DE102013202540A1 - Treatment device for cleaning and disinfecting surgical instruments i.e. endoscopes, has fluid connectors connected with surgical instrument, where receiving device is arranged in space, and camera monitored by part of cleaning space - Google Patents

Abstract

The device (10) has fluid connectors (14, 14', 15, 15') connected with a surgical instrument (11) that receives a receiving device (12), where the receiving device is arranged in a cleaning space (13). A camera (16) is monitored by a part of the cleaning space. The camera is utilized for evaluating recorded image data in a control device (17), where the control device performs image recognition process in software, where the device is changed depending on evaluation of image data during operation of the device and controls a command of the control device. An independent claim is also included for a method for operating a treatment device for cleaning and disinfecting surgical instruments i.e. endoscopes.

Description

The invention relates to a treatment device for cleaning and / or disinfecting surgical instruments, in particular endoscopes, with at least one receiving a surgical instrument receiving device, which is arranged in a cleaning room and with at least one fluid connection for connection to a surgical instrument.

The invention further relates to a method for operating a treatment device for cleaning and / or disinfecting surgical instruments, in particular endoscopes, wherein a control device ( 17 ), in particular in the treatment device, which controls the cleaning and / or disinfecting of the surgical instrument or the surgical instruments depending on a surgical instrument inserted in a cleaning space of the treatment device or introduced surgical instruments.

Dressers of surgical instruments, particularly endoscopes, typically have systems that clean and disinfect both the outer surfaces of the surgical instruments and the channels or channel systems thereof. For this purge cycles are usually provided. Particularly in the case of the internal-canal flushing of a surgical instrument, in particular an endoscope or a flexible endoscope, the hygienic result of the preparation depends on the flow rates whose size is limited by the maximum flushing pressures permissible for the respective surgical instrument. These maximum permissible flush pressures are set differently for different manufacturers of surgical instruments. These range, for example, in some manufacturers of 0.8 bar differential pressure up to 2.0 bar differential pressure on the part of the applicant.

The rinsing cycles for the preparation of the channels or channel systems of surgical instruments, in particular flexible endoscopes, are preferably designed for the highest possible flow. However, the permissible flow rate is defined by the surgical instrument with the lowest permissible pressure, which is compatible with the treatment device or with the treatment system.

Since the treatment devices or preparation systems are suitable for various surgical instruments, this results in endoscopes with a higher pressure release of the fluid or with a higher permissible fluid pressure is accepted that the corresponding surgical instrument for a good hygienic outcome be processed longer got to. This is due to the fact that the treatment device or the treatment system is designed for a pressure that is caused by the surgical instrument that can withstand the lowest maximum pressure.

In order to improve the hygienic effectiveness of the reprocessing of surgical instruments, in particular endoscopes, in treatment devices, also referred to as washer-disinfectors, additional components have been developed which monitor critical process variables, such as the flow of internal passages of the surgical instrument so either user errors, such as incorrectly connected fluid connections or process errors such as a clogged inner channel or a worn seal within the fluid paths, especially waterways to recognize.

For example, this is off DE 44 40 363 C2 a method for testing and cleaning instruments for minimally invasive surgery or minimally invasive examination of body cavities are known, wherein the instruments have at least one continuous channel with instrument-type-specific flow values, wherein the following method steps are performed: the at least one channel of an instrument is connected to a Fluid source is connected, a flow value of the at least one channel is checked by the fluid from the fluid source is supplied to the channel and the amount of fluid flowing through the channel in a time unit is determined. The amount of fluid thus determined, with the corresponding predetermined instrument type specific values, is compared to a group of candidate instrument types. If there is a match between the determined amount of fluid and one of the predetermined values based on this match, the instrument type is identified and a type-specific flush with disinfectants and / or detergents is initiated or, in the absence of a match between the predetermined fluid amount and one of the predetermined values Registration of the instrument (s) for disposal.

In the event that such devices are used for fault detection within a treatment device or such processes are carried out, it may happen that a user of a corresponding treatment device refers to the displays of the treatment device or a corresponding supplementary device thereto, which performs such methods, leaves and thus reduces its own plausibility checks.

