APC 2 User Manual V1.4.x Dec 2004

APC 2 User manual

EN ISO 9001 EN ISO 13485 User Manual Art. No. 80110-201 All rights to this User Manual, in particular rights of duplication, dissemination and translation, are reserved. No part of this User Manual may be reproduced in any form (by photocopying, microfilming or other methods) or processed, duplicated or disseminated by the use of electronic systems without the written consent of ERBE Elektromedizin GmbH. The information contained in this User Manual can be changed or expanded without prior notice and without obligation on the part of ERBE Elektromedizin GmbH. Printed by: ERBE Elektromedizin GmbH Printed in Germany Copyright © ERBE Elektromedizin GmbH, Tübingen 2004

Table of Contents

Table of Contents

Chapter 1

Titel

Page

Safety instructions ... 7 Intended use ... 7 Safety notations... 7 Safety of equipment and accessories ... 7 Importance of the User Manual and training of medical personnel... 7 Protection from the risk of electric shock ... 8 Ambient conditions ... 8 Maintenance ... 9 Attention: WARNING! ... 9

2

Physics and Description of Argon Plasma Coagulation, Possible Risks... 11 Principles of argon plasma coagulation ... 11 Risks of argon plasma coagulation ... 11

No. 80110-201 12/ 2004

3

Description of the Controls ... 15 Controls... 15 Controls of the front panel ... 15 Controls on the back ... 16

4

Working with the APC 2 (in combination with a VIO from the D series) ... 17 Preparations for start-up... 17 Setup parameters on the APC 2 ... 17

5

Working with the APC 2 (in combination with a VIO from the S series) ... 19 Preparations for start-up... 19 Setup parameters on the APC 2 ... 19

6

Description of socket hardware... 21 Socket combinations on the APC module ... 21 Purchasing further receptacles ... 21 APC socket module... 22 Monopolar socket, bipolar socket, multifunctional socket ... 22

7

Installation of the APC 2 and the Argon Pressure Cylinders... 23 Ambient conditions ... 23 Installing the unit on an ERBE equipment cart ... 23 Fixing argon pressure cylinders, connection of the working cylinder, detachment of the working cylinder on the VIO CART... 24 Fixing argon pressure cylinders, connection of the working cylinder, detachment of the working cylinder on the Universal Cart ... 27 Warnings! for installation of argon pressure cylinders... 29 Refilling the working cylinder ... 30

5 / 42

Table of Contents

8

Cleaning and Disinfection ... 31 Wipe disinfection...31 Instructions for cleaning and disinfection ...31 Safety Instructions ...31

9

Status Messages, Error Messages ... 33

10

General Technical Data... 35

11

Information on electromagnetic compatibility (EMC) ... 37 Guidelines for avoiding, recognising and rectifying unwanted electromagnetic effects on other equipment or systems, which are the result of operating the VIO system...37

12

Maintenance, Customer Service, Warranty, Disposal... 41

No. 80110-201 12/ 2004

Maintenance ...41 Customer service ...41 Warranty ...42 Disposal ...42

6 / 42

1 • Safety instructions

CHAPTER 1

Safety instructions

Intended use The APC 2 is an argon plasma coagulator used in conjunction with the VIO electrosurgical instrument manufactured by ERBE Elektromedizin.

Safety notations WARNING!

The WARNING! safety indication refers to a risk of personal injury.

CAUTION!

The CAUTION! safety indication refers to a risk of damage to property.

ATTENTION:

The ATTENTION: safety indication refers to a risk which can cause equipment to become unserviceable.

No. 80110-201 12/ 2004

Safety of equipment and accessories Compliance with safety information

Appropriate application of and compliance with the safety information makes a considerable contribution to the safety of the user, patients, and environment.

Safety of equipment and instruments

ERBE devices complys with all relevant and generally accepted engineering practices as well as with the applicable occupational protection and accident prevention regulations.

Combination with other equipment

You can combine this device with other ERBE equipment and instruments. You will then have a well-conceived, coordinated system.

Contribution of medical personnel to safety

Working with medical equipment is basically associated with certain risks to medical personnel and patients. Risks cannot be entirely eliminated by design measures alone. Safety does not depend solely on the equipment but depends to a large extent on factors influenced by you. These factors are dealt with in the safety information in this chapter.

Importance of the User Manual and training of medical personnel Who should read this User Manual?

