Notes on maintenance and use of hard tube endoscope

　　硬管内窥镜在手术过程中受到损坏的现象并不多，虽然会与人体的组织如肌肉、黏膜、骨骼等有接触和磕碰，但是这些磕碰是轻微的，不会造成窥镜的损坏，因为它只是起观察的作用，不是其他器械的受力点。但是在使用其他器械时，尤其是咬合力较大的钳、剪类器械应注意镜管的前端不要伸进器械的咬合区内，以免误伤镜管。在使用这类器械时，有时医生为了看清楚咬合区的组织，把窥镜伸得很靠近组织，器械咬合时窥镜没有退回，误伤了窥镜。手术时如注意让器械的咬合口全部都在窥镜的观察范围内就可以避免此类事故发生。

　　There are not many cases of damage to the hard tube endoscope during the operation. Although it may contact and bump with human tissues such as muscles, mucosa and bones, these bumps are slight and will not cause damage to the endoscope, because it is only used for observation, not the force bearing point of other instruments. However, when using other instruments, especially forceps and scissors with large bite force, the front end of the lens tube should not extend into the occlusal area of the instrument, so as to avoid accidental injury to the lens tube. When using this kind of instrument, sometimes the doctor extends the endoscope very close to the tissue in order to see clearly the tissue in the occlusal area. When the instrument is occluded, the endoscope does not return and the endoscope is injured by mistake. This kind of accident can be avoided if the occlusal mouth of the instrument is all within the scope of the endoscope.
             

　　有些手术窥镜是在鞘管内使用，在更换其他角度窥镜或插拔器械时，应注意动作要轻，不可用力过猛。尤其是插拔窥镜过程中，当遇到阻力拔不动时应仔细查找原因，必要时应连同鞘管一起拔取，不要用蛮力。

　　Some operating endoscopes are used in the sheath tube. When replacing the endoscope with other angles or inserting and pulling out the instrument, the action should be light and the force should not be too strong. Especially in the process of inserting and pulling out the endoscope, when the resistance is encountered, the reason should be carefully found out. If necessary, it should be pulled out together with the sheath tube, without brute force.

　　当窥镜配合激光汽化、高频电切、微波等光电技术进行手术时，应注意窥镜前端与治疗点的距离，保证窥镜前端不被电击或烧灼。首次使用这些器械时，主刀医生应反复练习，掌握窥镜图像中物距和实际物距的关系，确认窥镜前端与治疗点的最近距离，以便在实际手术中应用自如。

　　When the endoscope is operated with laser vaporization, high-frequency electrosurgical excision, microwave and other photoelectric technologies, attention should be paid to the distance between the front end of the endoscope and the treatment point to ensure that the front end of the endoscope is not shocked or burned. When using these instruments for the first time, the chief surgeon should practice repeatedly to master the relationship between the object distance in the endoscope image and the actual object distance, and confirm the nearest distance between the front end of the endoscope and the treatment point, so that it can be used freely in the actual operation.

　　目前在耳鼻喉科、骨科的临床手术中已经广泛使用刨削器来切除病变组织。其刀头锋利、硬度高、旋转速度快、力矩大，如果削到内窥镜，窥镜必损无疑。在此类手术中要注意调整冲洗和吸引的速度，随时保证窥镜图像清晰不被血污遮挡，控制刀头的旋转部分始终在窥镜的观察范围内，在手术范围较大时，应先停止刀头转动，再移动窥镜，然后在窥镜监视下移动刀头，到合适部位后再开机刨削。当感觉到刨刀工作异常或照度突然降低时，有可能窥镜已经受损，应及时更换，以免造成更大损失。

　　At present, the planer has been widely used in otolaryngology and orthopedics to remove the pathological tissue. The cutter head is sharp, high hardness, fast rotation speed and large torque. If it is cut to the endoscope, the endoscope will be damaged. In this kind of operation, attention should be paid to adjusting the speed of washing and suction to ensure that the endoscope image is clear at any time, and the rotating part of the knife head is always within the scope of observation of the endoscope. When the operation range is large, the rotation of the knife head should be stopped first, then the endoscope should be moved, and then the knife head should be moved under the monitoring of the endoscope, and then the machine should be started to planing after reaching the appropriate position. When the planer blade works abnormally or the illumination suddenly decreases, the endoscope may have been damaged, so it should be replaced in time to avoid greater loss.

　　一般重要手术，应有一套备用窥镜和关键器械，在发现问题时可以从容地更换；如果使用角度不合适的窥镜或不配套的器械勉强手术，也容易造成窥镜的损坏。

　　For general important surgery, there should be a set of spare endoscopes and key instruments, which can be easily replaced when problems are found; if the endoscope with inappropriate angle or incompatible equipment is used to force the operation, it is easy to cause damage to the endoscope.