Contour CS40B Manual Del Usuario página 5

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loaded into the instrument (press down) after the retainer has been removed. Discard the staple
retainer.
3 Grasp the instrument handle in the palm of the hand with the fingers around the closure trigger.
Position tissue to be cut and stapled between the anvil and the cartridge.
NOTE: Any tissue covering the hole in the anvil will be pierced by the retaining pin. Reposition the
tissue if necessary.
4 Either manually advance the retaining pin using the actuator button on top of the handle to capture
the tissue within the jaw opening (Illustration 3A), or automatically advance the retaining pin by
squeezing the closure trigger (Illustration 3B). Note that there is an audible click halfway through the
closure stroke indicating that the device is in the intermediate position. In the intermediate position,
the pin is fully seated in the anvil capturing the tissue, and the jaws are partially open. Reposition
tissue within the instrument if desired. The closure trigger can be released at this point, and the
instrument will maintain its jaw opening to allow for final positioning of the tissue to be cut and
stapled. The retaining pin is fully engaged.
Caution: Make sure tissue to be stapled is properly positioned in the jaws before stapling. Bunching,
stretching or uneven loading of tissue could result in leakage, lack of hemostasis, or disruption of
staple line.
NOTE: If using the automatic advancement of the retaining pin, ensure that the tissue is correctly
placed to avoid accidental piercing of tissue.
NOTE: Do not grasp the firing trigger before the instrument is to be fired.
NOTE: Recommended operation is to manually advance the Retaining Pin.
5 Squeeze the closure trigger and handle together until the closure trigger is latched. Listen for an
audible click. When the closure trigger is latched, the firing trigger moves to the ready-to-fire position
(Illustration 4). The cartridge has clamped onto the tissue which is ready to be cut and stapled. Ensure
that the closing stroke is completed. All fingers should be completely removed from the closing trigger
to ensure that the closing system holds.
NOTE: If the tissue needs to be repositioned within the instrument before stapling, open the jaws by
squeezing the handle and closure trigger together slightly, push the release button, and slowly release
grasp of the closure trigger. The closure trigger will return to the fully open position and the jaws will
release the tissue but the retaining pin will remain extended. Tissue can now be repositioned.
NOTE: The C
ONTOUR
if a used reload, no reload, or an incorrectly inserted reload is in the instrument. In these cases, the
device will close approximately one-third of the stroke and stop, but will return to the full open
position when the closure trigger is released. The used or misloaded cartridge module should then
be replaced with a new reload or, if no cartridge was present, a cartridge should be loaded in the
instrument. After following the above steps, any device which does not close either partially or
completely should not be used.
NOTE: After closing, pausing for 15 seconds prior to firing may result in better tissue compression
and better staple form.
NOTE: If closure trigger (1) is difficult to lock, reposition the instrument and take a smaller amount of
tissue. (See Contraindications for appropriate reload selection).
6 With the handle and closure trigger grasped in the palm of the hand, place all fingers around the
firing trigger. Before firing, check to ensure the retaining pin is seated in the anvil.
Caution: Always ensure complete closing prior to firing.
Caution: Before firing, verify that the intended tissue is in the closed jaws of the instrument. If the pin
is not properly positioned, staples may not form properly, which may result in leakage or disruption of
the staple line.
Caution: When positioning the stapler on the application site, ensure that no obstructions such as
clips, stents, guide wires, etc., are incorporated into the instrument jaws. Firing over an obstruction
may result in incomplete cutting action and/or improperly formed staples.
Caution: Care should be taken not to fire this instrument when the resulting staple line will be in
tension.
7 Completely fire the instrument by squeezing the firing trigger until it touches the closure trigger
(plastic to plastic), signifying that the instrument has fired the staples and knife blade, and the tissue
has been transected. (Illustration 5) The firing trigger automatically returns to the intermediate
position as soon as the hand releases it, leaving the closure trigger in the fully closed position. Make
sure that the release button is not pressed during firing as proper formation of staples and cut line
may be compromised.
Curved Cutter Stapler is designed with a feature which allows partial closing
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