Cleaning of laparoscopic instruments

　　腹腔镜器械的清洗是和中的一个重要环节，经过清洗能去除器械90%以上的病原体。现在腹腔镜器械的清洗有人工和运用超声自动清洗机两种办法。普遍选用的是人工清洗法。手术完毕后，立即将腹腔镜器械放在1∶ 300中性多酶清洁剂浸泡10 min，因酶可敏捷分化蛋白质和有机物，使残留血液、有机物、粘液等不于凝结而吸附在器械上，从而易于清洗。并将一切能拆卸的部件悉数取下，分开放置，各套管芯拔出，充沛浸泡。然后用流动水认真清洗每一部件，带有管腔的器械运用柔软的毛刷反复洗刷，以两头见刷头为准，一切的组织碎片，一起去除其他有机物。清洗洁净后放在器械专用光滑液里光滑约2 min后取出，并将各关节各钳叶翻开，有管腔的器械用高压气枪向管腔吹入压缩气体直无水分排出，使其充沛枯燥，横放或悬挂在阴凉枯燥的专用储存柜内备用。

　　The cleaning of laparoscopic instruments is an important part of disinfection and sterilization, which can remove more than 90% of pathogens. Now there are two ways to clean laparoscopic instruments: manual and automatic ultrasonic cleaning machine. The commonly used method is manual cleaning. After the operation, immediately immerse the laparoscopic instrument in 1:300 neutral multi enzyme detergent for 10 minutes, because the enzyme can rapidly differentiate protein and organic matter, so that the residual blood, organic matter, mucus, etc. will not coagulate and will be absorbed on the instrument, so that it is easy to clean. All the parts that can be disassembled shall be taken down and placed separately. Each casing core shall be pulled out and fully soaked. Then carefully clean each part with flowing water. For instruments with lumen, use soft brush to wash repeatedly, and the brush head is the criterion. Remove all tissue fragments and other organic matters together. After cleaning, put it in the special smooth liquid of the instrument for about 2 minutes, take it out, turn over the tongs and leaves of each joint, blow compressed gas into the lumen with a high-pressure air gun until there is no water to discharge, make it full and dry, put it horizontally or hang it in a cool and dry special storage cabinet for standby.
              

　　镜头和光缆的处理

　　Lens and cable handling

　　手术完毕后运用蘸有中性多酶清洁剂的湿纱布对镜头及各种导线表面血迹、污渍进行擦洗，运用吸水较强的软布擦干，对光缆进行放置时，应无视点自旋放置于腹腔镜专用盒内，禁止成角折叠或过度弯曲，镜面用脱脂棉球或拭镜纸顺时针方向进行擦洗，避免用粗糙布巾擦洗，避免损害镜面，影响术中运用。

　　After the operation, use wet gauze dipped with neutral multi enzyme cleaner to clean the blood and stains on the lens and various wires, and use soft cloth with strong water absorption to dry them. When placing the optical cable, place it in the special box of laparoscope without view point spin. It is forbidden to fold or bend it excessively. The mirror surface shall be wiped clockwise with absorbent cotton ball or wiping paper to avoid roughness Wipe with cloth to avoid damaging the mirror surface and affecting the operation.

　　腹腔镜器械清洗时注意事项

　　Precautions for laparoscopic instrument cleaning

　　清洗时要避免腹腔镜器械各附件的缺失，因为腹腔镜器械紧密杂乱，许多器械都配有小的附件，因而在拆卸清洗时，冲洗槽内要铺有过滤网，以防冲入下水道丢掉。另外冷光源和摄像镜头连接在清洗及过程中，不行打折，盘旋的视点应成钝角，避免损害光导纤维。

　　During cleaning, it is necessary to avoid the loss of the accessories of the laparoscopic instruments. Because the laparoscopic instruments are closely and disorderly, many instruments are equipped with small accessories. Therefore, when disassembling and cleaning, the washing tank should be paved with a filter screen to prevent them from being washed into the sewer. In addition, the cold light source and camera lens are connected in the process of cleaning and disinfection, without discount. The rotating point of view should be obtuse to avoid damage to the optical fiber.

