Questions and answers about common problems during surgery:

1) After the product is assembled and debugged, it is found that the image is not clear and there is a strong reflective point.

Reason: Foreign matter sticks to the front end of the fiber endoscope during product sterilization and assembly, and a strong reflective spot appears after the light source is connected.

Solution: After the water is rinsed, the foreign matter can be washed away without a strong reflective spot.

1) Bubbles appear during surgery

Reason: The air is not exhausted before entering the human body; the inlet channel is not tightly connected; the pump water is not replaced in time to cause air to enter the home; when the water is handed, the water is mixed with air bubbles into the human body.

Solution:

1 Connect the whole channel, check whether the channel is tightly connected before use, then empty the air of the whole channel, replace the liquid in time, the water should be even and slow, avoid the air when replacing the syringe; enter the front air of the human body .

2 If bubbles have been generated, it can be treated by flushing, gently shaking the mirror body, pumping back the liquid from the inlet hole of the catheter, facing the air bubbles, and gently rubbing the laser.

3) Halo or crescent in the field of view

Cause: The displacement compensator is not properly adjusted during assembly, causing the fiberscope to not reach the fore end of the catheter or the flexible extension of the flexible catheter after bending for a long time.

Solution: After loosening the compensator, adjust the compensator slightly according to the product assembly/user manual.

4) 钬Laser fiber cannot be worn out

Cause: The front end of the 钬 laser fiber re-conductor is in the active or passive bending state of the front end.

Solution: soft and hard ureteral sheath (catheter) needs to wear krypton laser in the straight state, when soft and hard ureteral sheath

When the bending angle of the (catheter) is greater than 90°, the holmium laser fiber cannot be smoothly passed out as a normal condition. When the angle of penetration is less than 90°, the laser fiber cannot be worn out. Check whether the front end of the catheter is passively bent due to the structure of the kidney. In this case, the soft and rigid ureter sheath (catheter) needs to be retracted into the ureter sheath to pass through the krypton laser. Go find the target stone again. If the direction of the soft and rigid ureteral sheath (catheter) can be adjusted to try to wear the holmium laser fiber when the ureteral sheath cannot be worn out, consider the problem of the catheter when the holmium laser fiber is still not able to be worn out, and replace the soft and rigid ureter sheath ( Catheter) to complete the surgery.

5) The stone can not be processed

     the reason:

1) When the IPA angle is<30°, the bending angle of the soft mirror is not enough, and the squat stone is difficult to handle;

2) The neck is too deep and too narrow, the soft mirror cannot enter or the flexible mirror can not be long enough to reach the stone;

Approach:

1) Gravel can be carried out by shifting the stone basket with the stone size allowed.

2) From the inspection results, when the stone is close to the back side, the position of the stone can be adjusted by the kidney area.

Gravel; if the stone is located close to the ventral side, the gravel can be assisted by pressing the location of the ventral kidney.

3) Vibrate the kidney area to change the position of the stone to assist in the completion of the gravel.

4) If necessary, the stone can be made by pushing the stone through the back side puncture to make the stone change position.

5) Replacement of other surgical methods that cannot be handled after various methods have been tried.

6) Lost direction during surgery

       the reason:

1) Soft mirror surgery is not proficient, the overall sense of space is not established

2) There is a soft mirror base, but I am not familiar with our products.

Solution:

1) Complete the simulator operation before the operation and feel the operation performance of our products.

2) Adjust the direction after assembly according to «Product Assembly / Instruction Manual».

3) Don't rush to move forward during the process of entering the mirror, but pay attention to each stop when you arrive at an iconic tissue. When I went to the renal pelvis, I stopped and observed the relative positional relationship of several groups of renal pelvis and then went to the upper group. After entering the upper jaw, I stopped and observed the relationship between the small sputum in the upper sputum. Use this type of advancement to find stones.

4) When the direction is lost, the soft and rigid ureter sheath (catheter) can be retracted to the position of the renal pelvis and re-entered to distinguish the direction.

5) A guide wire can be placed between the ureteral sheath and the soft and rigid ureteral sheath (catheter), and the guide wire can be placed in the upper or middle jaw to help identify the relationship between the renal pelvis in each group during the operation.

7) The problem of poor coaxiality in intraoperative feedback

Cause: The problem of coaxiality in soft surgery is ubiquitous

solution:

1 Increase the use of the simulator before surgery to increase the proficiency of product use.

2 When the ureteral soft sheath is not connected to the ureteral pelvic junction, the operation of the ureteroscope will be affected during the operation. The coaxiality will be worse. Master the technique of the upper sheath and make the sheath as close as possible to the ureteropelvic junction.

3 The ureteral soft mirror needs time to rotate to the front end during use. Therefore, it is not too fast to rotate the handle during the operation to prevent the target field of view from appearing in the actual field of view when the rotation of the handle is transmitted to the front end. .

4 During the operation, the handle can be held in one hand, and the other hand holds the soft mirror body. When the handle is rotated, the other hand gently rotates the soft mirror body in the direction of the handle rotation. Note that the movement should be gentle, do not force Too fierce.

8) intraoperative bleeding

       the reason:

1 The ureteral wall is damaged when the ureter is delivered to the sheath.

2 The krypton laser damages the kidney tissue during the operation.

3 stone broken to damage the kidney and ureter tissue.

4 pressure withdrawal bleeding: a large amount of fluid after the upper ureteral sheath is excreted in a short time, resulting in a sudden drop in intrarenal pressure leading to diffuse bleeding in the kidney.

       solution:

1 When you encounter bleeding, first find the bleeding point and observe the bleeding.

2 It can be suspended when spotted hemorrhage, and hemostasis can be automatically stopped by his own bleeding function.

3 Suspension of surgery When bleeding cannot be stopped, the bleeding point can be flushed with perfusate and hemostasis can be performed by flushing.

4 flushing can not stop bleeding in the case of increased water intake, reduce the amount of bleeding and increase intrarenal pressure to stop bleeding.

5 It is recommended to stop the operation when diffuse bleeding, and then choose surgery.