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Problems with the arthroscopic tower equipment
1. Problems with the Arthroscopic Tower
A.Catherine Claudepierre, Celine Bardet,
M. Pierre Plumet,
Isabelle Zakk (sté Arthrex)
&
Dr. Pascal Gleyze
Dr Tasos Deligeorgis
What to do?
Hôpital Albert Schweitzer, COLMARCenter for Shoulder Arthroscopy
IASO General Hospital
Athens, Greece
Head Manos Antonogiannakis
2. Create a reaction protocol for every possible malfunction.
The principle of aviation :
1st Record, Predict, and Describe All the cases
2nd Each person should know what to do in each case
3rd Each possible scenario should have a reaction protocol
4th For every material that might have a problem there must be at least 1 replacement
Example: Engine malfunction: Reaction of Pilot/Copilote/Navigator/Technician
3. Joyeux bordel
The principles of the Operating Theatre.
“We do everything we can with the persons present…
that know.. or might not know!”
Ex :
1st Monitor-Screen malfunction
2nd Problems with the hand piece
3rd Problems with the recording/printing
device
6. 1°Video in sockets : rgb (red green blue with synchronization), yc et bnc et HDMI with
the possibillity to change channels.
2° Power supply from tower or wall socket
3°Possibility to choose the channel (switch or menu or automatic).
4° Image settings menu
The Screen
THE EQUIPMENT
7. The screen: Video in
Sockets
1°Video in sockets : rgb (red green blue with synchronization), yc et
bnc et HDMI with the possibility to change channels.
8. 2° Power Supply from current transformer
on the tower or wall socket
The Screen:
The Power Supply:
9. Menu of image settings.Choose channel
3°Possibility to choose the channel (switch or menu or automatic).
4° Image settings menu
The Screen: Choose Channel + The Menu
22. - With Recorder : arthroscope => Camera Head => Camera Control Unit =>
Recording/Printing System => Monitor
- Without Recorder : As above without the Recording/printing System
(The 2 Circuits can be simultaneously connected to 2 different monitor inputs )
2) Image Circuit
27. MALFUNCTIONS
1) The Surgeon manages the situation (important …)
2) The Surgeon has to pinpoint the malfunction
3) The faulty circuit must be identified
4) Finally , the faulty circuit element is diagnosed
Keep the faulty circuit under close surveillance!
Course of Action:
28. THE MALFUNCTIONS: General Malfunction
1) Nuclear Bomb???
2) Power supply ( Wall Socket )
3) Power Supply ( Tower Socket)
4) UPS ( Anti-Surge) Malfunction ?
GENERAL MALFUNCTION(Systemic unresposiveness)
29. The Malfunctions: Image Circuit
1. Test the screen circuit
2. Test the input cables in the back ( RGB etc..) (Are they properly connected ?
3. Recording system: is it on? Are the cables connected correctly?
4. Is the camera control unit connected properly?
5. Make sure that the light source is switched on (standby button)
6. The arthroscope state. Anything interfering with the view?
Does the screen work?
? ? ?
30. Malfunctions: The Screen circuit
1°Connections and Power supply ok?
2° Intensity of cold light ok?
3°Cable of cold light proprly connected?
4°The quality of the viewer?
5°Cable quality?
6°Lamp working hours (diminishes after 500h )
7°Camera protection sheeth entraped between viewer and camera head?
8°Camera head not clean?
No Light?
31. THE MALFUCTIONS: The image Circuit
1° Too Yellow? You have to do white balance on a white gauze
2° Everything Red : (In the following order))
Too much bleeding?
Ask the anaesthesiologist if the Blood Pressure is too high? appeler un vasculaire
Call a vascular surgeon
3° Check the cable connections
4 If there is no solution rebout to factory setting from
the menu button
5° Call the Company representative
6 Change the tower if no solution in a few minutes
IMAGE DEARRENGEMENT
32. THE MALFUNCTIONS : The Screen Circuit
Test both endings of the auxiliary camera cable while
monitoring the screen..
INTERFERENCE ?
Nb : It is highly important that the cable is stored wrapped around the pedals (see screen) to avoid unnecessary cable wearing
33. THE MALFUNCTIONS : WATER CIRCUIT
Check the Circut :
- Is the water bag full and the valve open ?
- Are the clamps loose enough ?
- Is there water running through the pump ?
(ask the surgeon tactfully..)
NO WATER ?
? ?
34. THE MALFUNCTIONS : Water Circuit
1° Clamp too tight , folded tubes , pump not configured properly
- Check the Circuit
- If the pump is faulty , call the Company
- 2° Check if changing the pump level relieves the pressure problem
THERE IS NO PRESSURE ?
35. THE MALFUNCTIONS : Shaver Circuit
Is the console connected to the power supply and the switch in the ‘’ON’’ position ?
- Check the cable connection on both ends ( Console + Main Instument)
- Is the shaver end Connected properly-
- - Listen to the sound of the instrument to check for probable motor malfunction
- If connection to the power supply checks out OK : we change both the cable and the main insturment , then
after the surgery we check the cable and the main instrument (if detachable)
Not Working?
Proper cable storage is of UTMOST importance!
36. THE MALFUNCTIONS : The shaver Circuit
- Check cable connections (console/main instrument)
- Check cable connections (pedals)
- If the console buttons respond properly = Pedal Malfunction
- If the console buttons don’t respond = Console Malfunction
Intermittent function ?
Importance du bon rangement des cables
37. THE MALFUNCTIONS : Coagulation Circuit
ΟΙ ΒΛΑΒΕΣ: κύκλωμα πήξης
1° power supply/ON/OFF switch
2°Check cable connections
IT DOESN’T WORK ?
Proper cable storage is of UTMOST importance
38. THE MALFUNCTIONS : Coagulation Circuit
1°Check cable connections on both console AND pedals
Intermittent function ?
39. CONCLUSION
1° Identify the exact malfunction
2° Identify the responsible circuit (power supply / screen / water / main instrument / coag
3° Identify the exact cause of the malfunctioning circuit
4° FIX / REPLACE THE FAULTY PART
5° > 5min : CHANGE THE WHOLE TOWER
Keep
Calm!!
