entellus MEDICAL 3260-001-rC Medical Rigid Endoscope Focess Sinuscope Instruction Manual

: June 2, 2024
: entellus MEDICAL

Table of Contents

entellus MEDICAL 3260-001-rC Medical Rigid Endoscope Focess Sinuscope
Intended use
Safety information
Description
Preparation for use
Use
Processing
Assembly
Disassembly
Disposal
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entellus MEDICAL 3260-001-rC Medical Rigid Endoscope Focess Sinuscope

entellus-MEDICAL-3260-001-rC-Medical-Rigid-Endoscope-Focess-Sinuscope-
procut About this document

Purpose

This document describes the correct handling and function of the rigid endoscope, as well as recommended processing methods.
This document may not be used to carry out endoscopic examinations or surgeries, nor may it be used for training purposes.
The respective current version of this document can be requested from Entellus Medical.
If you as the user of this endoscope believe that you require more detailed information regarding the product’s use and maintenance, please contact your representative.

Symbols used
The following symbols are used in this document to make it easier for you to access the information:

Intended use

The FocESSTM Sinuscope is intended to provide the physician with a means for endoscopic diagnostic and therapeutic sinus surgical procedures.
The Sinuscope is indicated for use in, but not limited to such procedures as examination of sinus passages and cavities, removal of abnormal growths such as polyps, and facio-plastic surgery.

Safety information

The endoscope may only be used by trained medical professionals in medical facilities.

After delivery, inspect the endoscope for completeness and damage.
Read, observe, and keep the instructions for use.
Use the endoscope only as intended, see “Intended use” on page 2.

For storage, transport, and processing, ensure that the endoscope is not subjected to mechanical strain, particularly to prevent damage to the sensitive lens system.

WARNING: Risk of infection to the patient or medical professionals! The endoscopes are delivered non-sterile as reusable products. The state of the art and national laws require the observance of validated processes. In general, users are responsible for the validation of their processes.

Ensure that the processing, material, and personnel are suitable for achieving the results necessary.
Observe any valid local operator regulations- ons for all manual cleaning and drying processes.
Clean / disinfect and sterilize the endoscopy- pe before initial use as well as each subsequent use of the endoscope.
Bring the endoscope to the decontamination- the area after use. Observe valid protective measures to prevent contaminating the environment.

WARNING: Risk of burns!
The optical fibers emit high-energy light at the distal end of the endoscope. This can cause the temperature of the body tissue to rise to 41 °C.

Avoid direct contact of the distal end with body tissue or flammable materials as it can cause burns.
Reduce the light intensity of the cold light source when working near body tissue or flammable materials.

WARNING: Risk of injury due to faulty endoscopes!

Carry out a visual inspection and function check before each use.
Only use endoscopes that are in perfect condition.

Testing, handling, and maintenance
Endoscopes from Entellus Medical are precision medical instruments, and handling them requires great care.

Inspect the endoscope for damage before and after use.
If the endoscope is damaged, discontinue use and contact the manufacturer.
Do not subject the endoscope to impact.
Put the endoscope down carefully.
Hold the endoscope only by the ocular funnel / main part and not by the sheath.
Do not bend the sheath.
Do not bend the body after inserting the endoscope into the body. A piece broken off the endoscope can become lodged in the soft tissue or no longer appear in the endoscope’s field of vision and thus remain in the body.
Transport endoscopes individually and store them safely by using a screen basket or container.

Description

Construction

Distal end
Sheath
Main part
Ocular funnel
Proximal end
Irradiation surface of the illumination fibers
Connection for illumination fiber, type ACMI
Adapter for illumination fiber, type Wolf, pre-assembled Adapter for illumination fiber, type Storz / Olympus (assembly, see “Assembly” on page 9.)

Markings

Serial number
For autoclavable endoscopes: Writing “autoclavable”
Specification of the direction of view
Writing GERMANY
Writing ENTELLUS MEDICAL

Available designs and sizes
The endoscopes are available in the following designs and sizes:

Straight endoscopes with 0°, 30°, 45° and 70° viewing angles
A sheath diameter of 3 mm

Combinable products
You can combine the endoscopes with existing camera systems and with illumination fibers and instruments.

Preparation for use

Visual inspection and function check

WARNING: Risk of injury due to faulty endoscopes!

Carry out a visual inspection and function check before initial use as well as each additional use.
Only use endoscopes that are in perfect condition.
Clean / disinfect and sterilize the endoscope before initial use as well as each additional use of the endoscope. Contaminants on the irradiation surface of the illumination fibers can burn in during use, which impacts image quality.
Ensure that the proximal end of the endoscope is dry to prevent the endoscope from fogging up during the examination/procedure.
Ensure that no parts are missing or loose.
Ensure that there are no residual cleaning agents or disinfectants on the endoscope.
Inspect the entire endoscope, particularly the sheath, for contaminants and damage of any type, such as dents, scratches, cracks, bending, and sharp edges.
Inspect the distal end, proximal end, and the irradiation surface of the illumination fibers for contamination and scratches. Make contaminants and scratches visible using light reflexes. Hold the connection of the optical fibers against the light and inspect whether the optical fibers illuminate evenly at the distal end.
Check image quality: The image may not be blurry, clouded, or dark. If necessary, remove deposits on the optical end surface using the polishing paste provided, see “Re-moving deposits from optical end surfaces” on page 7.
For endoscopes with a locking device:- spect between the sheath and the main part for contaminants and damage to ensure a fixed and secure connection.

