APC 2 Quick Guide Feb 2005

Combination of APC 2 and HF electrosurgical units in the VIO D / VIO S series You can only operate the APC 2 together with an HF electrosurgical unit from the VIO D / VIO S series. You can control most of the functions of the APC 2 on the display of the HF electrosurgical unit. Please also read the User Manual for the VIO HF electrosurgical unit.

Operation of the APC 2 with an HF electrosurgical unit from the VIO D series Switching on the unit, performance test GO

Switch on the unit with the power switch.

The unit conducts a performance test and checks all the receptacles. Connected units and footswitches are recognized. All the pilot lamps and Focus buttons are lit. The version number of the software appears on the display.

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Select program You can see a selection list of programs (1).* If you press the Up / Down buttons (2) and more than 4 programs are stored, the window scrolls through the program selection list. The active program has a green mark. GO Press the selection button opposite the required program. Example: program xy.

Window Select program

Connect instrument GO

Plug your APC instrument into the APC receptacle (1).

APC receptacle

* Or the window Guide depicted on the left. You can set the start screen in the service programs of the VIO.

APC 2 with VIO D: Switching on, selecting a program, connecting an instrument

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Focus View The instrument recognition system recognizes the APC instrument. The VIO user interface is automatically set to the Mode, Effect, Flow, and Power Limitation that are stored in the selected program. You can use the settings. However, you can also change the settings. You only ever see the CUT settings (1) and COAG settings (2) of a receptacle. APC receptacle can be seen on display. The Focus button (3) next to the APC receptacle is lit. Activation by footswitch Window CUT / COAG Settings, APC receptacle

The program contains a stored setting to indicate which CUT / COAG mode has to be activated with which footswitch. How can I see the assignment of the footswitches? Example: In the window Cut / Coag Settings you will see the APC receptacle. The assigned yellow and blue pedals are highlighted on the display. On the APC receptacle the yellow and blue pedals of the dual-pedal footswitch (1) are lit. You can activate the CUT and COAG functions of the APC receptacle using the dual-pedal footswitch. Activation by fingerswitch Do I have to set anything on the VIO? No. If you have connected an instrument with a fingerswitch to the APC receptacle, you can also activate CUT and COAG modes by fingerswitch

Window CUT / COAG Settings, APC receptacle

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How do I change the mode? Example: Coag Mode. GO

Press the selection button next to the menu item Mode.

Window CUT / COAG Settings, APC receptacle

You switch to the window Select Coag Mode. On the left-hand side you will see a selection list of modes (1). If you press the Up / Down buttons (2), the window scrolls through the selection list. You can also press the selection button next to the menu item Other Modes. The active mode has a green mark. Press the selection button next to the required Coag Mode (example: PULSED APC). You return to the window Cut / Coag Settings. GO

If you wish to deactivate the COAG mode of the receptacle, choose COAG on the selection list. Window Select Coag Mode, APC receptacle

APC 2 with VIO D: Focus View, activation, setting the mode

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How do I change the Effect? GO

Press the selection button next to the menu item Effect. You switch to the window Select Coag Effect.

You will see a numeric display of the Effect (1) and a display in the form of a bar chart (2). A graphic (3) shows the impact of the Effect on the tissue. GO Select an Effect with the Up / Down buttons (4) (example: Coag Effect 1).

Confirm the selection by pressing the Enter button (5) or by pressing the selection button next to the menu item Back. You return to the window Cut / Coag Settings.

Window CUT / COAG Settings, APC receptacle

Window Select Coag Effect, APC receptacle

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How do I change the Flow? In the window Select Coag Effect press the selection button next to the menu item Flow. GO

You switch to the window Select Gas Flow. You will see a numeric display of the Flow (1) and a display in the form of a bar chart (2). A graphic (3) shows the residual amount of argon in gas bottle. GO Select a Flow with the Up / Down buttons (4) (example: 1.9 l/min).

Window Select GasFlow, APC receptacle

Confirm the selection by pressing the Enter button (5) or by pressing the selection button next to the menu item Back. You return to the window Cut / Coag Settings.

APC 2 with VIO D: Setting Effect, setting Flow

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How do I change the Power Limitation? GO

Press the selection button next to the menu item Max. Watt.

You switch to the window Coag Power Limitation. The selection of Power Limitation is for the patient’s safety and protects the instrument against damage. You will see a numeric display of the Power Limitation (1) and a display in the form of a bar chart (2). GO Select a Power Limitation using the Up / Down buttons (3) (example: 50 W).

Confirm the selection by pressing the Enter button (4) or by pressing the selection button next to the menu item Back. You return to the window Cut / Coag Settings.