The User Manual forms an important part of the safety concept of the unit. Therefore everyone who is concerned with •

preparing,

•

adjusting,

•

operating,

•

disassembling, as well as

•

cleaning and disinfecting

the unit and instruments as applicable should read the User Manual and the instructions for using the instruments. Please pay particular attention to the safety instructions in each chapter.

7 / 42

1 • Safety instructions

Training

WARNING! The equipment must be used only by medical professionals who have been appropriately trained (In-Serviced) and authorized by ERBE. Training must be carried out only by personnel who are suitable on the basis of their knowledge and practical experience. ERBE is not responsible for damage caused by user error. In the event of uncertainties or if you have any questions, please contact ERBE. We will be glad to give you further assistance and will be pleased to receive your suggestions concerning this User Manual.

Protection from the risk of electric shock Leakage current

The equipment conforms to the requirements of Type CF (Cardiac Float) and is protected against the effects of a defibrillator discharge.

Inspecting the equipment, equipment cart, accessories

WARNING! Inspect the equipment or equipment cart and the accessories (e.g. foot control, cable) for damage after every period of use. You must not use damaged equipment, a damaged equipment cart or damaged accessories. Exchange defective accessories. If the equipment or equipment cart is damaged, please contact our customer service. For your safety and that of patients, never attempt to effect repairs yourself. Any modification will invalidate liability on the part of ERBE Elektromedizin GmbH.

Potential equalisation

If necessary, connect the potential equalisation pin of the unit or of the equipment cart to the potential equalisation system of the operating room using a potential equalisation conductor.

Do not operate in potentially explosive atmospheres

WARNING! The device may only be operated in rooms used for medical purposes. Position the device in such a way that it is located outside of potentially explosive atmospheres. Potentially explosive atmospheres can form due to the use of combustible anesthetics, skin cleansers and disinfectants.

Operating conditions

ATTENTION: The device must be operated at a certain temperature and humidity. You will find the specified temperature and humidity in the Technical Data. If levels exceed or fall below the tolerances specified there, the device may fail. If other conditions have to be observed for operation of this device, you will also find them in the Technical Data.

Portable and mobile communication equipment HF

ATTENTION: Portable and mobile communication equipment HF can influence the device.

Transport and storage

ATTENTION: The device must be stored and transported at a certain temperature and humidity. You will find the specified temperature and humidity in the Technical Data. If levels exceed or fall below the tolerances specified there, the device may fail. If other conditions have to be observed for operation of this device, you will also find them in the Technical Data.

Acclimatization

ATTENTION: If the device was stored or transported below a certain temperature, it will take a certain time to acclimatize to room temperature. You will find the temperature and acclimatization time in the Technical Data.

Ventilation

ATTENTION: The device must be installed in such a way that there is an unobstructed circulation of air around the housing. Installation in confined wall recesses is not permitted.

Penetration of liquids

ATTENTION: The housing is not absolutely watertight. Therefore do not place the device in the immediate vicinity of tubes or tanks containing liquids.

8 / 42

No. 80110-201 12/ 2004

Ambient conditions

1 • Safety instructions

Maintenance WARNING! The unit must undergo a safety check at least once a year.

Attention: WARNING! Failure of display elements

The unit must not be used following failure of display elements.

Electrical capacity of instruments

The ERBE instructions for use of the instruments indicate the maximum electrical capacity of the instrument. Check that the instrument is suitable for the required mode and the required power limitation. This can be done with the help of the performance diagrams for each mode.

Patient plate

Place the patient plate with its entire surface on the patient's body to ensure proper functioning. The patient plate must be as close as possible to the area of the operation. Insert the contact tab of the patient plate completely into the connecting clamp. The contact tab must not touch the patient's skin. There is the danger of burns.

No. 80110-201 12/ 2004

Do not apply the patient plate over the heart or in the region of the heart. Special points to observe with the "Neutral electrode: Either way" setup

If a short circuit occurs in the connecting cord, or in the clip of a dual surface neutral electrode, the unit can no longer monitor the contact between the electrode and the patient's skin or the application direction of the contact surface. You will not receive a warning if the electrode becomes detached from the skin and there is a danger of burns. You will not receive a warning if the application direction of the contact surface is incorrect.

Insulation of patient

The patient should not come into contact with metal parts which are grounded or have high capacitance to ground (e. g. operating table holders). The use of antistatic drapes is recommended to insulate the patient.

