基本系統(tǒng)組成：腹腔鏡攝錄像監(jiān)視系統(tǒng)、CO2氣腹系統(tǒng)、電切割系統(tǒng)、沖洗—吸引系統(tǒng)、手術(shù)器械等。

Basic system components: laparoscopic video surveillance system, CO2 pneumoperitoneum system, electric cutting system, flushing suction system, surgical instruments, etc.

腹腔鏡攝錄像監(jiān)視系統(tǒng)由腹腔鏡、光源及光路、微型攝像頭、攝像轉(zhuǎn)換器、監(jiān)視器(電視機(jī))、自動(dòng)冷光源、錄像機(jī)組成。腹腔鏡常用的有0°和30°視角。直徑為10mm、5mm、2.5mm各種規(guī)格器械。

The laparoscopic video surveillance system consists of a laparoscope, a light source and optical path, a miniature camera, a camera converter, a monitor (TV), an automatic cold light source, and a video recorder. Laparoscopy is commonly used with 0 ° and 30 ° viewing angles. Various sizes of instruments with diameters of 10mm, 5mm, and 2.5mm.

氣腹系統(tǒng)

Pneumoperitoneum system

由彈簧氣腹針(Veness針)、充氣導(dǎo)管、氣腹機(jī)和CO2鋼瓶組成。其目的是為手術(shù)提供寬廣的空間和視野。

It consists of a spring pneumoperitoneum needle, an inflation catheter, an pneumoperitoneum machine, and a CO2 steel cylinder. Its purpose is to provide a wide space and field of view for surgery.

預(yù)定手術(shù)所需的腹腔內(nèi)壓12-15mmHg及自動(dòng)氣腹機(jī)。

Reserve the required intra-abdominal pressure of 12-15mmHg and an automatic pneumoperitoneum machine for the surgery.

沖洗－吸收系統(tǒng)主要包括兩個(gè)部分：

The flushing absorption system mainly consists of two parts:

沖洗：作用為觀察與保護(hù)組織、防止粘連、止血、修復(fù)組織等。

Rinsing: Its function is to observe and protect tissues, prevent adhesions, stop bleeding, repair tissues, etc.

吸引：利用導(dǎo)管效應(yīng)進(jìn)行吸引，有時(shí)還要用濾過(guò)器。

Attraction: Using the catheter effect for attraction, sometimes even using a filter.

手術(shù)器械系統(tǒng)<膽囊切除基本器械：10mm套管針(trocar)2個(gè)，5mm套管針2個(gè)，10mm器械轉(zhuǎn)換器1個(gè)，無(wú)損傷抓鉗2把，彎解剖鉗1把，氣腹針、剪刀、鈦夾鉗、沖洗—吸引管、電凝分離鏟、分離鉤各1把。

Surgical instrument system<Basic instruments for cholecystectomy: 2 10mm trocars, 2 5mm trocars, 1 10mm instrument converter, 2 non-invasive grasping forceps, 1 curved dissecting forceps, 1 pneumoperitoneum needle, scissors, titanium clamp, flushing suction tube, electrocoagulation separation shovel, and separation hook.

特殊器械：膽道造影的造影管、持針鉗、逢合針及套扎用的圈套器、取物網(wǎng)等。腹腔鏡常見(jiàn)故障分析

Special instruments: contrast tubes for cholangiography, needle holding forceps, interlocking needles and snares for ligation, retrieval nets, etc. Analysis of common faults in laparoscopy

1.故障一：圖像干擾

1. Fault 1: Image interference

主要反映在監(jiān)視器上出現(xiàn)水平條狀雜波，影像手術(shù)。

Mainly reflected in the appearance of horizontal stripe clutter on the monitor and imaging surgery.

有兩種原因可造成故障。當(dāng)手術(shù)過(guò)程中使用電刀時(shí)出現(xiàn)干擾，一般處于電磁干擾，是由于視頻傳輸線(xiàn)的屏蔽不好所致，更換屏蔽效果好的視頻傳輸線(xiàn)后故障即可排除。另外一種情況是干擾出現(xiàn)晃動(dòng)攝像頭時(shí)，此種干擾出現(xiàn)的原因是攝像頭連線(xiàn)內(nèi)部接觸不良。接觸不良導(dǎo)致圖像干擾。此時(shí)更換攝像頭連接線(xiàn)是可靠的維修手段。在特殊情況下，也可以逐段扭動(dòng)，彎折連線(xiàn)，找到出現(xiàn)斷點(diǎn)出現(xiàn)的大致部位，然后在X線(xiàn)下確定是那跟信號(hào)線(xiàn)出現(xiàn)斷點(diǎn)，持續(xù)后故障也可排除。但這種發(fā)放維修后的攝像頭連接線(xiàn)容易再次出現(xiàn)同樣故障。

There are two reasons that can cause malfunctions. When using an electric knife during surgery, interference usually occurs due to electromagnetic interference, which is caused by poor shielding of the video transmission line. The fault can be eliminated by replacing the video transmission line with a better shielding effect. Another situation is interference when the camera shakes, and the reason for this interference is poor internal contact of the camera wiring. Poor contact leads to image interference. Replacing the camera connection cable at this time is a reliable repair method. In special circumstances, it is also possible to twist and bend the connecting line segment by segment, find the approximate location where the breakpoint appears, and then determine under X-ray which signal line has the breakpoint. If it continues, the fault can also be eliminated. But this type of repaired camera connection cable is prone to the same malfunction again.

2.故障二：冷光源燈泡不亮

2. Fault 2: The cold light source bulb does not light up

排除燈泡不亮的故障有兩個(gè)可能原因。

There are two possible reasons for excluding the malfunction of the light bulb not turning on.