Provisioning

Clean / disinfect and sterilize the endoscope before initial use as well as each additional use of the endoscope, see “Processing” on page 5.
Ensure that the proximal end of the endoscope is dry to prevent the endoscope from fogging up during the examination/ procedure.
If necessary mount an adapter for illumination fiber, see “Assembly” on page 9.
Mount illumination fiber (see manufacturer’s specifications).
If required, adapt the camera (see manufacturer’s specifications).

Use

WARNING: Risk of burns!
The optical fibers emit high-energy light at the distal end of the endoscope. This can cause the temperature of the body tissue to rise to 41 °C.

Avoid direct contact of the distal end with body tissue or flammable materials as it can cause burns.
Reduce the light intensity of the cold light source when working near body tissue or flammable materials.
Prepare the endoscope for processing immediately after use to prevent surface drying of the contaminants.

Processing

Safe storage and transport
If possible, reprocessing endoscopes immediately after use is recommended. Endoscope containers and trays are reusable. Trays must be inspected for visible contamination and cleaned prior to use. They can be cleaned manually or in an automatic cleaning unit using a cleaning agent.

Always store the endoscope securely and transport it to processing in a closed container to prevent damage to the endoscope and contamination of the environment.

Cleaning and disinfection
Manual cleaning / pre-cleaning and chemical disinfection

Do not use fixating cleaning agents or hot water (>40 °C) as it can cause fixation of the contaminants and jeopardize successful cleaning.
Do not scratch contaminants off with hard objects as this can cause damage to the optical end surfaces.
Do not clean the endoscope in an ultrasonic bath.

Existing adapters are dismounted

Remove coarse contamination from the endoscope. Clean the endoscope with a soft brush under cold tap water until all visible contaminants have been removed.
For holes and threads: Rinse with a water pistol for at least 10 seconds at a pressure of at least 3.8 bar (absolute).

INFO: The endoscopes have material compatibility with the SterisTM System 1 process.

Disinfect endoscope. In doing so, observe the specifications of the disinfectant solution manufacturer regarding tempera- ture, concentration and application time.

INFO: Non-compliance with the manufacturer’s speci- fications can result in damage to the endos- cope.

Rinse the endoscope with running water.
Dry endoscope with a soft cloth.
Carry out visual inspection, function check and servicing, see “Testing, handling and maintenance” on page 3.

Machine cleaning and thermal disinfection

The FocESSTM Sinuscopes are suitable for prevalent machine methods of cleaning and thermal disinfection. In doing so, use gentle cycles for rigid endoscopes and suitable cleaning agents and disinfectants. The instructions of the machine, cleaning agent and disinfectant manufacturers must be observed. The cleaning and disinfectant result must be confirmed by the machine, cleaning agent and disinfectant manufacturers in cooperation with the user.

The following methods have been validated for the endoscopes:

Fix the endoscope to the loading rack in such a way that da- mage is prevented during cleaning.

The following materials and machines were used for the validation:

Cleaning agent:
- Alkaline: Neodisher FA; Dr. Weigert; Hamburg
- Enzymatic: Endozime, Ruhof
Neutralizer:
- Neodisher Z; Dr. Weigert, Hamburg
Cleaning and disinfecting unit:
- Miele G 7736 CD
Loading rack:
- Loading rack E 327-06
- MIC rack E 450
Start cleaning process:
- Pre-rinse with cold water for 1 minute
- Drain
- Pre-rinse with cold water for 3 minutes
- Drain
- Clean with 0.5% alkaline cleaning agent for 5 minutes at 55 °C or with 0.5% enzymatic cleaning agent at 45 °C
- Drain
- Neutralize for 3 minutes with warm tap water (<40 °C) and neutralizer
- Drain
- Intermediate rinse for 2 minutes with warm tap water (<40 °C)
- Drain
Carry out machine thermal disinfection considering the national requirements regarding the Ao value (see DIN EN ISO 15883).
Ensure that the exteriors of the endoscope are dry. If necessary, dry with a soft cloth.
Carry out visual inspection, function check, and servicing, see “Testing, handling and maintenance” on page 3.

Removing deposits from optical end surfaces
If deposits are found when checking the image quality, they can be removed with the provided polishing paste as follows:

INFO: Only clean with polishing paste if the image that you see through the endoscope is cloudy and blurry.