Dry bedding of patient

Avoid skin-to-skin contact (e. g. between the patient's arms and body), e. g. by packing with dry gauze.

Position of monitoring electrodes

When simultaneously using an electrosurgical unit and physiological monitoring equipment you should position any monitoring electrodes as far as possible from the surgical electrodes. Needle electrodes for monitoring are not recommended. In all cases monitoring electrodes which are designed to limit high-frequency current are recommended.

Active electrodes

The lines to the surgical electrodes should be fitted so that they do not touch the patient or other lines. Any active electrodes not currently in use should be put to one side so that they can not touch the patient.

Parts of body with a relatively small cross-section

For surgical procedures which involve HF current flowing through parts of the body with a relatively small cross-section the use of bipolar technology may be indicated to avoid unintentional coagulation.

Power output

The power output should be set as low as possible for the relevant purpose. An apparently low output value or functional failure of the electrosurgical unit during normal operation may be caused by poor positioning of the patient plate or insufficient contact in its lines. In this case the positioning of the patient plate and its lines should be checked before a higher power output is selected.

Flammable anesthetics, easily combustible gases

The use of flammable anesthetics or easily combustible gases such as nitrous oxide (N2O) and oxygen should be avoided when an operation is being performed on the thorax or the head, unless these substances are removed by extractors.

9 / 42

Non-combustible substances for cleaning and disinfection

Where possible, non-combustible substances should be used for cleaning and disinfection. Combustible substances which are used as cleaning agents or disinfectants or as a solvent for adhesives should have evaporated before electrosurgery takes place. There is the risk that combustible liquids may accumulate underneath the patient or in bodily recesses such as the navel or in bodily cavities such as the vagina. Any liquid which has collected at such places should be wiped away before the electrosurgical unit is used. Please be aware of the risk of ignition of endogenous gases. When saturated with oxygen, certain materials such as cotton wool and gauze may be ignited by sparks occurring during proper use of the electrosurgical unit.

Patients with cardiac pacemakers

In the case of patients with cardiac pacemakers or other active implants there is a risk that a malfunction may occur in the pacemaker function or the cardiac pacemaker might become damaged. In the case of doubt expert advice should be obtained.

Unwanted increase in power output

Failure of the electrosurgical unit may result in an unwanted increase in the power output level.

Interference with other electronic equipment

Interference generated during operation of the electrosurgical unit may affect the functioning of other electronic equipment.

Unintentional electrical stimulation of nerves and muscles

A known risk of electrosurgery is the unintentional electrical stimulation of the patient's nerves and muscles. Such stimulation may be caused by low-frequency electrical currents which are produced either by low-frequency power sources or by electric arcs between the active electrode and the patient's tissue. Electrical alternating current with a frequency above 300 kHz can not stimulate nerves and muscles. However, the unavoidable electric arcs occurring between the active electrode and tissue during cutting procedures, forced coagulation and spray coagulation have the effect of rectifying part of the high-frequency alternating current, resulting in lowfrequency current components modulated to a greater or lesser extent, which act on structures susceptible to electrical stimulation, such as nerves and muscle. This may bring about possibly violent spasms or muscle contractions.

10 / 42

No. 80110-201 12/ 2004

1 • Safety instructions

2 • Physics and Description of Argon Plasma Coagulation, Possible Risks

CHAPTER 2

Physics and Description of Argon Plasma Coagulation, Possible Risks

Principles of argon plasma coagulation Besides the three generally known states of matter, i.e. solid, liquid and gas, physics also recognises a fourth1state, namely plasma. Plasmas are on the one hand gaseous and are thus subject in mechanical terms to the physical description for gases.. On the other hand, plasmatic states are also characterised by electrical conductivity and other electromagnetic properties which are not known in gases and place plasma nearer to the category of metals. In this context we therefore also speak of metallic gases.. Such gases owe their ability to conduct electricity to the state of their atoms: they are in a state of excitation in which all (fully ionized plasma) or at least some of the atoms of the plasma (partly ionised plasma) have been deprived of their external electrons (ionization state). If this state is maintained, e.g. by sufficiently high temperatures or electrical field strengths, these free charge carriers can produce an electric current if an electrical voltage is applied or an external electrical field is maintained.