It is an object of the present invention to provide an efficient treatment device for cleaning and / or disinfecting surgical instruments and a method for operating a corresponding treatment device, by means of which on the one hand optimal and efficient cleaning and / or disinfection is possible and on the other error sources are reliably detected ,

This object is achieved by a treatment device for cleaning and / or disinfecting surgical instruments, in particular endoscopes, with at least one receiving a surgical instrument receiving device, which is arranged in a cleaning room and at least one fluid connection for connection to a surgical instrument, which further developed in that a camera is provided by means of which at least a part of the cleaning room is or is monitored.

By providing a camera by means of which at least part of the cleaning space is or is monitored, errors in the preparation of surgical instruments can be detected very efficiently. In this case, for example, the surgical instrument or a part of the surgical instrument, connections to the surgical instrument and other components are monitored.

Preferably, a control device is provided, by means of which the image data recorded by the camera can be evaluated or evaluated. By evaluating the recorded image data, it can be detected, for example, whether flushing fluid escapes through a channel of the surgical instrument or not.

It is particularly preferred if, by means of the evaluated image data, a type of the surgical instrument, the number of surgical instruments in the receiving device, the fluid connection to the surgical instrument, the suitability of the fluid connection for the surgical instrument, and / or the arrangement of the surgical instruments in the recording device are determined or detected. By recognizing the type of the surgical instrument, for example, a special cleaning and / or disinfection program can be carried out automatically by means of the control device. The number of surgical instruments in the receiving device may be significant in order to adjust the duration of the cleaning or disinfecting. The fluid connection to the surgical instrument or the evaluation of the image data for this purpose can provide additional security, since it can thus be detected whether the fluid connection is actually correctly connected to a channel of the surgical instrument. For example, it may also be possible to detect whether fluid is leaking from the fluid port in the wrong place. The suitability of the fluid port for the surgical instrument provides added security to ensure that the operator has also used the proper fluid ports for the appropriate surgical instrument. For this purpose, the fluid connections can have, for example, different colors, color combinations or different geometries that are provided for corresponding surgical instruments or for different channels of different surgical instruments. Proper placement of the surgical instruments in the receiving device serves to accomplish successful cleaning and / or disinfection. For this purpose, the individual components of the surgical instrument should be arranged at appropriate distances from one another so that fluid or a fluid can act on the surgical instrument everywhere. This can also be recognized accordingly.

Preferably, a control command of the control device is or is changed as a function of the evaluated image data in the operation of the processing devices. For example, based on the degree of cleanliness of an outer wall of the endoscope, a washing program or a cleaning program can be lengthened or shortened. In addition, an abort command can also be generated if, for example, a fluid connection is detached from the surgical instrument.

Preferably, the camera is pivotable so as to be able to inspect more precisely specific areas in the cleaning space of the treatment device or to actually be able to detect the entire cleaning space. The camera can be provided with a corresponding zoom lens to make the detail shots. It can also be provided an extremely wide-angle lens to cover a larger area. It can also be provided several cameras, on the one hand to cover a larger area and on the other to be able to make some detail shots. This further improves the reliability of the treatment device.

The camera can be arranged in the cleaning room. For this purpose, this is then provided watertight or hermetically sealed. Alternatively, a hermetically sealed container may be provided into which the camera is inserted. It can also be provided to provide only a window in a wall of the cleaning room and to place the camera behind the window. In this case it is not necessary to provide a hermetically sealed camera.

The object is further achieved by a method for operating a treatment device for cleaning and / or disinfecting surgical instruments, in particular endoscopes, wherein a control device, in particular in the treatment device, is provided, which is dependent on introduced in a cleaning room of the treatment device surgical instrument or introduced surgical instruments, the cleaning and / or disinfecting of the surgical instrument or surgical instruments, which is further developed in that by means of a camera recorded image data from the cleaning room of the treatment device controlling the cleaning and / or disinfecting is affected.

By influencing the cleaning and / or the disinfecting, it is understood, in particular, that when an error is detected, for example, a faulty connection of a fluid connection to a surgical instrument, an error message is generated and cleaning and / or disinfection is not started until this error has been eliminated. Influencing also means, in particular, that the cleaning and / or disinfecting is adapted, for example, as a function of the recognition of a type of surgical instrument. In addition, influencing the cleaning and / or disinfecting also means a shortening or lengthening of the process time if, on the basis of the recorded image data, it follows that an extension or shortening makes sense.

