Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
  • A61B1/12—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements
  • A61B1/121—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements provided with means for cleaning post-use
  • A61B1/125—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with cooling or rinsing arrangements provided with means for cleaning post-use using fluid circuits
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/70—Cleaning devices specially adapted for surgical instruments
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
  • A61B90/70—Cleaning devices specially adapted for surgical instruments
  • A61B2090/701—Cleaning devices specially adapted for surgical instruments for flexible tubular instruments, e.g. endoscopes

Definitions

• the invention relates to a method for rinsing endoscope channels of an endoscope.
• the invention further relates to a device for flushing endoscope channels of an endoscope and the use of a corresponding device.
• a measuring device for example a flow meter or a pressure gauge, is provided in the flushing line.
• the channels are rinsed and tested one at a time or simultaneously.
• the processing time is significantly reduced if the channels are flushed in parallel.
• the effort for the flow test increases with the number of channels, because a measuring device with associated electronics must be provided per channel.
• the invention has for its object to keep the processing time for cleaning an endoscope with multiple endoscope channels as short as possible and the necessary effort as low as possible.
• the endoscope channels of an endoscope are thus checked one after the other for blockages, but parallel or simultaneously further endoscope channels or at least one further rinsed endoscope channel. Since the duration for testing an endoscope duct for a blockage is generally much shorter than the intended or prescribed time for rinsing and cleaning the endoscope channel, a significant proportion of the processing time is saved by the parallel rinsing. At the same time the effort remains low regardless of the number of endoscope channels, because according to the invention a single tester is sufficient. Preferably, several other or all other endoscope channels are rinsed simultaneously.
• a flow rate or a pressure of the rinsing agent is measured or determined by means of the testing device.
• Pressure and flow rate are particularly dependent on the diameter of an endoscope channel, which changes with partial or complete blockage, in particular reduced.
• the measurement or determination of pressure and / or flow rate, in particular a volume flowing per unit time thus ensures that a blockage of an endoscope or an endoscope channel is reliably detected.
• the method according to the invention is discontinued as soon as the checking for an endoscope channel results in a blockage.
• Endoscope must be specially treated or retired, so that a continuation of the method according to the invention would only unnecessarily prolong the processing time.
• a device for flushing endoscope channels of an endoscope with detergent from a detergent supply having a first detergent distributor and a second detergent distributor, which are respectively connected to the detergent supply, and a number of flushing channels for introducing detergent from the Detergent supply in each case comprises an endoscope channel, wherein for each flushing channel, a switching valve is provided, by means of which the flushing channel is connected in a first position of the switching valve with the first flushing agent distributor and in a second position with the second flushing agent distributor, wherein the first flushing agent distributor comprises a first testing device by means of which an endoscope channel connected to the first flushing agent distributor via one of the flushing channels can be checked for blockage.
• a rinsing agent is in particular a rinsing liquid, for example a disinfecting solution.
• a flushing channel is in particular a connection for an endoscope channel or comprises a connection for an endoscope channel.
• the number of flushing channels is preferably greater than or equal to a number of endoscope channels of an endoscope to be flushed, so that each endoscope channel can be connected to exactly one flushing channel.
• the second flushing agent distributor preferably has a second checking device.
• the first test device and / or the second test device preferably comprise a flow meter or a pressure gauge.
• one of the two test devices may comprise a flow meter and the other of the two test devices may comprise a pressure gauge.
• the second test device in the form of a flow meter, may preferably measure the total flow through the other channels.
• a flow rate meter determines the amount of flushing agent flowing per unit of time through a test device or the associated flushing agent distributor, in particular the volume.
• a blockage in an endoscope channel which is connected in particular as the only endoscope channel to the corresponding flushing agent distributor or connected thereto, can be seen in particular in that the measured or determined flow rate of flushing agent deviates from the flow rate expected for this endoscope channel.
• blockage or constrictions in particular, can also be partially detected in an endoscope channel in which the endoscope channel is not completely closed or blocked.
• a pressure gauge in particular the pressure of the rinsing agent in the test device or the corresponding detergent Distributor measured or determined, which is directly related to the detergent pressure within an endoscope channel connected to the detergent dispenser.
• This also constipations or constrictions of the endoscope channel are detectable, because the cross section of the endoscope channel, which is reduced by deposits or blockages, exerts a direct influence on the detergent pressure in the endoscope channel.
• a flushing agent distributor is designed as a flushing agent chamber or as a flushing agent reservoir. This makes possible a particularly compact flushing agent distributor with very short line paths, which for reasons of hygiene are preferable to longer and / or branched lines.
• a changeover valve has an actuating drive, in particular automatically controllable.