Necessity of ignition under normal conditions

Under normal conditions (atmospheric pressure at sea level, temperature 0 °C) and in the absence of high-energy radiation, plasma states do not occur, as such conditions are not sufficient to ionize gases. This means that the electrons are bound in their atoms. Nevertheless, plasmas are more common in everyday life than is generally assumed. Every fluorescent tube, for example, maintains a plasma when it is in operation. Under normal conditions, however, the gas have to be ignited, i.e. a certain number of electrons have to be released for ionization to snowball over the rest of the gas and for the gas to take on a plasma state. Such ignition may be thermic or be brought about by a sufficiently strong electrical field. However, in terms of the cosmos, the plasma state is the norm. The sun is a gigantic ball of plasma, just like any other luminous star. Interstellar masses of gas near stars radiate as plasma. Polar lights are plasma states in the Earth's upper atmosphere, ionized by particle radiation of the sun (solar wind).

Plasmas in electrosurgery: Argon plasma coagulation

In electrosurgery, plasmas can be used to apply HF current to tissue without contact, so to speak, as plasma conducts electricity, but no contact between the tissue and an electrode is required. The charge carriers of the electric current are formed by the ejected electrons of the argon atoms and the remaining positively charged argon ions. In medicine, argon (Ar) is used as the working gas because, being inert, it shows virtually no chemical reactions. The effect on animal tissue is coagulation, and this coagulation technique is thus known as argon plasma coagulation (APC).

No. 80110-201 12/ 2004

Physics:What is plasma?

Risks of argon plasma coagulation Argon plasma coagulation (APC) is an electrosurgical procedure. When used properly and according to the safety instructions, APC is without risk to the user, patient and environment. For argon plasma coagulation the same safety rules apply in principle as for monopolar electrosurgery. Please bear in mind the following risks and measures to minimise such risks:

1.Apart from other extremely unusual states.

11 / 42

Who should read this user manual?

Everyone who is responsible for preparing the unit and instruments, for its adjustment, usage, stripping-down, cleaning and disinfection should read the user manual for the APC 2, the user manual for the electrosurgical unit and the instructions for use of the instruments. In each chapter please pay special attention to the safety instructions.

Risks of argon plasma coagulation

Argon plasma coagulation is a monopolar procedure of electrosurgery, i.e. HF current flows through the patient's body to the patient plate, as in the case of monopolar electrosurgery. WARNING! All the safety rules as for monopolar electrosurgery apply here. When carrying out procedures, in particular endoscopy, make sure that there is no accidental thermal damage to neighboring tissue structures by uncontrolled HF current . The active electrode must not directly touch the tissue, as this may result in a cutting effect and uncontrolled coagulation of the tissue so touched.

Risk of fire

WARNING! Argon itself is neither combustible nor promotes the combustion of combustible materials. However, argon plasma has such a high temperature that it can ignite flammable, combustible materials. Combustible materials include plastic insulation on the distal end of the bronchoscope or a tracheal tube. However, ignition is only possible if a combustion-promoting gas, such as oxygen, is also present or is mixed with the argon and applied to the combustible materials. This applies in particular to highly concentrated or even pure oxygen. Therefore always observe the following rules:

Gas embolisms, emphysema, intraluminal gas pressure

•

Before, and especially during APC do not introduce oxygen into the tracheobronchial system. This also applies to other combustible or combustion-promoting gases and liquids.

•

If you use APC for longer than a few seconds, apply the oxygen required for ventilation and APC alternately.

•

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

WARNING! To avoid gas embolisms, the flow rate of the argon should not be set so high that argon can be introduced into the open vessels. To avoid gas embolisms or emphysema do not point the distal end of APC applicators directly at open vessels and do not press it against tissue. WARNING! When using the APC in bodily cavities make absolutely sure that the intraluminal gas pressure does not rise too high.

Combustible gases in the gastrointestinal tract

WARNING! When using electrosurgery in the gastrointestinal tract, there must not be any combustible or explosive endogenous gases present. Special care is essential during resection or coagulation of obstructive tumors in the colon using an HF loop or argon plasma coagulation. It must be assumed that there will be combustible gases behind every stenosis found in the colon. It is essential to flush out those sections of the intestine where there is danger using CO2 or argon before activating the electrosurgical unit.

Overdosing of argon

Overdosing with argon may result in individual organs being supplied with too little oxygen or the occurrence of a gas embolism. For this reason the lowest possible argon flow should always be used!

Unintentional activation

The APC module can be unintentionally activated by the operating surgeon, staff or due to a device error. For this reason never place APC instruments on the patient or in his immediate vicinity!