Preferably, it is checked by means of the image data whether the treatment device, in particular a receiving device in the cleaning room, is correctly filled and / or the surgical instrument or the surgical instruments is or are correctly connected to at least one fluid connection.

It may also preferably be provided to determine the number of surgical instruments introduced into the cleaning space and / or into a receiving device of the cleaning space in order to adapt the cleaning and / or disinfecting on the basis of these data.

Preferably, a type of surgical instrument is determined by means of the image data, and on the basis of this determination, a cleaning and / or disinfection program provided for the type of surgical instrument is run. It may also be the case that various types of surgical instruments are introduced and intended that are not compatible with one another for cleaning and / or disinfecting. So it may be that a surgical instrument should be treated at a correspondingly high temperature or with the appropriate aggressive chemicals and another surgical instrument would not tolerate this. In this case, an error message is issued to the operator and prevents that a cleaning and / or disinfection program is shut down. It is also possible to cancel a cleaning and / or disinfection program if a wrong type of surgical instrument is to be treated by the operator with a corresponding cleaning and / or disinfection program. In this case, the operator can be shown which cleaning and / or disinfection programs are suitable for this type of surgical instrument. In addition, a type determination of the surgical instrument can be carried out by means of an image recognition, namely on the basis of specific features of the surgical instrument. Thereafter, a display can be made by means of which the operator can select one or more alternative cleaning and / or disinfection programs. Alternatively, the most suitable cleaning and / or disinfection program can be run automatically.

The image data are preferably evaluated continuously in order to influence the cleaning and / or disinfecting by temporal variation of the image data. Thus, for example, a time-varying variation of the image data may preferably be considered as a detaching fluid connection, a changed position of the surgical instrument, a quality of external cleaning of the surgical instrument and / or a quality of external drying of the surgical instrument. Depending on one of these parameters, the cleaning and / or disinfection program can be adapted.

Preferably, it is checked by means of the image data whether a channel of a surgical instrument is permeable to liquid. For example, it can be evaluated whether water exits at the distal end of a channel.

Preferably, a degree of contamination of the processing device is determined by the evaluation of the image data. For this purpose, for example, be provided to monitor the walls of the cleaning room in terms of pollution. It can also be provided to arrange a light source below the sump of the cleaning space, by means of which light is transmitted through the liquid present in the sump. The light intensity or discoloration of the light can be evaluated accordingly by means of the camera.

Preferably, a mechanical defect of the processing device is detected by the evaluation of the image data. As a mechanical defect, for example, a lack of coupling of the receiving device, for example a basket on the treatment device can be considered, a defective antenna, a defective chamber wall, a defective spray arm or a non-rotating spray arm or a defective sump of the treatment device. It can also be recognized accordingly whether there are tissue parts in the sump, so that a cleaning of the treatment device or the cleaning room appears necessary.

The object is further achieved by the use of image data obtained by a camera from a cleaning space of a treatment device for cleaning and / or disinfecting surgical instruments, in particular endoscopes, for controlling a method for operating the treatment device, wherein, in particular, an aforementioned method is preferably used.

For monitoring the correct loading of the receiving device or the receiving devices, in particular baskets, in a corresponding processing device, the correct connection of the surgical instruments to the corresponding fluid connection and / or to a flow measuring device and / or the verification of the flow of a fluid through a surgical instrument an optical system, in particular a camera including image recognition algorithms can be used. In the cleaning room or the washing chamber of a treatment device, one or more cameras may be provided, which are either fixed or adjustable or pivotally arranged so as to be able to create a complete picture of the cleaning room and the loading of the cleaning room with surgical instruments. In the control device of the processing device or in a control device which is assigned to the camera or the cameras, an image recognition algorithm is provided by means of which various plausibility checks can be carried out. A check for correctness of a load can be made. For example, it can be checked whether there is at most one standard endoscope per receiving device. It can also be tested alternatively per recording device, whether a maximum of two ENT endoscopes are provided. ENT endoscopes are ear-nose-throat endoscopes. It can be checked whether a flow measuring device or a fluid connection are correctly connected to the respective endoscope or the channels of an endoscope. For this purpose, a type of endoscope can be detected beforehand. In comparison with an internal database, it is determined which connections are to be connected, so that it can be determined on the basis of the image recognition whether the corresponding adapters of the fluid connection are correctly placed.

