Endoscope Maintenance And Care

Rigid endoscopes are currently the most convenient, direct, and effective medical instruments for medical personnel to observe internal lesions and tissues. They offer advantages such as high image clarity and realistic colors, and are easy to operate. With the expanding use of rigid endoscopes, doctors across various departments are using them more frequently. Rigid endoscopes are relatively delicate medical instruments and are easily damaged. The following is an introduction to the use, maintenance, and care of rigid endoscopes to help medical personnel better utilize this instrument and extend its lifespan.

 

Basic Structure of Rigid Endoscopes

To use a rigid endoscope correctly, one should understand its structure. Although the optical paths and appearances of products from various rigid endoscope manufacturers worldwide differ, their basic structure is consistent: consisting of a working endoscope tube, structural components, an eyepiece, and a fiber optic interface. The main structural components, eyepiece, and fiber optic interface are generally not easily damaged except by severe impacts. The most easily damaged part is the working endoscope tube. Taking a φ4mm rigid endoscope as an example: the working tube mainly consists of four parts: the outer tube, the inner tube, optical lenses, and optical fibers. The optical lenses are housed in the inner tube to form the optical system, while the optical fibers are placed between the inner and outer tubes for illumination. The outer tube is a 0.1mm thick φ4mm stainless steel tube, which is easily deformed by impacts or pressure. Most of the optical lenses are glass cylinders approximately φ2.8mm in diameter and 25mm in length; even slight impacts or pressure can cause cracking, chipping, or optical axis misalignment. Blurred vision and darkened edges in endoscopes are often due to these reasons. The optical fibers are made of extremely fine optical glass; a single φ4mm endoscope requires more than 1500 fibers. External force inside the outer tube can cause fiber breakage, affecting illumination. The connections between the various components of a rigid endoscope are mostly bonded with epoxy resin adhesive; the quality of the adhesive and the encapsulation technology also affect the endoscope's lifespan. Although rigid endoscopes are delicate, they will not be damaged if used and maintained correctly.

Maintenance of Rigid Endoscopes

 

1. Precautions During Use
Damage to rigid endoscopes during surgery is rare. Although they may come into contact with and bump against tissues such as muscles, mucous membranes, and bones, these bumps are minor and will not damage the endoscope, as it is only for observation and not a point of force for other instruments. However, when using other instruments, especially forceps and scissors with strong biting force, care should be taken to ensure that the tip of the endoscope tube does not enter the biting area of ​​the instrument to avoid accidental injury to the endoscope tube. Sometimes, when using these instruments, surgeons may insert the endoscope very close to the tissue in order to see the biting area clearly, and if the endoscope does not retract when the instrument bites, it can be accidentally injured. Such accidents can be avoided by ensuring that the entire biting area of ​​the instrument is within the observation range of the endoscope during surgery.

Some surgical endoscopes are used inside a sheath. When changing to other angles of the endoscope or inserting/removing instruments, care should be taken to be gentle and avoid excessive force. Especially during the insertion and removal of the endoscope, if resistance is encountered and it cannot be pulled out, the cause should be carefully investigated. If necessary, the sheath should be removed along with the endoscope; brute force should not be used. When the endoscope is used in conjunction with laser vaporization, high-frequency electrocautery, microwave, or other photoelectric technologies for surgery, attention should be paid to the distance between the tip of the endoscope and the treatment point to ensure that the tip of the endoscope is not electrocuted or burned. When using these instruments for the first time, the surgeon should practice repeatedly to master the relationship between the object distance in the endoscopic image and the actual object distance, and confirm the closest distance between the tip of the endoscope and the treatment point so as to use them freely in actual surgery. Currently, shaving tools are widely used in clinical surgery in otolaryngology and orthopedics to remove diseased tissue. Their blades are sharp, hard, rotate quickly, and have a large torque; if they cut into the endoscope, the endoscope will undoubtedly be damaged. In such surgeries, it is important to adjust the irrigation and suction speeds to ensure the endoscopic image remains clear and unobstructed by blood. Keep the rotating part of the blade within the endoscopic's field of view at all times. When the surgical area is large, stop the blade rotation first, then move the endoscope, and then move the blade under endoscopic monitoring until it reaches the appropriate location before resuming the planing. If you notice any abnormality in the planer's operation or a sudden decrease in illumination, the endoscope may be damaged and should be replaced immediately to avoid further damage. For important surgeries, a spare endoscope and key instruments should be available for immediate replacement if problems arise. Using an inappropriately angled endoscope or incompatible instruments during surgery can easily damage the endoscope.

 

2. How to Maintain a Rigid Endoscope Rigid endoscopes should be stored by designated personnel in a dedicated cabinet within a special packaging box lined with soft sponge or polyurethane foam. All endoscopes and surgical instruments should be neatly stacked and not overlapped. Ensure the box lid is closed to prevent the endoscopes and instruments from colliding during transport. Because the endoscope tube is very thin, it can easily bend and deform due to pressure, impacts, bending, or dropping, leading to lens damage or optical axis misalignment, resulting in unclear images or rendering the endoscope unusable. Therefore, when removing or placing a rigid endoscope from its packaging, hold it gently with both hands, and never lift or pull it out by a section. When moving the endoscope within a hard container such as a tray, keep it separate from other instruments and avoid excessive jostling to prevent damage. A desiccant should be provided in the packaging to keep the inside of the box dry.

Ordinary rigid endoscopes are not resistant to high temperatures and pressures, mainly because the sealing adhesive deteriorates and deforms at high temperatures, causing the endoscope to come unglued and water to enter. Therefore, boiling and high-pressure steam sterilization methods should not be used. Most damage to rigid endoscopes is caused by improper maintenance, impacts, or dropping. In some cases, problems with the sealing adhesive, sealing technology, or sealing structure from certain manufacturers can also cause water ingress and adhesive ungluing, but these are repairable. Although rigid endoscopes are delicate medical devices, they are not prone to problems during normal clinical surgeries or observations. As long as they are used correctly, carefully maintained, and meticulously cared for, doctors can use them with confidence, and rigid endoscopes will achieve their maximum benefits.