12 / 42

No. 80110-201 12/ 2004

2 • Physics and Description of Argon Plasma Coagulation, Possible Risks

2 • Physics and Description of Argon Plasma Coagulation, Possible Risks

Operating errors due to failure to observe instructions for use or the user manual

Failure to observe instructions for use for accessories, the user manual, unit alarm signals and similar may result in operating errors which put the patient at risk. You should therefore make sure that you read through all information carefully! If in any doubt consult ERBE Elektromedizin or your distributor!

Instrument detection

CAUTION! The APC 2 has an instrument detection system which assigns a suitable CUT flow l/min and COAG flow l/min) to every instrument for use. You can of course adjust the specified values within limits. If the flow selected is too small, the applicator may be damaged. Please read the instructions for use for the applicators and probes!

Protection from the risk of electric shock

The applied part conforms to the requirements of Type CF (Cardiac Floating). The applied part is defibrillator-protected.Connect the potential equalization pin of the APC 2 to the equipment cart using potential equalization conductors. Connect the potential equalization of the equipment cart to the potential equalization system of the operating room.

No. 80110-201 12/ 2004

WARNING! Before use always check the electrical insulation of the applicators and all lines for damage. Use sterile filters!

A difference in levels between the probe tip and the APC module may allow bodily fluids to run to the terminal at the APC 2 if the sterile filter supplied is not used!

Training by authorized persons, Queries, Liability

WARNING! The APC 2 may only be used by persons who have been instructed in the proper handling of the APC 2 or combination of units (APC 2, electrosurgical unit, instruments ) with reference to this User Manual. Such training may only be carried out by persons who are suitable in this regard in terms of their skills and practical experience. ERBE Elektromedizin GmbH is not liable for damage caused by improper usage. In the case of problems or queries please contact ERBE or your distributor. We would be pleased to be of assistance.

Caution when handling argon pressure cylinders!

Argon pressure cylinders are highly pressurised, so that certain safety rules must be observed without fail. WARNING! No force may be used on cylinders, cylinder connections or pressure reducers. Use chains, brackets or safety straps to protect argon cylinders from falling during transport, storage and use. WARNING! Argon cylinders must only be transported with valve protection (cylinder cap or collar). WARNING! Argon cylinders must only be connected to the APC 2 using the pressure reducers and pressure lines intended by ERBE. WARNING! The APC 2 may only be operated with argon. A cylinder with hazardous content may possibly be attached to the cylinder connections of the unit. Check the gas cylinder to see whether it actually contains argon: Labelling must not be damaged or removed. WARNING! There may be a risk of asphyxiation due to enrichment of the air. Symptoms are drowsiness, a rise in blood pressure and dyspnea. In a pure argon atmosphere immediate unconsciousness and asphyxiation result without any prior indication. WARNING! When the cylinder valves are opened, the flow of argon into the pressure lines causes a brief hissing sound. If this hissing lasts longer than 2 sec. after opening a gas cylinder, there is a leak. The argon cylinder must be closed again immediately. The unit must not be used until the leakage has been remedied. Make sure that the pressure lines are securely connected to the APC 2. The same also applies to connection of the pressure reducer to the argon cylinder. Close the safety valves of the argon cylinders after finishing use!

13 / 42

No. 80110-201 12/ 2004

2 • Physics and Description of Argon Plasma Coagulation, Possible Risks

14 / 42

3 • Description of the Controls

CHAPTER 3

Description of the Controls

Controls The APC 2 itself represents a separate socket module within the VIO system as a whole. It must therefore only be used in connection with a VIO electrosurgical system, as the central controls are found there, including those for the APC 2. For operation of the APC 2 the following controls and options are thus basically available: •

the controls of the VIO electrosurgical system (see also relevant section)

•

the controls on the sockets of the APC 2

•

the footswitches for VIO.

Controls of the front panel

ERBE

No. 80110-201 12/ 2004

A PC 2

Fig. 3-1

(1) Purge button

Before the instrument can be activated for the first time, it must first be purged with argon. The Purge button only functions for the socket whose Focus button is lit up. In the service programs of the VIO system, a technician can make the appropriate setting according to whether the APC instrument is to be automatically purged with argon when it is connected to the APC socket.

(2) Focus button for APC socket

If a Focus button next to the socket is pressed, the functions of the socket and the setting of the functions will be shown in the display.

(3) Pilot lamps

The footswitch symbol lights up when the respective footswitch is assigned to the socket.