In principle, a database can also contain other data, for example images of a completely clean cleaning room, which can be compared with an operating cleaning room. It can also be recognized whether, in addition to the surgical instruments or endoscopes, accessories specified exclusively for these surgical instruments are located in the respective receiving device.

In addition, it can be recognized whether corresponding types of surgical instruments for treatment in the treatment device are even released.

In addition or as a supplement or alternatively, specific cleaning programs or disinfection programs can be started by recognizing an endoscope type or a type of surgical instrument for this surgical instrument.

Through continuous image evaluation of the load, detaching adapters or fluid connections, which may have been plugged by the operator without being locked, can be detected during the process. By picking up and evaluating the distal end of a surgical instrument, it can be detected if any water is flowing through the surgical instrument. As a result, for example, a total blockade can be detected. In addition, due to the amount of water leaving, it can also be recognized if there is a partial blockage.

Furthermore, the position of the surgical instrument can be continuously checked. If, for example, the fluid pressure causes the distal end to move into a position that is unfavorable to the surgical instrument, the rinsing process or cleaning process and / or the disinfection process can be interrupted.

In addition, the quality of an external cleaning or an external drying can be determined in order to carry out temporally variable, result-dependent, methods.

In addition, additional safety devices can be provided or security procedural steps can be provided. For example, starting a self-disinfection or a thermal disinfection program can be prevented if thermolabile surgical instruments are detected as a load. It can also be a general malfunction of the treatment device recognized such as voiding, untagged basket coupling, external defects on antennas, chamber walls, sump and / or spray arms.

Further features of the invention will become apparent from the description of embodiments according to the invention together with the claims and the accompanying drawings. Embodiments of the invention may satisfy individual features or a combination of several features.

The invention will be described below without limiting the general inventive idea by means of embodiments with reference to the drawings, reference being expressly made to the drawings with respect to all in the text unspecified details of the invention. Show it:

1 FIG. 2 is a schematic plan view of a sectional view through a treatment device according to the invention, FIG.

2 a schematic representation of a method according to the invention and

3 a schematic representation of another method of the invention.

In the drawings, the same or similar elements and / or parts are provided with the same reference numerals, so that apart from a new idea each.

1 schematically shows a plan view of a sectional view through a processing device according to the invention 10 , In a reception basket 12 is an endoscope 11 brought in. The endoscope 11 is a flexible endoscope in this embodiment. The reception basket 12 is in a cleaning room 13 the processing device 10 brought in. They are fluid lines 14 . 14 ' provided a liquid to the endoscope 11 conduct and in particular into channels of the endoscope. These are the fluid lines 14 . 14 ' with adapters 15 . 15 ' connected to the corresponding terminals on the endoscope. It is also a camera 16 provided, the shots of or from the cleaning room 13 makes, and the appropriate recordings over a data line 18 to a control device 17 passes.

By means of the control device 17 can control signals via a data line 19 for example, in a fluid delivery device 21 be delivered. For example, recognizing that from the working channel 20 no liquid emerges at the distal end or only little liquid escapes, briefly increasing the pressure of the fluid to block the working channel 20 possibly to be able to eliminate this.

The camera 16 can be pivoted to the entire area of the cleaning room 13 to be able to measure. There can be several baskets 12 be provided, for example, one above the other, ie from the level of 1 can be arranged out.

In place of a camera 16 It is also possible to provide several cameras. The control device 17 In addition, the control device of the processing device 10 in itself and take all control measures to clean and / or disinfect the endoscope 11 perform. It is insofar referred to the above information explicitly.

