the need to strengthen the daily cleaning and maintenance, regularly open the cover to clean up: and pay attention to the use of cold light source on the ventilation of a spacious location, do not close to the wall or with other equipment piled up together.
Stryker x7000 cold light source light output is not stable, when the light is off cold light source host on the front panel of the bulb time display, after checking the bulb time has been more than 500 h. Remove the bulb to see, found that the wick in the middle of the gray and black flocculent. Although the bulb is not completely damaged, but has affected the normal lighting of the laparoscopic system. Replace the bulb with a new one and the problem is solved. In daily use, pay attention to the life of the bulb. When close to the use of the limit, it is necessary to timely replacement of new parts to ensure the normal operation of the whole set of equipment? Stryker X7000 cold light source does not light up after power on or can be seen flashing and accompanied by "popping" continuous sound, generally the internal high-voltage module is damaged, can not output a high voltage to penetrate the bulb to light up. Replace the high-voltage module, the problem is solved.
3.2 camera system troubleshooting and maintenance
The use of Stryker 988i camera system, the image has a diagonal ripple interference, which is due to high-frequency equipment, such as high-frequency electric knife electromagnetic interference caused by. Usually, the camera system control host and video cable has a good shielding effect, but when the video cable aging or shielding layer is damaged, the above phenomenon of diagonal ripple clutter will occur. Replacing a new video cable with a good quality one can solve the problem.
With the Stryker 988i camera system, when the camera is moved intraoperatively, the image has a ripple noise interference. This is caused by a weak connection or broken wire in the hard or soft part of the camera cable. Replacing the cable with a new one will eliminate the problem. In the daily use of the camera, pay attention to the soft approach, and make the connection line naturally drooping, to avoid bending and twisting, and more can not be crushed with a cart called.
In addition, after the operation, pay attention to clean the gap between the camera and the coupler to avoid dirt and moisture, always keep it clean and dry. Only in this way can we ensure the clarity of the image
3.3 Troubleshooting and maintenance of the pneumoperitoneum machine
The Stryker 201. high-flow pneumoperitoneum machine reported an E22 "error, the pneumoperitoneum machine stopped working. By checking the manual, it was a "valve error" fault. First of all, a number of calibration debugging program, the results of the calibration can pass. The result was that all calibrations passed. It was then decided that replacing the solenoid valve would solve the problem. Replacement of the solenoid valve, troubleshooting.
Stryker 20L. High-flow pneumoperitoneum machine reported "E21" error, pneumoperitoneum machine stopped working. To the operating room site straight look found that the position of the pneumoperitoneum machine placed below the bed surface (the patient's abdomen). When the pneumoperitoneum machine stops gas insufflation, due to the abdominal pressure is higher than the internal pressure of the pneumoperitoneum machine, part of the abdominal pressure release, so that some intraoperative fluid from high to low easily into the pneumoperitoneum machine, contamination of the equipment, resulting in this failure. Replace the machine, remove the cover, and clean the internal piping, especially the liquid-phase sensor. Then use the software to restore and calibrate. After testing the machine, it was found that the problem was still not solved, which proved that the contamination was more serious. So, replace the liquid-phase sensor, and then use the software recovery and calibration, troubleshooting.
In short, the usual use of the pneumoperitoneum machine, to choose high-quality medical carbon dioxide gas source, purity is higher than 99.99%, and the pneumoperitoneum machine placed in a position higher than the surface of the surgical bed, to ensure that the air outlet is clean.
4 Summary
Long-term maintenance experience tells us that 60% of the failures of the laparoscopic system are simple failures, most of which are caused by improper use or operational errors. Therefore, we must master the working principle of the equipment, strictly abide by the operating procedures, and do a good job of daily cleaning and maintenance in order to reduce the failure rate and improve the efficiency of use".