Window CUT / COAG Settings, APC receptacle

Does the VIO support me with help texts? Yes. In every window where you see an Info button you can get help. GO Press the selection button next to an Info button. Scroll through the text field using the Up / Down buttons. You can also press the selection button next to the menu item Other.

Window of VIO information Window COAG Power Limitation, APC receptacle

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Operation of the APC 2 with an HF electrosurgical unit from the VIO S series Switching on the unit, performance test

ERBE

GO

300 S

+

The unit conducts a performance test and checks all the receptacles. Connected units and footswitches are recognized. All the pilot lamps and Focus buttons are lit. The version number of the software appears on the display.

+ Effect

Effect

+

CUT

+

COAG

max. Watts

max. Watts

Switch on the unit with the power switch.

F

Select program

2

You see the program selection window with a program selection list (1).*

1

With the right-hand upper and lower selection buttons (2) you can scroll through the selection list until the required program is backlit. In order to select the program that is currently backlit, press the right-hand center selection button. GO

2 Program selection window

The CUT-COAG window appears on the display. The CUT-COAG window shows the program settings of the focused (selected) receptacle (in this case the program settings of the Bipolar receptacle by way of example).

1

* Or the CUT-COAG window of the currently focused receptacle (see bottom illustration). You can set the start screen in the service programs of the VIO. CUT-COAG window of the Bipolar receptacle

APC 2 with VIO D: Select Power Limitation, help texts / APC 2 with VIO S: Switching on, selecting a program

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APC

Connect instrument

1

GO

APC

2

Plug your APC instrument into the/an APC receptacle (1). The LED (2) of the APC receptacle is lit.

Prog/ 2 Setup

+

5

HIGH 3CUT 4

Effect

+

MONOPOLAR

3

FORCED COAG

5

4

+

Effect

6

Checking the settings

6

CUT

The instrument recognition system recognizes the APC instrument. The VIO user interface shows the settings stored in the selected program for the instrument: Modes (3), Flow levels (4), Effects (5) and Power Limitations (6). You can use the settings. However, you can also change the settings.

+

COAG

max. Watts

max. Watts

Check the settings and change them if required (see the following pages). GO

VIO user interface: Modes (3), Flow levels (4), Effects (5), Power Limitations (6)

Activation by footswitch The program contains a stored setting to indicate which CUT / COAG mode has to be activated with which footswitch. 1

How can I see the assignment of the footswitches?

CUT-COAG window of the APC receptacle APC

2

Footswitch assignment of the APC receptacle is indicated in the CUT-COAG window of the focused APC receptacle at top right (1) and at the APC receptacle below the Focus button (2). An assigned footswitch pedal is highlighted on the display or is lit on the receptacle display. In the illustrated example the yellow and blue pedals of the dual-pedal footswitch are assigned to the APC receptacle. This means you can activate the CUT mode of the APC receptacle with the yellow pedal and the COAG mode with the blue pedal.

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Activation by fingerswitch Do I have to set anything on the VIO? No. If you have connected an instrument with a fingerswitch to the APC receptacle, you can also activate CUT and COAG modes by fingerswitch. How do I change the mode? Example: Cut Mode. GO

Press the left-hand center selection button. You switch to the first page of the CUT mode window.

With the left-hand lower selection button (1) you can switch to the second page of the CUT mode window. CUT-COAG window of the APC receptacle GO Press the selection button next to the required CUT Mode (example: argon-supported DRY CUT Mode). You return to the CUTCOAG window.

If you wish to deactivate the CUT mode of the receptacle, select the setting CUT OFF (on the second page of the CUT mode window). 1

CUT-Mode window (first page)

How do I change the Effect?

+

GO Select an Effect with the +/- buttons next to the CUT / COAG effect display (example: CUT Effect 5).

Effect

How do I change the Power Limitation? Power Limitation is for the patient’s safety and protects the instrument against damage.

+

Select a Power Limitation with the +/- buttons next to the CUT / COAG wattage display (example: CUT Power Limitation 170 W). GO

max. Watts

APC 2 with VIO S: Connecting an instrument, activation, changing Mode, changing Effect, changing Power Limitation

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How do I change the Flow? The default Flow settings are generally such that no change of settings is required. GO To change the Flow for the CUT mode press the left-hand lower selection button and to change the Flow for the COAG mode press the right-hand lower selection button.