2 schematically shows an inventive method for operating a treatment device for cleaning and / or disinfecting a surgical instrument in a schematic block diagram. at 100 gets a picture from a cleaning room 13 the processing device 10 included, at 110 an image recognition is performed. For this purpose, the recorded image data are evaluated, for example, so that they are compared with images stored in a database. It is also possible to compare typical features such as color or shape or connection arrangement and respective sizes with a database for corresponding endoscopes. at 120 it asks if an endoscope type has been detected. If this is not the case, it will be added 190 a warning signal is issued and an abort signal is delivered. Alternatively, it is also possible for an operator to be given the option of starting a specific rinsing program, which in any case is harmless to the endoscope. If an endoscope type has been detected, is at 130 asked whether the endoscope is approved for a desired disinfection or cleaning. If this is answered in the negative, it will be added again 190 a warning signal is issued and the procedure is aborted. The question becomes 130 in the affirmative, the image data is used to check whether the endoscope is correctly connected. If this is not the case, the operator is issued a request to connect the corresponding adapter. The question becomes 140 answered with yes, the washing program is included 150 began.

at 160 it is checked whether at a channel outlet, for example, at the distal end of a channel, rinse water exits. If this is not the case, a signal will be provided 210 issued that there is a blockage. Alternatively, the control device 17 also generate a signal that temporarily increases the pressure in the fluid supply to try to get one eliminate existing blockage. The question becomes 160 answered with yes, it is queried whether the wash program has gone through, namely at 170 , If this is the case, it will be added 180 for example, started with the disinfection or finished the wash program. The question becomes 170 If answered with no, the system asks whether the position of an adapter has changed during operation. If this is the case, it will be added 230 the washing program is aborted and an error message is issued. If no change in position has occurred, it goes back to the procedure 160 with the question whether rinse water is present at the channel exit.

3 shows a further inventive cleaning or disinfection program in a schematic block diagram. at 180 a disinfection program is started. at 240 is then then checked whether there is a critical change in position of the endoscope, for example, a distal end of an endoscope. If this is answered with yes, it goes to the block 340 , namely to abort the procedure and an error message. The question becomes 240 answered with no, finds 220 checking whether there is a change in position of an adapter. If so, go to the block 340 and thus a cancellation because of an error message. If no change in position of an adapter has been found, is at 250 queried whether another defect was detected, such as a non-rotating spray arm of the treatment device. If such a defect is detected, it goes back to the block 340 , ie cancellation and error message.

If a corresponding defect in 250 is not determined, it goes on 290 namely, to start the wash program. In addition, before the block 290 be provided a query whether the disinfection program has been completed. If this is answered with yes, then it goes to the block 290 , If answered no, it would be shown in the block diagram of FIG 3 downstream of the block 180 go on and with the appropriate queries from the block 240 ,

After the beginning of the washing program at 290 is at 220 For example, again queried whether an adapter has changed its location. Should this be answered with yes, finds 340 an abort and an error message instead. If the question is answered with no, will be at 300 queried whether the wash program has gone through. As long as this is not the case, it goes back to block 220 , Should the wash program be included 300 have passed through the drying of the endoscope 310 instead of. It is then checked, for example with a camera, if the endoscope is completely dry, this can be determined, for example, by appropriate reflections or changes in the reflections. If the endoscope is not dry, the drying process continues. If it is determined that the endoscope has dried completely, the procedure is included 330 completed.

All mentioned features, including the drawings alone to be taken as well as individual features that are disclosed in combination with other features are considered alone and in combination as essential to the invention. Embodiments of the invention may be accomplished by individual features or a combination of several features.

LIST OF REFERENCE NUMBERS

10

 treatment device

11

 endoscope

12

 receiving basket

13

cleaning room

14, 14 '

 fluid line

15, 15 '

 adapter

16

 camera

17

control device

18

data line

19

data line

20

working channel

100

 image capture

110

image recognition

120

Endoscope type detected?

130

Endoscopic type approved?

140

Endoscope connected correctly?

150

Start the wash program

160

Rinsing water at the channel outlet?

170

Rinse program gone through?

180

Start of disinfection

190

Issue warning signal / abort

200

Specify prompt for connection

210

Output blockage signal

220

Change in the position of an adapter?

230

Cancel wash program and error message

240

critical change in the position of the endoscope?

250

Defect detected?

