Automated endoscope reprocessor

FIELD: medicine.

SUBSTANCE: group of inventions refers to medical equipment, to sterilisation of medical devices. A processor for medical devices, particularly endoscopes, comprises a device fixation chamber, a liquid distribution system for delivering a liquid containing a sterilant to the device, a sterilant (e.g. ortho-phthalaldehyde) concentration measurement subsystem. The above subsystem comprises a bubble filter coupled with the liquid distribution system, a sample chamber with transparent walls coupled to a sample outlet of the bubble filter, a light source, a light sensor, a control system for measuring the sterilant concentration in the sample based on the light supplied to the sensor. The bubble filter comprises a cross flow filter. A liquid flow is directed through the bubble filter. The liquid sample is directed to the sample chamber. The light of specific intensity and wave length is provided to pass through the liquid sample in the sample chamber. The light having passed through the chamber and the sample therein is detected by means of the sensor, and the sterilant concentration in the sample is measured. The liquid flow passes along the membrane and a portion of the fluid passes through the membrane while providing the sample and thereby preventing the bubble collection in front of the membrane.

EFFECT: use of the group of inventions enables higher accuracy of the sterilant concentration measurement in the processor for various medical devices.

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The present invention relates to the field of disinfection, including the sterilization area. It finds particular application in conjunction with the decontamination of medical devices, especially medical devices such as endoscopes and other devices having channels or gaps that need to be decontaminated after use.

Endoscopes and similar medical devices having channels or passages formed within them, are used on an increasing basis in performing medical procedures. The popularity of these devices has led to the need to improve the decontamination of these devices between uses, both from the point of view of the rate of disinfection, and the effectiveness of decontamination.

In one of the popular methods of cleaning and disinfection or sterilization of such endoscopes used auto reprocessor endoscope washing and then disinfect or sterilize the endoscope bactericidal solution. Typically, such an apparatus consists of a tank to selectively open and close the overlapping elements that provide access to the tank. The pumps are connected to different channels within the endoscope, pour the liquid and the pump fills the liquid on the outer surface of the endoscope. Usually my the economic cycle detergent substance followed by rinsing and then sterilization or disinfection and flushing.

Supply of sterile water is required for rinsing the endoscope at the end of the washing and disinfection cycle. Usually this water includes water from local municipal water supply, which is passed through a filter with pores too small for the passage of infectious microorganisms. Further, it is preferred some form of isolation, to prevent expiry of water and other liquids inside reprocessor back into the municipal water supply. The generally accepted method is the provision of an air gap at the entrance to reprocessor. Periodically, the filter needs to be disinfected. The existing method of cleaning the filter is the removal and processing it in the autoclave. This method is very cumbersome, the authors encourage use of the components of reprocessor to clean the filter, at the same time not violating the clean water gap and at the same time clearing the line from the filter to the water gap.

In addition, to ensure proper handling of the endoscope is an important determination of whether a bactericidal solution of appropriate concentration. There are manual ways to make this assessment, but during the automatic cycle processing is desirable to automatically conduct such an analysis. Certain sterilizing agents, such as legaly, can be measured by passing the light beam through the sample. In this process, the measurement may be distorted in the presence of bubbles in the sample and it is desirable to remove such bubbles. If you use a traditional filter, delivers the anxiety that bubbles can accumulate in front of the filter and create a vapor barrier for passing fluid through them. Can be applied to the air valve, but such removal gas is burdensome in the automatic processing cycle. The present invention addresses this and other limitations of the previous techniques.

Reprocessor endoscope in accordance with the present invention includes a camera for fixing the endoscope. Supply of sterile water includes the water supply line and filter, adapted to filter potentially infectious microorganisms, has inlet and outlet openings, the outlet is connected with an air gap and an inlet connected with the water supply line. Distribution system fluid associated with the camera is adapted to direct the flow germicidal liquid in the chamber. The drain tube leading from the distribution system fluid to the air gap. Dual connector has a normal position in which the water supply line connects to what iltram and the drain tube is connected with an air gap, and, moreover, has the position of samorezentatsija, in which the water supply line is connected with an air gap and drain tube connects to the filter, thus allowing bactericidal liquid to penetrate into the filter and disinfect it while maintaining the supply of water in reprocessor and isolate the water supply from reprocessor air gap.