• the rinsing, cleaning and testing of the endoscope channels can be carried out automatically, in accordance with a, in particular predetermined, cleaning procedure. in particular without intervention of an operator.
• a flushing channel or endoscope channel which has already been flushed for a sufficiently long period can be completely separated from the flushing agent supply, so that the efficiency of the flushing device is increased, in particular Saves detergent.
• irrigation channels to which no endoscope channel is connected can be closed during cleaning. It can therefore be provided a larger number of flushing channels, which is possible due to the invention without much effort, so that a single device according to the invention for flushing or cleaning differs dener endoscopes or endoscope types with different numbers of endoscope channels or for cleaning several endoscopes is used simultaneously.
• the device comprises a flushing agent pump to pressurize at least one flushing agent distributor with flushing agent from the flushing agent supply under a, in particular specifiable, pressure.
• a flushing agent pump to pressurize at least one flushing agent distributor with flushing agent from the flushing agent supply under a, in particular specifiable, pressure.
• the device comprises at least one, in particular switchable, pressure boosting pump, for example in a supply line from the detergent supply to the first detergent distributor.
• the pressure booster pump can also be arranged in one of the flushing channels.
• the pressure of the flushing agent in the endoscope channels or in a part of the endoscope channels can be specified separately. This is particularly advantageous for testing individual, relatively narrow endoscope channels, for example an albarran channel.
• the device according to the invention is characterized in particular by the fact that it is suitable for the application of the method according to the invention.
• the object underlying the invention is also achieved by the use of a device according to the invention in a method according to the invention.
• a rinse which is a cleansing solution. It can be used, for example, a disinfectant solution or a solution that antibacterial effect. Dishwashing solutions for this purpose are known to the person skilled in the art.
• the endoscope After the endoscope has been adequately cleaned, it is rinsed with purified water to remove any chemical components of the detergent solution or detergent.
• the changeover valves are switched so that all detergent residues are flushed out.
• Fig. 1 shows schematically a flushing device according to the invention
• Fig. 2 shows schematically a circuit diagram of another flushing device according to the invention.
• Fig. 1 shows schematically a flushing device 1 according to the invention with four flushing channels 30a, 30b, 30c, 30d.
• An unillustrated Doskop is connected to the flushing device, wherein in each case an endoscope channel is connected to a flushing channel.
• the cleaning of the endoscope and the endoscope channels is carried out with detergent, which is introduced via the flushing channels in the endoscope channels.
• the rinsing agent for example a liquid disinfectant solution, is provided in a rinsing agent container 10 and conveyed by means of a pump 12 via a first supply line 21 into a first distribution chamber 20 and via a second supply line 23 into a second distribution chamber 22.
• a test device 24 with a flow meter 28 is also provided.
• the flowmeter 28 is particularly a flow volume meter, i. the amount of flushing agent flowing through the first supply line 21 per unit of time is measured or determined.
• a flow meter 28 may also be a flow mass meter, i. the mass of the rinsing agent flowing through the first supply line per unit of time is measured or determined.
• the variable to be determined can correspond to the measured value measured or can be determined from the measured value.
• Switching valves 32a-d are arranged between the flushing channels 30a-d on the one hand and the two distributor chambers 20, 22 on the other hand, with a separate switching valve 32a-d being provided for each flushing channel 30a-d. This results in a mutual assignment of one switching valve 32a-d, one flushing channel 30a-d and one endoscope channel connected to this flushing channel 30a-d.
• a switching valve 32a-d is respectively configured such that the corresponding purge passage 30a-d is connected to the first distribution chamber 20 in a first position of the changeover valve 32a-d and to the second distribution chamber 22 in a second position of the changeover valve 32a-d.
• the corresponding endoscope channel is thus optionally fed or supplied with rinsing agent via the first distribution chamber 20 or the second distribution chamber 22.
• the switching valves 32 a - d For switching between the first position and the second position, the switching valves 32 a - d, for example, rotated.
• the change-over valves 32a-d each have an actuator (not shown), for example a setting cylinder or a worm drive.
• the flushing agent thus flows from the flushing agent supply 10, assisted by the pump 12, via the first supply line 21 and the checking device 24, the first distribution chamber 20, the switching valve 32a and the flushing passage 30a to one to the flushing channel 30a connected endoscope channel.
• the switching valve 32a is switched over, i. placed in the second position (position B)
• the endoscope channel is acted upon by the second supply line 23, the second distribution chamber 22, the switching valve 32a and the flushing channel 30a with detergent and rinsed.
• a state of the flushing device 1 is exemplified, in which the switching valve 32b in position A and the other switching valves 32a, 32c, 32d are in position B.