Apply polishing paste to a clean cotton swab.
For large end surfaces: press a cotton swab lightly on the end surface to be cleaned and rub it over the glass.
For small end surfaces: place a cotton swab lightly on the end surface to be cleaned and turn it.
Clean all optical end surfaces with warm water and mild tergent to remove all polishing paste residue.
Rinse optical end surfaces under running water.
Dry optical end surfaces with a soft cloth.
Clean / disinfect and sterilize the endoscope.
Carry out visual inspection. If the deposits were not removed: send in an endoscope for repair.

Sterilization
Prior to each sterilization, rigid endoscopes must be cleaned and disinfected according to the methods in these instructions for use.

Sterilize endoscopes in suitable packaging to prevent subsequent contamination.

Steam sterilization (autoclaving)
In general, users are responsible for the validation of their processes.

INFO: Only endoscopes that are marked with the writing “autoclavable” are intended for autoclave-ving. The permissible processing methods are explained in the instructions at hand.

When selecting the processing method, observe the valid national hygienic regulations and local provisions for hospital hygiene.
- INFO: Comply with specified process parameters. The specified parameters have been validated to ensure the sterility of the endoscopes. Deviating process parameters could damage the endoscope. In this case, the guarantee and warranty shall become void.
- Autoclavable endoscopes can be sterilized with the French cycle (134 C, 18 minutes, 3.1 bar (absolute) without restrictions regarding material compatibility.

Existing adapters are dismounted

Sterilize endoscopes.
When the sterilization process has ended, allow the endos- copes to cool gradually to room temperature.

Fractionated pre-vacuum method
The following process has been validated:

Temperature	132–137 °C (270–278 °F)
Time	At least 3 minutes
Configuration	Double-packed in sterilization bags
Drying	At least 10 minutes

Gravitation method

INFO: The endoscopes have material compatibility with the gravitation method for a hold time of 15 minutes.

Hydrogen peroxide sterilization (STERRAD® method) Endoscopes can be sterilized with the following STERRAD systems:

STERRAD 100S
STERRAD NX
STERRAD 100NX

Observe the specifications of the manufacturer (ASP) regarding the corresponding method.

Ethylene oxide sterilization

INFO: The endoscopes are material compatible with ethylene oxide sterilization.

Special precautions: Pathogens of Transmissible Spongiform Encephalopathy
A comprehensive explanation of the necessary preventative measures about agents of Transmissible Spongiform Encephalopathy (TSE) would go beyond the scope of this document.
It is assumed that pathogens of the Creutzfeldt Jakob Disease cannot be killed using normal disinfection and sterilization processes. Therefore, the standard methods for decontamination and sterilization are not sufficient if there is a risk of transferring Creutzfeldt Jakob Disease.
In general, only tissue with a low potential of TSE infection comes into contact with surgical instruments. Despite this, special preventative measures must be taken for instruments that are used to treat patients with a known or suspected infection of TSE, as well as for patients at risk.

Processing restrictions

Repeated processing has only minimal effect on the endoscopes. The service life of the units is usually determined by wear and damage.
The endoscope can be damaged if the manufacturer’s specifications are not observed.
- Do not clean the endoscope in an ultrasonic bath.

Assembly

Connection for illumination fiber, type
ACMI Adapter type Wolf
Adapter type Storz / Olympus

If necessary mount an adapter for illumination fiber
Ensure that the irradiation surface of the illumination fiber is clean.
Mount illumination fiber (see manufacturer’s specifications).
If required, adapt the camera (see manufacturer’s specifications).

Disassembly

WARNING: Risk of burns!
Allow the illumination fiber to cool sufficiently before removing it. The ends can become very hot and cause serious burns.

Remove illumination fiber.
Do not remove the ocular funnel because otherwise the endoscope will be damaged.
Unscrew existing adapters.

Storage

Unsterile metal units must be stored in a clean, dry environment. The storage time of unsterile units is not limited; the units are made of a non-degradable material that maintains its stability when stored under the recommended conditions.
As long as endoscopes are stored unsterile in the original packaging, the following storage conditions apply:
- Temperature: –10 °C to +40 °C
- Humidity: 10% to 90%
Avoid direct sunlight.
Store the endoscope either in the original packaging or in a screen tray/container.
Ensure that the endoscope is stored securely.
Observe the respective valid national provisions when storing in a sterile condition.

Service and maintenance
Entellus Medical does not supply original parts to independent workshops or other endoscope manufacturers. Thus only Entellus Medical is in a position to carry out repairs using original parts. The original technical specifications and the operational safety of the endoscope can only be guaranteed by using the original parts. The warranty for Entellus Medical products shall become void if repairs are carried out by a workshop not authorized by Entellus Medical. In this case, Entellus Medical is also no longer responsible for the technical specifications or safety of the product.

Have the endoscopes repaired by Entellus Medical only. For service, send the defective endoscope to Entellus Medical.
Clean, disinfect, and sterilize the endoscope thoroughly before returning it for repair.
Ideally, send in the endoscope in its original packaging. If this is not possible, package the endoscope to secure it for transport.

Entellus Medical is not liable for damage resulting from improper shipping.

Accessories / spare parts