　　腹腔镜器械的及

　　Disinfection and sterilization of laparoscopic instruments

　　当时普遍运用的办法才是牢靠的过氧化氢等离子低温，与传统的办法相比较具有作用切当、快速、、等长处，也有效地减少腹腔的损害，一般由专人负责办理低温器，将腹腔镜器械放置在专用器械盒内，用无纺布包装，包装外注明腔镜器械的称号、时间及有效期。正常选择的形式是加强形式，达69 min。一起我们在严格地检测系统，化学指示胶带和卡片的监测，每一锅都有生物监测，十分紧密，确实可达到抱负的作用。

　　At that time, the commonly used method was the safe and reliable hydrogen peroxide plasma low-temperature disinfection. Compared with the traditional sterilization method, it had the advantages of sterilization, such as proper, fast, safe and environmental protection, and also effectively reduced the damage to the abdominal cavity. Generally, a special person was responsible for handling the low-temperature sterilizer, placing the laparoscopic instruments in a special instrument box, packing them with non-woven fabric, and indicating the cavity on the outside of the package The title, sterilization time and validity of the mirror instrument. The normal choice of sterilization form is to strengthen the form of sterilization for 69 minutes. Together we are in strict detection system, chemical indicator tape and card monitoring, each pot has biological monitoring, very close, can achieve the desired sterilization effect.

　　腹腔镜感染手术的器械

　　Disinfection of instruments in laparoscopic infection operation

　　依据现在大都医院的现有条件，有无抱负的办法，因而我们关于有特异性感染(结核、乙肝阳性)以及其他流行症的患者组织在之后做。用后遵从、清洗、清洗的准则。

　　According to the current conditions of most hospitals, there is an ideal sterilization method, so we will do it later for patients with specific infection (tuberculosis, hepatitis B positive) and other epidemics. Follow the guidelines of disinfection, cleaning and disinfection after use.

　　腹腔镜器械的保养

　　Maintenance of laparoscopic instruments

　　腹腔镜器械精细，精细。清洗时分开放置，用软毛刷冲洗后，吹风机吹干，器械轴节部浸入光滑剂中，整齐排列、放入盒中。管腔器械用气枪吹干后在上油。尖细器械套硅胶管维护，松紧适合。生锈的器械选用专用除锈剂进行除锈处理，然后进行惯例清洗，清洗后再作煮沸、光滑、枯燥处理。这样对器械起到保养、延伸其运用寿命的作用。

　　Laparoscopic instruments are fine and delicate. During cleaning, it shall be placed separately. After washing with soft brush, the blower shall be dried. The instrument shaft part shall be immersed in the smooth agent, arranged in order and put into the box. The lumen apparatus is oiled after being dried with an air gun. The tip of the fine instrument is covered with silicone tube for maintenance, which is suitable for tightness. Special rust remover shall be used for rust removal of rusty instruments, and then conventional cleaning shall be carried out. After cleaning, boiling, smooth and boring treatment shall be carried out. In this way, it can maintain the equipment and extend its service life.

　　腔镜器械有必要定点寄存

　　It is necessary to store the endoscopy equipment at designated place

　　腔镜器械比较精细，不能与一般器械一起进行放置，要有专用储存柜，腔镜必定放置在原装盒内，气腹针与一些可拆的部分小零件要放在小盒内，避免折断和丢掉；导线清洁后寄存时不行打折避免折损。

　　The cavity mirror equipment is relatively fine, so it cannot be placed together with the general equipment. There should be a special storage cabinet. The cavity mirror must be placed in the original box. The pneumoperitoneum needle and some detachable small parts should be placed in the small box to avoid breaking and losing. The wire should not be folded or damaged after cleaning.

　　统一办理

　　Unified handling

　　跟着腹腔镜运用范围的不断扩大，为进步腹腔镜临床运用效率，应组织责任心强、具有杰出职业道德、有必定的和医院感染知识的人员统一办理，并树立记载腹腔镜器械运用挂号专册，保证腹腔镜运用。

　　With the continuous expansion of the application scope of laparoscopy, in order to improve the clinical application efficiency of laparoscopy, it is necessary to organize personnel with strong sense of responsibility, outstanding professional ethics, certain knowledge of disinfection and hospital infection to handle it in a unified way, and establish a special register for recording the application of laparoscopic instruments to ensure the safe use of laparoscopy.

　　加强作用的检测

　　Strengthen the test of disinfection effect

　　对后的器械进行作用监测十分重要。因腹腔镜器械的管径长、窄及关节的密闭性，在浸泡时会存在单个区域液体渗透不全的现象。医院感染科应定期对腹腔镜器械的作用进行检测，发现问题及时处理。以保证腹腔镜器械达到有效。

　　It is very important to monitor the disinfection effect of sterilized instruments. Because of the long and narrow diameter of the laparoscopic instruments and the airtight of the joints, there will be the phenomenon of incomplete liquid penetration in a single area during immersion disinfection. The Department of nosocomial infection should test the disinfection effect of laparoscopic instruments on a regular basis and deal with the problems in time. In order to ensure the effective sterilization of laparoscopic instruments.