Johnson & Johnson ETHICON echelon flex 45 Manual Del Usuario página 6

Clinical Section
Examples of procedures in which linear cutters and staplers may be used include:
General
• Anastomoses
• Partial Gastroplasty
• Appendectomy
Illustration and Nomenclature (Illustration 1)
1. Closing Trigger (1)
2. Firing Trigger (2)
3. Rotating Knob
4. Articulation Fins
5. Manual Knife Reverse Switch
6. Stroke Count Indicator
7. Knife Direction Indicator
8. Anvil Release Button
9. Handle
10. Reload Gripping Surface
Instructions for Use
Prior to Using Instrument:
1
Verify that the reload size matches the instrument size to be used (e.g. use an ECHELON  reload with an
ECHELON Flex  instrument).
2
Become familiar with the articulating action of the instrument by pulling on the fins of the rotating knob with the index finger
and articulating the jaws with the other hand. (Illustration ) As lateral pressure is applied in either direction, the jaws pivot to
a maximum angle of  degrees, at which point the pivoting force increases to signal the end of the articulating arc. Maintain
the lateral pressure while releasing the rotating knob to lock the angle of the shaft. After locking the jaws, release the lateral
pressure. The jaws will also lock at approximate 1 and 0 degrees by releasing the rotating knob before the end of the
articulation arc. To return the jaws to the straight position, pull on the fins of the rotating knob to release the lock; the jaws
will return automatically.
3
Verify compatibility of all instruments and accessories prior to using the instrument (refer to Warnings and Precautions).
Loading the Instrument:
4
Using sterile technique, remove the instrument and reload from their respective packages. To avoid damage, do not flip the
instrument or reload into the sterile field.
5
Remove the multiple stroke firing instructions tag and plastic sleeve from the instrument. To do this, slide the tag and sleeve
over the shaft of the instrument.
6
Prior to loading, ensure the instrument is in the open position. (Illustration )
7
Examine the reload for the presence of a staple retaining cap. If the retaining cap is not in place, discard the reload.
Caution: Tissue thickness should be carefully evaluated prior to using the instrument.
Caution: Selection of the appropriate staple cartridge should be based upon the combined thicknesses of both the tissue
and the staple line reinforcement material. The use of staple line reinforcement material with the instrument may require an
increased force to fire and may reduce the number of times the device may be fired. When using staple line reinforcement
material, the instructions of the manufacturer of the material should be followed.
WARNING: Loading the incorrect reload for the instrument size or model may result in transecting the tissue without sealing
(e.g. loading a 60 mm reload into a  mm instrument).
8
Insert the new reload by sliding it against the bottom of the cartridge jaw until the cartridge alignment tab stops in the reload
alignment slot. Snap the reload securely in place. Remove the staple retaining cap and discard. The instrument is now loaded
and ready for use. (Illustration )
Caution: After removing the staple retaining cap, observe the surface of the new reload. The reload must be replaced with
another reload if any colored drivers are visible. (If colored drivers are visible, the reload may not contain staples.)
Using the Instrument:
9
Close the jaws of the instrument by squeezing the closing trigger (light gray and labeled with a Number "1") until it locks in
place. An audible click indicates that the closing trigger is locked. (Illustration )
Caution: Do not squeeze the firing trigger (dark gray and labeled with a Number "") at this time.
10
Introduce the instrument into the body cavity through a trocar of the appropriate size or through an incision. (Illustration 6)
When using a trocar, the instrument jaws must be visible past the trocar sleeve before opening the jaws.
Caution: When placing the instrument through the trocar or incision, avoid advancing the firing trigger () accidentally. If
this occurs, the instrument will lockout and the stroke indicator will display a lock symbol; in this state, the instrument will
not allow the anvil release button to reopen the instrument jaws. To recover from this condition, remove the instrument,
push the red manual knife reverse switch downward to reverse the knife motion; the knife indicator will display an arrow
pointing towards the proximal end of the instrument to indicate the knife is in the return mode. Squeeze the firing trigger ()
completely until it rests on the closing trigger (1); the stroke count indicator will display zero to indicate the knife has been
returned to its home position. (Illustration 7) Press the anvil release button and replace the reload, then follow the instructions
above for Loading the Instrument.
11
Once in the cavity, press the anvil release button to reopen the instrument jaws and return the closing trigger (1) to its original
position. (Illustration 8)
12
If needed, rotate the jaws by pushing on the fins of the rotating knob with the index finger using a downward or upward
pressure. The instrument shaft will rotate freely in either direction.
Gynecologic
• Vaginal Hysterectomy
Urologic
• Prostatectomy
• Nephrectomy
• Cystectomy
11. Reload Alignment Tab
12. Staple Retaining Cap
13. Anvil Jaw
14. Cartridge Jaw
15. Reload Alignment Slot
16. Knife Blade Indicator
17. Staple Line
18. Cut Line
19. Proximal Black Line
6
Thoracic
• Lung Resection and Biopsy
• Pulmonary Wedge Resection