Ethicon Echelon Flex PCEE45A Manual Del Usuario página 9

Clinical Section
Examples of procedures in which linear cutters and staplers may be used include:
General
• Anastomoses
• Partial Gastroplasty
• Appendectomy
llustrations and Nomenclature (Illustration 1)
1. Closing Trigger
2. Red Firing Trigger Lock
3. Firing Trigger
4. Anvil Release Button
5. Battery Pack
6. Battery Pack Release Tab
7. Manual Override Access Panel
Instructions for Use
Prior to Using Instrument
Verify that the reload size matches the instrument size to be used (e.g. use an ECHELON ENDOPATH 45 mm Reload with Gripping
1
Surface Technology reload with an ECHELON FLEX™ 45 Powered Plus instrument).
Become familiar with the articulating action of the instrument by pulling on the fins of the rotating knob with the index finger and
2
articulating the jaws with the other hand (Illustration 2). As lateral pressure is applied in either direction, the jaws pivot to a maximum
angle of 45 degrees, at which point the pivoting force increases to signal the end of the articulating arc. Maintain the lateral pressure
while releasing the rotating knob to lock the angle of the shaft. After locking the jaws, release the lateral pressure. The jaws will also lock
at approximate 15 and 30 degrees by releasing the rotating knob before the end of the articulation arc. To return the jaws to the straight
position, pull on the fins of the rotating knob to release the lock; the jaws will return automatically.
Verify compatibility of all instruments and accessories prior to using the instrument (refer to Warnings and Precautions).
3
Preparing the Instrument for Use
Using sterile technique, remove the instrument, battery pack, and reload from their respective packages. To avoid damage, do not flip the
4
instrument, battery pack, or reload into the sterile field.
Install the battery pack. The battery pack must be installed prior to use. Insert the battery pack by lining up the release tabs on the battery
5
pack with the slots on the rear of the instrument. It can be inserted in either orientation; there is no up or down (Illustration 3). Ensure
battery pack is fully inserted into the device. An audible click will be heard when the battery pack is fully inserted.
Caution: The instrument must be used within 12 hours of inserting the battery pack. Refer to the Battery Pack Disposal section for
battery pack disposal instructions.
Prior to inserting the reload, ensure the instrument is in the open position (Illustration 1).
6
Examine the reload for the presence of a staple retaining cap. If the retaining cap is not in place, discard the reload.
7
Caution: Tissue thickness should be carefully evaluated prior to using the instrument. Refer to the Reload Product Codes Table for
proper reload selection.
Caution: Selection of the appropriate staple reload should be based upon the combined thicknesses of both the tissue and the staple line
reinforcement material. The use of staple line reinforcement material with the instrument may require an increased force to close and may
reduce the number of times the device may be fired. When using staple line reinforcement material, the instructions of the manufacturer of
the material should be followed.
Insert the reload by sliding it against the bottom of the reload jaw until the reload alignment tab stops in the reload alignment slot. Snap the
8
reload securely in place. Remove the staple retaining cap and discard (Illustration 4). The instrument is now loaded and ready for use.
Caution: After removing the staple retaining cap, observe the surface of the new reload. The reload must be replaced with another reload
if any colored drivers are visible. (If colored drivers are visible, the reload may not contain staples.)
Using the Instrument
Close the jaws of the instrument by squeezing the closing trigger until it locks in place (Illustration 5). An audible click indicates that
9
the closing trigger and the jaws are locked. When the jaws of the instrument are closed, the red firing trigger lock and firing trigger are
exposed.
Caution: Do not pull the red firing trigger lock or firing trigger at this time. The instrument may be partially or completely fired and will
need to be reloaded before using on tissue.
Visually inspect the stapler to ensure proper reload seating. Introduce the instrument into the body cavity through a trocar of the
10
appropriate size or through an incision (Illustration 6). When using a trocar, the instrument jaws must be visible past the trocar sleeve
before opening the jaws.
Caution: For insertion and removal of articulating instruments, the jaws of the instrument must be straight, parallel to the shaft of the
instrument. Failure to have the instrument jaws in the straight position will result in difficult insertion or withdrawal of the instrument and
may result in damage to the instrument.
Caution: When placing the instrument through the trocar or incision, avoid inadvertently pulling the red firing trigger lock and the
firing trigger. The instrument may be partially or completely fired and will need to be reloaded before using on tissue. If the instrument
is partially fired, remove the instrument and slide the knife reverse switch forward to return the knife to home position (Illustration 7).
To open the jaws, squeeze the closing trigger, then simultaneously press the anvil release button on either side of the instrument
(Illustration 8a). While pressure is still on the anvil release button, slowly release the closing trigger (Illustration 8b). Remove the
reload and insert a new one (see Reloading the Instrument). If the instrument is fired completely, the knife will return to home position
automatically. Remove the instrument and insert a new reload (see Reloading the Instrument).
Gynecologic
• Vaginal Hysterectomy
8. Knife Reverse Switch
9. Rotating Knob
10. Articulation Fins
11. Reload (Cartridge)
12. Reload Gripping Surface
13. Reload Alignment Tab
14. Reload Alignment Slot
Urologic
• Nephrectomy
• Cystectomy
15. Staple Retaining Cap
16. Anvil Jaw
17. Reload Jaw
18. Staple Line
19. Cut Line
20. Proximal Black Line
21. Knife Blade Indicator
2
Thoracic
• Lung Resection and Biopsy
• Pulmonary Wedge Resection