原因一：當(dāng)更換燈泡后故障排除，說(shuō)明燈泡已報(bào)廢。目前冷光源都是氙氣燈泡。氙氣燈泡是消耗品，它的保證壽命是500h，冷光源的面板上已計(jì)時(shí)器，500h內(nèi)燈泡出現(xiàn)的問(wèn)題的概率極小，超過(guò)500h后冷光源的計(jì)時(shí)器出現(xiàn)閃爍提示。STORZ的氙氣燈泡壽命較長(zhǎng)，一般都會(huì)用到700h以上，但也不能一直用到燈泡不亮，以為氙氣燈泡是高壓激發(fā)氣體燈泡，燈泡老化嚴(yán)重時(shí)需要多次高壓激發(fā)才能發(fā)亮，這樣就有可能造成冷光源高壓模塊過(guò)載損壞。合理地更換燈泡既可以減少成本也可以減少機(jī)器的故障，當(dāng)燈泡被點(diǎn)亮?xí)r可以聽(tīng)到一聲“啪”的激發(fā)聲，激發(fā)3次才能點(diǎn)亮燈泡時(shí)，燈泡必須更換。

Reason 1: When the malfunction is resolved after replacing the bulb, it indicates that the bulb has been scrapped. Currently, all cold light sources are xenon bulbs. Xenon bulbs are consumables with a guaranteed lifespan of 500 hours. The panel of the cold light source has a timer, and the probability of bulb problems occurring within 500 hours is extremely low. After more than 500 hours, the timer of the cold light source will flash. STORZ's xenon bulbs have a longer lifespan, usually lasting for more than 700 hours, but they should not be used continuously as the bulbs do not light up. It is believed that xenon bulbs are high-pressure excitation gas bulbs, and when the bulbs age severely, multiple high-pressure excitations are required to light up, which may cause overload and damage to the high-voltage module of the cold light source. Reasonably replacing the light bulb can reduce both costs and machine malfunctions. When the light bulb is lit up, a "snap" excitation sound can be heard. When the light bulb can only be lit up three times, it must be replaced.

原因二：當(dāng)跟換燈泡后依然不亮?xí)r，可以判斷故障是由冷光源高壓模塊損壞造成的，只能更換高壓模塊。合理地更換燈泡及不在燈泡高壓時(shí)激發(fā)燈泡可以防止高壓模塊損壞。

Reason 2: When the light bulb still does not light up after replacement, it can be determined that the fault is caused by damage to the cold light source high-voltage module, and only the high-voltage module can be replaced. Reasonably replacing the light bulb and not stimulating the light bulb when it is under high voltage can prevent damage to the high-voltage module.

3.故障三：氣腹機(jī)液體污染

3. Fault three: Liquid contamination of the pneumoperitoneum machine

當(dāng)氣腹機(jī)內(nèi)部進(jìn)入液體被污染后氣腹機(jī)出現(xiàn)故障代碼E32，此時(shí)機(jī)器鎖死不能工作。故障時(shí)由于氣腹管內(nèi)存在液體，倒流會(huì)對(duì)機(jī)器內(nèi)部造成損壞的，排除故障時(shí)首先需要徹底排除及其內(nèi)部的液體，然后用RS232連接線(xiàn)連接氣腹機(jī)與電腦，用專(zhuān)用軟件消除故障代碼后氣腹機(jī)可恢復(fù)正常。此故障出現(xiàn)時(shí)，為防止手術(shù)污染，機(jī)器立即鎖死，手術(shù)不能正常進(jìn)行，所以在使用中應(yīng)極力避免。只要手術(shù)前徹底排干氣腹管內(nèi)的液體，同時(shí)升高氣腹機(jī)的放置高度，此故障是完全可以避免的。

When the liquid inside the pneumoperitoneum machine is contaminated, the machine shows fault code E32, and the machine is locked and cannot work. Due to the presence of liquid in the pneumoperitoneum tube during the malfunction, backflow can cause damage to the internal parts of the machine. To troubleshoot, it is necessary to thoroughly eliminate the liquid inside the machine. Then, connect the pneumoperitoneum machine to the computer using an RS232 cable, and use specialized software to eliminate the fault code before the machine can return to normal. When this malfunction occurs, in order to prevent surgical contamination, the machine immediately locks and the surgery cannot proceed normally. Therefore, efforts should be made to avoid it during use. As long as the fluid inside the pneumoperitoneum tube is thoroughly drained before surgery and the placement height of the pneumoperitoneum machine is raised, this malfunction can be completely avoided.

腹腔鏡維修常見(jiàn)故障：

Common faults in laparoscopic maintenance:

1、圖像故障：模糊、進(jìn)水、起霧、黑影、灰塵、位置不正；

1. Image faults: blurring, water ingress, fogging, black shadows, dust, and misalignment;

2、光束：發(fā)黃斷絲、灼燒崩缺，亮度不夠；

2. Beam: yellowing, broken wire, burning and missing, insufficient brightness;

3、鏡管：彎曲、斷裂、凹陷、脫落；

3. Mirror tube: bent, broken, dented, or detached;

4、物鏡:脫膠、磨損、脫落；

4. Objective lens: delamination, wear and tear, detachment;

5、光錐：灼燒發(fā)黑、發(fā)黃、脫落缺失；

5. Light cone: burnt, blackened, yellowed, and missing;

6、物鏡/目鏡保護(hù)片：破裂、崩缺、脫落缺失；

6. Objective/eyepiece protective film: broken, chipped, detached or missing;

7、眼罩：破裂、崩缺、脫落；

7. Eye masks: ruptured, missing, or falling off;

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