Preferably, the dual connector carries encoded color display, showing in what position is a double connector. Preferably, the dual connector contains a machine-readable sensor, showing in what position is a double connector. Control system reprocessor can be programmed to detect that the dual connector is in samorezentatsija before submission of the circulation fluid to the filter in the cycle of samorezentatsija and the double connector is in the normal position before executing the loop tool.

In one aspect of the present invention dual connector includes a first connector having a counter-current portion connected to the water supply line and a straight portion, movably connected to the inlet of the filter, and a second connector having a counter-current portion that is connected with a drain tube and a straight portion, movably connected with susnik gap. Preferably, a counter-current of the first and second connectors are joined to a common jumper, making easier the simultaneous connection and disconnection counter-current and direct-flow parts of the first connector and the second connector.

In one aspect of the present invention, a germicidal liquid is water having a temperature sufficient to disinfect the filter, preferably 70ºC or above, or 80º C or above. Bactericidal liquid may contain a chemical sterilizing agent, preferably ortho-phthalaldehyde.

The method accordingly the present invention provides for samorezentatsija filter the water supply reprocessor of the endoscope. Reprocessor includes camera for fixing the endoscope, the delivery system, sterile water, including the water supply line, having a filter adapted to filter potentially infective organisms, the distribution system of liquid associated with the camera, which is adapted to direct the flow germicidal liquid in the chamber, and the drain tube from the distribution system fluid to the air gap. The method includes the steps are carried out: a) disconnecting the water supply line from the filter; (b) disconnect the drain tube from the air gap; (c) the connection of the drain tube with filter; (d) connection of the supply line is an ode with an air gap; and (e) direction bactericidal liquid through the filter to disinfect the filter and lines its direct flow, leading to the air gap supporting at this time, the isolation of the water supply line from the liquid distribution.

Preferably, steps a) and b) are performed simultaneously and also preferably the steps c) and d) are performed simultaneously.

Preferred is a cleaning position, in which the water supply line is connected with an air gap and drain tube is connected to the filter. The method preferably includes the step of detecting that the cleaning position was established before performing step e).

Preferred is a normal working position in which the supply line is connected to the filter and the drain tube is connected with an air gap, and where the method includes a detection step that the normal working position has been correctly installed before running the loop tool.

Preferably, the method includes the stage of recognition with a visual indication that the steps c) and d) were performed prior to performing step e).

In one aspect of the present invention, the steps a), b), c) and d) are performed automatically.

The method accordingly the present invention provides a measurement of the concentration of bactericidal solution is the processor of the instrument. The method includes the steps are carried out: the direction of flow of the liquid containing a sterilizing agent through the filter for the bubbles to get free from bubbles of the liquid sample; the direction of sample fluid into the sample chamber having a transparent wall; and the passage of light radiation of known intensity through the chamber and the sample therein, the detection light beams passing through them, by a sensor, and based on its capacity determining the concentration of sterilizing agent in the sample. Filter bubbles contains crossflow filter, where the fluid flow passes along the membrane and part of the liquid passes through the membrane, providing the sample, whereby prevents the accumulation of bubbles in front of the membrane.

Preferably, the sterilizing agent contains ortho-phthalaldehyde. Preferably, the light beam has a wavelength of approximately 254 nm. More preferably, at least 90 percent of the spectrum of light radiation is in the range of 450 nm plus or minus 1 nm.

Preferably, the membrane is hydrophilic and has a maximum pore size of 0.2 μm, and more preferably 0.45 μm.

Preferably, the method further includes the step of interrupting the loop tool in the processor of the instrument, if the concentration is below C is a preset level, as in the case where the sterilizing agent contains ortho-phthalaldehyde and a pre-determined level is a 0,059% or below. The method further preferably includes the step of interrupting the loop tool in the processor of the instrument, if the concentration is higher than 0.1% or, alternatively, higher than 0.85 per cent.

The fluid flow along the membrane carries the bubbles away from the opposite edge of the membrane.