CUT-COAG window of the APC receptacle

You switch to the Flow window. The Flow window shows the currently set Flow as a numeric value in the unit of l/min. (1). 1

You can change the Flow with the left-hand upper or left-hand center selection button (example: 3.0 l/min). GO

2

Confirm the setting by pressing the left-hand lower selection button (2). You return to the CUT-COAG window. GO

Flow window

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The distal end of the APC applicator must always be in the field of view of the endoscope before and during activation of the argon plasma. Never activate the argon plasma without visual control.

The most important safety precautions Is APC a monopolar or bipolar procedure?

Due to combustible or explosive endogenous gases APC is a monopolar procedure. All the safety precautions applicable to monopolar electrosurgery apply. Read the safety instructions in the User Manual for the electrosurgical unit. How can I prevent an unintentional cutting effect or unintentional coagulation? If the active electrode comes into direct contact with the tissue, there can be a cutting effect and uncontrolled coagulation. GO

Do not touch tissue with the active electrode.

How should I use the active electrode (the instrument) safely? Always put the electrode down in a safe place. Never next to the patient or on top of the patient. Risk of unintentional activation. GO

When is there a risk of fire?

When using electrosurgery in the gastrointestinal tract there must be no combustible or explosive endogenous gases present. Special caution is required during the resection or coagulation of obstructing tumors in the colon with an HF loop or argon plasma coagulation: behind any stenosis in the colon it must be assumed that combustible gases are present. It is absolutely essential to irrigate any jeopardized sections of the intestine with carbon dioxide or argon before activation of the electrosurgical unit or argon plasma coagulator. GO

How do I prevent gas embolisms, emphysemas, and excessive intraluminal gas pressure? Excessive metering of the argon can cause the following: argon is injected into open vessels (gas embolism), individual organs receive insufficient oxygen, intraluminal gas pressure in body cavities rises too high. Meter the argon as low as possible.

GO

Due to the argon plasma Argon itself is neither combustible nor does it cause or promote the burning of combustible materials. However, the argon plasma has such a high temperature that it can ignite highly flammable, combustible materials. Combustible materials are, for example, plastic insulation at the distal end of the bronchoscope or a tracheal tube. Ignition can only occur though if there is also a fire-supporting gas present, such as oxygen, or it is mixed with the argon and applied to the combustible materials. This particularly applies to highly concentrated oxygen or pure oxygen. For this reason it is absolutely imperative that you observe the following rules:

Never point the distal end of APC applicators directly at open vessels. Do not push the distal end of APC applicators toward tissue. What is the purpose of the sterile filter? Due to a difference in the height of the probe tip and that of the APC module body fluid can flow to the port on the APC module. GO

Use the supplied sterile filter.

Do not admit any oxygen to the tracheobronchial system directly before, and particularly during, APC. This also applies to other combustible or fire-supporting gases or liquids. GO

If APC has to be used for longer than just a few seconds, apply the oxygen required for ventilation and the APC alternately.

APC 2 with VIO S: Changing Flow / APC 2 with VIO D or VIO S:

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Safety precautions

What do the icons mean?

Manufacturer:

Distributors:

The icons are provided for help and guidance.

ERBE Elektromedizin GmbH

Austria, Wien Telephone: (+43) 1-8 93 24 46 E-Mail: [email protected]

Your query, your problem. GO

Your procedure, action. View VIO display or controls. Audible warning signal. Safety instruction.

Postfach 1420 72004 Tübingen, Germany Waldhörnlestr. 17 72072 Tübingen, Germany Tel. (+ 49) 70 71 75 50 Telefax (+ 49) 70 71 75 51 79 E-mail: [email protected] Internet: http://www.erbe-med.de

Belgium, Diegem Telephone: (+32) 24 03 13 60 E-Mail: [email protected] China, Shanghai Telephone: (+86) 21-62 75 84 40 E-Mail: [email protected] France, Limonest Telephone: (+33) 4 78 64 92 55 E-Mail: [email protected] Great Britain, Leeds Telephone: (+44) 11 32 53 03 33 E-Mail: [email protected] Netherlands, Werkendam Telephone: (+31) 18 35 09 755 E-Mail: [email protected] Poland, Warszawa Telephone: (+48) 2 26 42 25 26 E-Mail: [email protected] Russia, Moscow Telephone: (+7) 095–258 19 05 E-Mail: [email protected] Switzerland, Winterthur Telephone: (+41) 52-2 33 37 27 E-Mail: [email protected] Hungary, Budapest Telephone: (+36) 1-2 62 69 86 E-Mail: [email protected] USA, Marietta Telephone: (+1) 770 955-4400 E-Mail: [email protected]

CE0124 EN ISO 9001 EN ISO 13485

Printed in Germany Copyright © ERBE Elektromedizin GmbH, Tübingen 2005

User Manual Art. No. 80110-241

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