• an endoscope channel connected to the flushing passage 30b becomes supplied via the first supply line 21 and the first distribution chamber 20 with detergent from the detergent tank 10, while the rinsing agent passes through the second supply line 23 and the second distribution chamber 22 to the other detergent channels 30a, 30c, 30d connected endoscope channels.
• the volume of flushing agent measured or determined by means of the flowmeter 28 corresponds to the amount of flushing agent flowing through the endoscope channel connected to the flushing channel 30b. If this endoscope channel is completely or partially blocked, the volume of flushing agent flowing through the endoscope channel per unit of time changes, which can be measured on the flowmeter 28. By means of the flow meter 28 or the test device 24, the endoscope channel 30b can thus be checked for blockage.
• the endoscope channels connected to the other flushing channels 30a, 30c, 30d can each be checked for blockage if the switching valves 32a-d are switched or switched in such a way that respectively the switching valve 32a-d associated with the corresponding endoscope channel is in position A and all other switching valves 32a-d are or are placed in position B.
• all other endoscope channels are supplied with rinsing agent via the second supply line 23 and the second distribution chamber 22 and are cleaned or rinsed.
• all endoscope channels are individually and successively connected to the first distribution chamber 20 and checked by the test device 24 in the manner described for blockages out.
• the respective other endoscope channels are connected to the second distribution chamber 22 and are rinsed.
• one line shows a combination of the simultaneously set positions of all the change-over valves 32a-d, and one column shows the positions consecutive for a specific change-over valve 32a, 32b, 32c, 32d.
• position A means that the corresponding endoscope channel is checked for blockage
• position B means that the corresponding endoscope channel is flushed.
• the switching valve 32a is in position A, ie, an endoscope channel connected to the flushing channel 30a is checked for blockage by means of the test device 24.
• the other switching valves 32b, 32c, 32d are in position B, so that the corresponding endoscope channels are flushed simultaneously. This configuration is maintained until a check for obstruction or a passage check of the endoscopic channel connected to the irrigation channel 30a has taken place with the desired accuracy.
• the duration of the corresponding test can vary in particular depending on the cross section of the endoscope channel to be tested.
• the switching valves 32a-d are brought into the configuration indicated by the sequential number 2 in which the switching valve 32b is in position A and the other switching valves 32a, 32c, 32d are in position B. Now the endoscope channel connected to the flushing channel 30b is checked for blockage and the endoscope channels connected to the other flushing channels 30a, 30c, 30d are flushed.
• the total duration for running through the configurations 1 to 4 thus results from the addition of the times required for testing the individual endoscope channels or the test times for the individual endoscope channels. This results in each endoscope channel automatically and without additional loss of time a certain flushing time, which essentially corresponds to the addition of the spent for all other endoscope channels test times. It is overall If necessary, it should be taken into account that, depending on the mode of operation of the test device 24, an endoscope channel may also be flushed with rinsing agent during the test for a blockage, which can then be taken into account for the rinsing time of this endoscope channel already taken.
• a configuration 5 may be set in which, for example, all the switching valves 32a-d are in position B and Thus, all endoscope channels are rinsed once again for any remaining time required.
• FIG. 2 schematically shows a circuit diagram of a further flushing device 1 according to the invention, from which some further developments and modifications of the invention can be seen by way of example.
• the flushing device shown in FIG. 2 has, by way of example, three flushing passages 30a, 30b, 30c, which can each be connected to a first distributor 20 or a second distributor 22 via a switching valve 32a, 32b, 32c.
• the distributors 20, 22 each have a supply line 21, 23 for supplying detergent, which is then distributed via the switching valves 32a-c and flushing channels 30a-c to endoscope channels of a connected endoscope.
• Both supply lines 21, 23 are separately equipped with a respective detergent dispenser 10 and a pump 12.
• the distributors 20, 22 can be supplied, for example, each with different rinsing agent and / or be acted upon by a different pressure with detergent.
• a test device 24 with a shut-off valve 26 and a pressure gauge 25 is provided in the supply line 21, a test device 24 with a shut-off valve 26 and a pressure gauge 25 is provided in the supply line 21, a test device 24 with a shut-off valve 26 and a pressure gauge 25 is provided. A blockage downstream of this test device 24 can be seen in that the measured in the supply line 21 by means of the pressure gauge 25, which is arranged downstream of the check valve 26, not or only slowly falls after the check valve 26 is closed.
• the pressure gauge 25 which is arranged downstream of the check valve 26 not or only slowly falls after the check valve 26 is closed.
• essentially a change or narrowing of the cross section of an endoscope channel is detected.
• the supply line 23 also has a test device 24, this test device comprising a flow meter 28 with the already described in connection with FIG. 1 operation.