The processor of the instrument accordingly, the present invention includes a camera for fastening tool; distribution system fluid for delivery of the liquid containing a sterilizing agent to the tool, located in the chamber; and a subsystem for measuring the concentration of the sterilizing agent. This subsystem includes a filter bubbles connected to the distribution system fluid; a chamber sample chamber connected with the outlet for the sample filter bubbles; a source of light radiation for passage of light radiation of known intensity and wavelength through the sample in the chamber for sample; a sensor for measuring the light radiation passing through the sample; and a control system for determining the concentration of sterilizing agent in the sample based on the light radiation reaching the sensor. Filter bubbles which engages the cross-flow filter, where the fluid flow passes along the membrane and part of the liquid passes through the membrane, preventing the accumulation of bubbles in front of the membrane.

The invention can be implemented with various components and their different location and at different stages and their order. The drawings are intended only to illustrate preferred embodiments and should not be construed as limiting the invention.

FIG. 1 is a front view of the cleaning apparatus in accordance with the present invention;

FIG. 2 is a schematic illustration of the cleaning apparatus shown in FIG. 1, with only one tank for cleaning, is shown for clarity;

FIG. 3 is a view in section of an endoscope suitable for processing in the cleaning apparatus of FIG. 1;

FIG. 4a and 4b are schematic image filing system fresh water in both modes - normal mode and sterilization filter, respectively; and

FIG. 5 is a front view of the system of fresh water FIG. 4a and 4b;

FIG. 6 is a schematic representation of an optical part of the system monitoring the concentration of disinfectant substances; and

FIG. 7 is a schematic illustration of the jet part of the system monitoring the concentration of disinfectant substances which FIG. 6.

In FIG. 1 shows a cleaning apparatus for cleaning endoscopes and other medical devices that include channels or passages formed within them; FIG. 2 shows the apparatus in the form of group schemes. The cleaning apparatus generally includes a first block 10 and the second block 12, which are, at least, for the most part similar in all respects, provided for the purification of two different medical devices at the same time or sequentially. The first and second tanks for cleaning 14a, 14b contain contaminated devices. Each of the tanks 14a, 14b are selectively sealed by a cover 16a, 16b, respectively, preferably to the blocking of microorganisms, preventing the ingress of microorganisms from the environment in the tanks 14a, 14b during the cleaning process. The cover may include removing microorganisms or air HEPA filter installed for ventilation.

The control system includes one or more microcontrollers, such as a programmable logic controller (PLC)to control cleaning and user operating interface. Despite the fact that one control system 20 is shown here as controlling both the cleaning unit 10, 12, specialists in the art will realize that each block 10, 12 may include destined actnow for it management system. The visual display 22 shows the cleanup options and the status of the machine for the operator and at least one printing unit 24 prints the output document with the technological data of cleanup options for registered or applied entries by purified devices or storage container to store them. The visual display 22 preferably is combined with the input device with a touch screen. Alternatively, the input parameters of the cleaning process and control apparatus provided with a keyboard or similar device. Other visual measuring devices 26, such as a pressure sensor and the like provide a digital or analog output for issuing test data cleansing or medical devices.

In FIG. 2 schematically shows one unit 10 of the apparatus for cleaning. Specialists in the art will understand that the unit for cleaning 12 is preferably similar in all respects to the unit 10 shown in FIG. 2. However, the block 12 is not shown in FIG. 2 for clarity. In addition, the apparatus for cleaning can be provided with a single unit for cleaning or many blocks.

Tank cleaning 14a holds the endoscope 200 (see FIG. 3) or other medical device to clean it. Any internal channels of the endoscope 200 are connected with promisec the scored lines 30. Each wash line 30 is connected with the outlet of the pump 32. The pumps 32 are preferably peristaltic pumps or the like, which is filled with the fluid, such as liquid or air through the wash line 30 and any internal channels of the medical device. Specifically, any of the pumps 32 may move fluid from the reservoir 14a equipped with a filter through the drain tube 34 and the first valve SI, or may move the cleaned air from the system air supply 36 through the valve S2. The air supply system 36 includes a pump 38 and the air filter to remove microorganisms 40, which filters out the microorganisms from the incoming air stream. It is preferred that each wash line 30 was provided with a dowry to her by the pump 32, ensuring adequate fluid pressure and facilitate private monitoring fluid pressure in each wash line 30. Relay or pressure sensor 42 is communicated with the liquid in each wash line 30 to detect excessive pressure in the flushing line. Any detected excessive pressure is pointing to partial or complete blockage of, for example, through body tissues or dried body fluids in the channel of the device that is attached to the appropriate promisec the nd line 30. Isolation of each wash line 30 relative to the other allows you to easily identify and isolate specific blocked channel, depending on which of the sensor 42 detects excessive pressure.