(4) Argon socket (5) Multiple socket

Insert the instrument's argon gas connection into this socket. Insert the instrument's multiple plug into this socket.

(6) CF symbol

The equipment conforms to the requirements of Type CF (Cardiac Float) and is protected against the effects of a defribrillator discharge.

(7) ECB indicator lamp

This lamp lights up red if there is no ECB connection between the APC and the electrosurgical unit

15 / 42

3 • Description of the Controls

Controls on the back

2 Ar

1

2

1

ECB

ECB

Fig. 3-2

(1) Outlet bolt

see chapter Installation.

(2) Argon connection

see chapter Installatio.

(3) High-pressure sensor

see chapter Installation.

(4) ECB connections

see chapter Installation.

No. 80110-201 12/ 2004

(5) Potential equalization

The ECB (ERBE Communication Bus) enables communication between the electrosurgical unit and connected units.

16 / 42

4 • Working with the APC 2 (in combination with a VIO from the D series)

CHAPTER 4

Working with the APC 2 (in combination with a VIO from the D series)

Preparations for start-up The APC 2 can only be operated in conjunction with the electrosurgical unit! The power connection, startup and the automatic performance test are thus carried out jointly (automatically) on startup of the electrosurgical unit (see also relevant section).

2. Getting an overview: assignment of the active program for the APC 2

The window for operation of the APC 2 is accessed by pressing the Down button. In the display you can see a symbol for the Down button, and underneath, APC if an APC 2 is connected.: The Down button can be used to move to the window Directoryof the APC 2. All other steps are exactly as for operation of the electrosurgical unit.

No. 80110-201 12/ 2004

1. Make power connection, switch on unit, automatic performance test

Fig. 4-1

Instrument detection

ERBE APC instruments possess an electronic identifier, i.e. the unit automatically detects the product and its specifications after the connecting cable has been inserted and several default settings are executed automatically on the unit. In this case when the instrument connector is inserted in the VIO socket, the display shows the message: New instrument detected by system. When the connector is removed, the instrument is logged off and this is acknowledged by the message Instrument disconnected from the system. Instrument detection of course does not prevent you from making your own preferred settings.

Setup parameters on the APC 2 When working with the APC 2 you can select and set up various parameters. To do this you use the display and the controls of the VIO electrosurgical unit, which is already known to you. The availability of these parameters can be seen from the Focus View for the APC socket. However, this task is generally carried out for you by the instrument detection system of the ERBE APC instruments: certain values are

17 / 42

4 • Working with the APC 2 (in combination with a VIO from the D series)

stored electronically on the instrument and are preset automatically when the instrument is inserted in the socket of the unit. Depending on the mode, the other parameters affect the coagulation result in completely different ways. It is therefore not possible to give simple rules of thumb for use. Here you can select a specific mode (FORCED APC, PRECISE APC, PULSED APC and possibly others). Modes vary according to their technical properties (voltage control etc.), which bring about different coagulation results.

Effect

The effect is an indicator for the strength of the mode selected. This does not mean that with a higher effect the result will be greater in everyregard. For example, although a higher effect results in faster coagulation of the tissue with FORCED APC, the coagulation depth is reduced as a consequence.

Flow

With the flow, the rate of argon flow is set in litres per minute (l/min). Depending on the application, a lower flow rate (e.g. if there is a risk of argon being introduced into bodily cavities, gas embolisms) or a higher rate may be appropriate.

No. 80110-201 12/ 2004

Mode

Fig. 4-2

Output

The power setting allows you to preselect the maximum output applied to the tissue.

Purging the instrument with argon

If you wish to purge the instrument with argon during the operation press the Purge button (1). The Purge button only refers to the socket whose Focus button is lit up. The instrument which you wish to purge must be connected to the socket with the illuminated Focus button.

18 / 42

5 • Working with the APC 2 (in combination with a VIO from the S series)

CHAPTER 5

Working with the APC 2 (in combination with a VIO from the S series)

Preparations for start-up 1. Make power connection, switch on unit, automatic performance test

The APC 2 can only be operated in conjunction with the electrosurgical unit! The power connection, startup and the automatic performance test are thus carried out jointly (automatically) on startup of the electrosurgical unit (see also relevant section).