260

Continue disinfection program

280

 Disinfection program driven through?

290

Start flushing program

300

Rinse program gone through?

310

dry

320

completely dry?

330

The End

340

Abort and error message

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• DE 4440363 C2 [0007]

Claims (15)

Processing device ( 10 ) for cleaning and / or disinfecting surgical instruments ( 11 ), in particular endoscopes, with at least one surgical instrument ( 11 ) receiving device ( 12 ) in a cleaning room ( 13 ) and with at least one fluid connection ( 14 . 14 ' . 15 . 15 ' ) for connection to a surgical instrument ( 11 ), characterized in that a camera ( 16 ) is provided, by means of at least a part of the cleaning space ( 13 ) is or is monitored. Processing device ( 10 ) according to claim 1, characterized in that a control device ( 17 ) is provided by means of the by the camera ( 16 ) recorded image data are evaluated or evaluated. Processing device ( 10 ) according to claim 2, characterized in that the control device ( 17 ) performs an image recognition software. Processing device ( 10 ) according to claim 2 or 3, characterized in that by means of the evaluated image data one type of surgical instrument ( 11 ), the number of surgical instruments ( 11 ) in the receiving device ( 12 ), the fluid connection ( 14 . 14 ' . 15 . 15 ' ) on the surgical instrument ( 11 ), the suitability of the fluid connection ( 14 - 15 ' ) for the surgical instrument ( 11 ) and / or the arrangement of the surgical instrument ( 11 ) in the receiving device ( 12 ) is determined or determined. Processing device ( 10 ) according to one of claims 1 to 4, characterized in that, depending on the evaluated image data in the operation of the processing device ( 10 ) a control command of the control device ( 17 ) is or is changed. Processing device ( 10 ) according to one of claims 1 to 5, characterized in that the camera ( 16 ) is pivotable. Method for operating a treatment device ( 10 ) for cleaning and / or disinfecting surgical instruments ( 11 ), in particular endoscopes, wherein a control device ( 17 ), in particular in the treatment device ( 10 ), which, depending on in a cleaning room ( 13 ) of the treatment device ( 10 ) introduced surgical instrument ( 11 ) or introduced surgical instruments ( 11 ) cleaning and / or disinfecting the surgical instrument or instruments ( 11 ), characterized in that by means of a camera ( 16 ) recorded image data from the cleaning room ( 13 ) of the treatment device ( 10 ) controlling the cleaning and / or disinfecting is influenced. A method according to claim 7, characterized in that by means of the image data is checked whether the processing device ( 10 ), in particular a receiving device ( 12 ) in the cleaning room ( 13 ) is correctly filled and / or the surgical instrument ( 10 ) or the surgical instruments ( 11 ) correctly with at least one fluid connection ( 14 - 15 ' ) is or are connected. Method according to claim 7 or 8, characterized in that by means of the image data one type of surgical instrument ( 11 ) and, for the purposes of this determination, a type of surgical instrument ( 11 ) provided cleaning and / or disinfection program is traversed. Method according to one of claims 7 to 9, characterized in that the image data are continuously evaluated to act by a temporal variation of the image data on the cleaning and / or disinfecting. A method according to claim 10, characterized in that as temporal variation of the image data, a detaching fluid connection ( 14 - 15 ' ), a changed position of the surgical instrument ( 11 ), a quality of external cleaning of the surgical instrument ( 11 ) and / or a quality of external drying of the surgical instrument ( 11 ) is seen. Method according to one of claims 7 to 11, characterized in that it is checked by means of the image data, whether a channel ( 20 ) of a surgical instrument ( 11 ) is permeable to liquid. Method according to one of claims 7 to 12, characterized in that by evaluating the image data, a degree of contamination of the processing device ( 10 ) is determined. Method according to one of claims 7 to 13, characterized in that by evaluating the image data, a mechanical defect of the processing device ( 10 ) is recognized. Using from a camera ( 16 ) from a cleaning room ( 13 ) a processing device ( 10 ) for cleaning and / or disinfecting surgical instruments ( 11 ), in particular endoscopes, obtained image data for controlling a method for operating the Processing device ( 10 ), in particular according to one of claims 7 to 14.

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