• test devices described are to be understood as examples within the scope of the invention.
• the scope of the invention includes any test device with which a downstream connected endoscope channel is testable for a blockage or by means of which a blockage of the endoscope channel is recognizable or detectable.
• the switching valve 32a of the exemplary flushing device 1 shown in FIG. 2 is designed as a 3/2-way valve, wherein in the first position flushing agent from the distributor 20 and in the second position flushing agent from the distributor 22 is directed to a flushing channel 30a, on which in turn an endoscope channel is or will be connected.
• the operation of the switching valve 32a thus substantially corresponds to the switching function described in connection with FIG.
• the switching valve 32b is designed as a 3/3-way valve. In a In the first position, rinsing agent is conducted from the distributor 20 into the rinsing channel 30b. In a second position, rinsing agent is conducted from the distributor 22 into the flushing channel 30b. In a third position, the valve is closed, ie no flushing agent flows.
• the flushing channel 30b is thus a switch-off flushing channel, which can remain free, for example, when the endoscope to be flushed has fewer endoscope channels than flushing channels 30a-c are present. This functionality is particularly advantageous in a flushing device with numerous, for example more than five, flushing channels.
• the switching valve 32c in Fig. 2 is again designed as a 3/2-way valve, similar to the switching valve 32a. However, it may be formed without abandoning the basic idea according to the invention as a 3/3-way valve or in a suitable other way.
• the flushing channel 30c connected to the switching valve 32c has an additional pump 34, by means of which the flushing agent pressure in the flushing channel 30c and the connected endoscope channel can be predetermined independently of the flushing agent pressure in the other flushing channels or endoscopic channels.
• the flushing channel 30c is particularly suitable for particularly narrow endoscope channels, for example an albarran channel, which are advantageously flushed under a relatively high pressure, for example to reduce the required flushing duration.
• an endoscope channel can be checked for blockage in two independent ways.
• a redundant check can take place.
• it can be excluded, for example, that due to a unidirectional clogged changeover valve 32a-d, a problem with a distributor 20, 22 or a faulty one Lead 21, 23 erroneously displays an endoscope channel that is actually open, as being clogged.
• An exemplary endoscope has three endoscope channels of different diameters.
• the thinnest endoscope channel i. the endoscope channel with the smallest cross-section or the greatest flow resistance
• the thickest endoscope channel or the endoscope channel with the lowest flow resistance is connected, for example, to the lockable flushing channel 32b and the third endoscope channel to the flushing channel 32a.
• position A means that the corresponding endoscope channel is connected to the first distributor 20
• position B assumes that the endoscope channel is connected to the second distributor 22, and position C, which is provided only for the switching valve 32b, that the corresponding endoscope channel of both distributors 20, 22 and thus of the detergent supply is completely separated.
• one of the endoscope channels is connected one after the other to the first distributor 20 one after the other and is connected by means of the first test device 24 in the supply line 21, i. be checked for blockage by means of the check valve 26 and the pressure gauge 25.
• the other two endoscope channels are supplied with rinsing agent via the second distributor 22 and rinsed.
• one of the endoscope channels is connected one after the other to the second distributor 22 one by one, and by means of the second testing device 24 in the supply line 23, i. be checked for blockage by means of the flow meter 28.
• the switching valve 32b is in the position C, in which the corresponding endoscope channel is separated from the detergent supply.
• This is, for example, the endoscope channel with the lowest flow resistance, which usually requires the least flushing time for proper cleaning. In this way, detergent is saved.
• each endoscope channel is checked twice for a blockage, in each case different test methods or measurement methods are used.
• test methods or measurement methods there are two independent and redundant tests for each endoscope channel, so that in particular apparatus errors, for example a one-sided blocked changeover valve 32a-c or a faulty distributor 20, 22, can be detected and eliminated.
• different test methods depending on, for example, the cross section of an endoscope channel provide different exact results or require different lengths of a certain precision of the test. If, as in the example shown in FIG.

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• 2011
  • 2011-09-15 DE DE102011082776A patent/DE102011082776A1/de not_active Ceased
• 2012
  • 2012-09-13 WO PCT/EP2012/003834 patent/WO2013037491A1/de unknown
  • 2012-09-13 EP EP12761907.0A patent/EP2755589A1/de not_active Withdrawn
  • 2012-09-13 JP JP2014530117A patent/JP6051221B2/ja not_active Expired - Fee Related
  • 2012-09-13 CN CN201280044521.6A patent/CN103796608B/zh not_active Expired - Fee Related
• 2014
  • 2014-03-14 US US14/210,637 patent/US9649019B2/en not_active Expired - Fee Related

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