2. Getting an overview: Assignment of the active program for the APC 2

When you press the focus button of the APC 2, the APC 2 settings of the active program are displayed on the base unit:

Prog/ 2 Setup

L2

R1 FORCED COAG R2

L3

R3

L1

MONOPOLAR

HIGH CUT

+ Effect

+ Effect

No. 80110-201 12/ 2004

+

+ CUT max. Watts

COAG max. Watts

Fig. 5-1

You can modify the APC 2 settings in the same way as the settings of the base unit using the selection buttons (L1, L2, L3, R1, R2 and R3) and the plus-minus buttons of the base unit. You can save modified parameters via the base unit in an existing or new program. Instrument detection

ERBE APC instruments possess an electronic identifier, i.e. the unit automatically detects the product and its specifications after the connecting cable has been inserted and several default settings are executed automatically on the unit. In this case when the instrument connector is inserted in the VIO socket, the display shows the message: "The connected instrument is ready for operation". When the connector is removed, the instrument is logged off, this is acknowledged by the message "An instrument has been disconnected". Instrument detection, of course, does not prevent you from making your own preferred settings.

Setup parameters on the APC 2 When working with the APC 2 you can select and set up various parameters. To do this you use the display and the controls of the VIO electrosurgical unit, which is already known to you. The availability of these parameters can be seen from the Focus View for the APC socket. However, this task is generally carried out for you by the instrument detection system of the ERBE APC instruments: certain values are stored electronically on the instrument and are preset automatically when the instrument is inserted in the socket of the unit.

19 / 42

5 • Working with the APC 2 (in combination with a VIO from the S series)

Depending on the mode, the other parameters affect the coagulation result in completely different ways. It is therefore not possible to give simple rules of thumb for use. Mode

Using the L2 or R2 selection buttons, open the CUT mode or the COAG mode window to select a particular CUT or COAG mode. You have the choice between a "real" APC mode for Argon Plasma Coagulation (FORCED APC) and various modes for argon-enhanced cutting or coagulation. In the modes for argon-enhanced cutting or coagulation the argon gas reduces smoke formation, however, no argon plasma is produced.

Flow

Using the L3 or R3 selection buttons open the window for setting argon flow (unit: litres per minute). Depending on the application, a lower flow may be necessary (e.g. when there is a risk of argon blowing into bodily cavities, gas embolism), as may be a higher flow.

Effect

Set the effect using the plus-minus buttons next to the effect displays. The COAG effect influences the coagulation depth and coagulation speed in different ways depending on the COAG mode. For this, read the description of the selected mode in the user manual for the VIO base unit. The CUT effect is a measurement of coagulation depth. As a rule, a higher CUT effect signifies a greater coagulation depth.

+ Effect

Fig. 5-3

Power limitation

Set the power limitation using the plus-minus buttons next to the watt displays. The power limitation sets the maximum power of the unit available in the selected CUT or COAG mode. The power limitation must not be confused with the actual power applied by the unit, which is regulated by the unit depending on the situation.

+ max. Watts

Fig. 5-4

Purging the instrument with argon

20 / 42

If you wish to purge the instrument with argon during the operation press the Purge button (1). The Purge button only refers to the socket whose Focus button is lit up. The instrument which you wish to purge must be connected to the socket with the illuminated Focus button.

No. 80110-201 12/ 2004

Fig. 5-2

6 • Description of socket hardware

CHAPTER 6

Description of socket hardware

Socket combinations on the APC module The APC module can accommodate two sockets. The following combinations are possible: •

One APC socket.

•

Two APC sockets.

•

One APC socket and one monopolar socket.

•

One APC socket and one bipolar socket.

•

One APC socket and one multifunctional socket. The multifunctional socket is only supported by the VIO 300 D.

No. 80110-201 12/ 2004

The sockets of the VIO electrosurgical unit and the APC module must be regarded as a single unit, i.e. as the socket connector (1) of a system.

Fig. 6-1

You control the Cut and Coag functions of all the sockets via the Selection buttons and the display of the VIO electrosurgical unit (see the chapter Tutorial in the VIO User Manual). If, for example, two or more monopolar sockets are installed in the VIO system's socket connector, these are counted from the top downwards. If you call up the monopolar sockets, you will see the designation Monopolar socket 1, Monopolar socket 2 etc. in the Cut/Coag Settings window on the VIO system display.

Purchasing further receptacles You can individually select the receptacles of your electrosurgical unit when placing your order. After purchase it is possible to add further receptacles or to replace existing receptacles with others.

21 / 42