Common Failures and Maintenance Strategies of Medical Electronic Endoscopes

     Electronic Endoscope is a high-tech medical instrument that carries out medical examination, diagnosis or treatment by penetrating into the natural cavities of the human body or the artificial orifices opened by surgery. In recent years, the government has introduced a number of policies to encourage scientific and technological innovation, and with the continuous progress of social science and technology and the people's demand for doctors' diagnostic and treatment techniques, electronic endoscopy technology is also developing continuously. Compared with traditional endoscopes, electronic endoscopes are characterized by higher safety, stronger signal-to-noise ratio, more accurate diagnosis rate and lower traumatization. Due to its precise and complex structure, the prolonged use of electronic endoscopes is very likely to cause wear and tear of the equipment, which affects the normal diagnosis and treatment work in the clinic. In order to keep electronic endoscopes efficient and safe for a long time, the following summarizes the common failures of electronic endoscopes, and summarizes and analyzes the troubleshooting and preventive measures to enhance work efficiency and improve work quality.

Failure Analysis and Maintenance Strategies

Ⅰ. The Water Supply and Air Supply Poor Failure

Cause Analysis:    1. Nozzle failure is the main reason for poor water and air delivery, which is manifested as follows: First, residual body fluid, tissue, blood clots and other foreign matter dry up and lead to nozzle clogging; second, endoscopes fail to be cleaned in time after use, or impurities enter the nozzle in the process of cleaning and lead to clogging; third, the direction is wrong when wiping the charge coupled device (CCD); fourth, the operator does not operate according to specifications, which leads to nozzle deformation and causes poor water and air delivery. Third, when wiping the Charge Coupled Device (CCD), the direction is wrong, resulting in impurities into the nozzle; Fourth, the operator does not operate in accordance with the norms of the deformation of the nozzle caused by the delivery of water to send gas is not smooth.

                             2. Negative pressure suction inhalation of large volume of body fluids or blood clots resulting in poor water and air supply.

                             3. Water and air button or suction button sealing ring wear and tear caused by water supply and air supply.

Maintenance Strategy: 1. After the use of electronic endoscopes should be timely, standardized cleaning and disinfection to prevent protein coagulation, and if necessary, pressure dredging.

                             2. Carefully check the airtightness of the water vapor button and the suction button sealing ring before use, and carry out regular maintenance.

                             3. The operator should be careful and standardized operation.

                             4. When wiping the CCD lens, it should be wiped in the opposite direction to the nozzle.

Ⅱ. The Endoscope Into the Water Fault

Cause Analysis:

Bending Part:     1. The bending part was damaged because the patient was not given a mouth cushion during surgery.

                           2. The aging of the bending parts of the electronic endoscope is not found in time.

                           3. Cleaning personnel use gauze to vigorously scrub the bending part, or make the bending tube come into contact with the biopsy forceps and the sharp metal part of the connecting part, resulting in pinholes or overlapping of the bending parts, and cleaning at this time is very likely to cause failure of the internal parts.

Insertion Part: The presence of pinholes in the pliers piping leads to water ingress into the endoscope. Specific reasons are: releasing needles in the pliers pipeline, bending angle is too large when passing the attachment; apex pliers are misaligned; inserting and pulling in the state of open needles; bending of positioning needles and so on.

Operation Part: Remote control button leakage, knob leakage. Specific causes are: sharp part of the electronic endoscope pierces the button and knob; when cleaning and taking, the button and knob of the endoscope collide with hard objects in the periphery.

Maintenance Strategy: 1. Relevant personnel should operate in strict accordance with the standardized procedures, and the cleaning and disinfection procedures must be correct.

                        2. Endoscopes should be placed separately to avoid being mixed with other instruments and subjected to pressure.

                        3. Wiping personnel should use gauze or paper towel dipped in appropriate amount of cleaning solution to gently wipe from the operation part.

                        4. close the biopsy forceps before inserting or removing.

                        5. make sure the biopsy forceps are functional and undamaged before applying them.

                        6. Train to use the correct grip to avoid collision between the button and hard objects in the vicinity.

                        7. Improve the specification of endoscope cleaning, and recommend that side leakage detection is required before each case of endoscope cleaning. If water ingress endoscopes are found, they should be contacted and sent for repair, and should not be continued to be used.

Ⅲ. The Angle of False Position

Cause Analysis: Improper method during operation; internal steel wire aging.

Maintenance Strategy: Operators should be strictly trained and assessed after the onboarding practice, the operation process must be rigorous and serious; if you find a problem, please contact the manufacturer in a timely manner for maintenance.

Ⅳ. Suction Failure

Cause Analysis: 1. The suction part is worn and chipped, resulting in a loss of airtightness.

                        2. The suction button is damaged.

                        3. Incorrect extraction method.

Maintenance Strategy: 1. Check the integrity of the suction button and test the suction function before use.

                        2. Replace the suction button if it is damaged. 3.

                        3. Do not forcibly pull out the attachment. The correct method is to hold the attachment underneath with the fingers and then pull it out horizontally.

V. Brightness Adjustment Failure

Cause Analysis: 1. Priority check containing light source bulb failure.

                         2. The line connection is not solid or false connection.

                         3. Signal line overheating: signal line is connected for a long time, line aging problem.

                         4. signal line broken or host failure.

Maintenance Strategy: 1. General cold light source xenon lamp life of about 500h, more than 500h must regularly check the brightness of the light source, the lack of brightness needs to be replaced in a timely manner.

                        2. Check the wiring connection in advance, or re-weld the camera and wire connections. 3.

                        3. Damaged wires should be replaced in time.

                        4. Pay attention to the protection of the line body at ordinary times, if necessary, add a protective sleeve to prevent the line from being crushed on the ground or dead-end problems.

                        5. Before using the endoscope, you should check whether the dimming function is normal.

Conclusion: In 2018, the U.S. Institute of Emergency Medicine listed electronic endoscopy as one of the 'Top 10 Clinical Risk Programs'. Subsequently, the National Health Commission and national tertiary hospitals also included endoscopic technology in the category of high-risk technology. The application of electronic endoscopy in clinical practice has always been both efficient and risky. The above summarizes the causes of failure and suggests preventive methods for future maintenance to extend the service life.

                   Electronic endoscopes are designed to be precise, and hospitals should strengthen the training and assessment of all the staff in the departments that use them, so that they should be aware of the common failure manifestations and preventive methods, and set up and arrange for the management of specialists, so as to minimize the economic losses caused by improper operation and other human factors. At the same time, endoscope cleaning and disinfection specifications should be updated in a timely manner, and the management of endoscope cleaning and disinfection personnel should be strengthened, so as to achieve the accountability management system that every link knows and every patient executes, and to maximize the service life of endoscopes.

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