Tank 14a is connected with the liquid using a water source 50, such as a connection to a municipal water supply or faucet, including the inputs of hot and cold water mixing valve 52, the current in the buffer tank 56. Eliminates germs filter 54, such as a filter with an absolute pore size of 0.2 μm or less, cleans the incoming water, which is delivered inside the buffer tank 56 through an air gap to prevent back after. Sensor pressure level 59 monitors the liquid level inside the tank 14a. If an appropriate source of hot water is not available, may not necessarily be provided with the water heater 53.

The condition of the filter 54 can be controlled through direct monitoring of the rate of flow of water through it, or indirectly by monitoring the time of filling the tank using float switches or similar. When the frequency drops flow below the selected threshold, this indicates a partial blockage of the filter element, which needs to be replaced.

The drain tube of the tank 62 separates the liquid from the reservoir 14a caressyou spiral tube 64, which can be inserted into the elongated portion of the endoscope 200. The drain pipe 62 is connected with a liquid recirculation pump 70 and the pump drain tube 72. The recirculation pump 70 provides a recirculation of the fluid from the drain tube of the tank 62 to the set of spray nozzles 60, which spray the liquid inside the tank 14a and the endoscope 200. Coarse and fine mesh filters 71 and 73, respectively, is filtered particles in the recirculating fluid. Pump drain tube 72 pumps the fluid from the drain tube of the tank 62 to the drain tube utilities 74. The level sensor 76 monitors the flow of fluid from the pump 72 to the drain tube utilities 74. The pumps 70 and 72 can be active simultaneously, so that the liquid is sprayed inside the tank 14a, at the same time merges, supporting the flow of residue from the tank and is removed from the device. Undoubtedly, combined single pump and valve are unlikely to replace the pair of pumps 70, 72.

Built-in heater 80 with temperature sensors 82, located behind the recirculation pump 70, which heats the liquid to the optimum for cleaning and disinfection temperature. Relay or pressure sensor 84 measures the pressure below the circulation pump 70.

The cleaning solution 86 is dosed into the stream above the circulation pump 70 through the om metering pump 88. Float level switch 90 shows the level of available cleaning solution. Typically, you only need a small amount of disinfectant 92. For a more accurate measurement metering pump 94 fills procamera 96 under the control relay high/low level 98 and, of course, the control system 20. Dosing pump 100 measures the exact amount of disinfectant when necessary.

Endoscopes and other reusable medical devices often include a flexible outer casing or shell surrounding the individual tubular elements and the like, which form internal channels and other parts of the device. This casing dissociates closed internal space, which is isolated from the tissues and fluids of the patient during the medical procedure. It is important that the shell was kept intact, without cuts or other openings that could allow contamination of the interior space under the shell. Therefore, the apparatus for cleaning includes a method for testing the integrity of the shell.

Air pump, one pump 38 or the same 110, pumps air into the inner space bounded by the casing of the device through the pipe 112 and the valve S5. Preferably HEPA or other removes microorganisms filter removes micro is organisme from the charge air. Relay overpressure 114 prevents the pressure in the shell. With full high pressure valve S5 is closed and the pressure sensor 116 is looking for reducing the pressure in the pipe 112, which would indicate air leakage through the shell. Valve S6 selectively removes the air from the pipe 112 and the shell through an optional filter 118, when the testing procedure is completed. Air buffer 120 smoothes the pulsating pressure from the air pump 110.

Preferably, each of the blocks 10 and 12 includes a condensate trap 130 and the leak sensor 132, the feed to alert the operator when a possible leak.

Supply of alcohol 134, which is controlled by valve S3, may bring alcohol into the channels of the pump 32 after rinsing, facilitating the removal of water from the channels of the endoscope.

The flow rate in the supply line 30 can be monitored by means of pumps, channels 32 and pressure sensors 42. Pumps channels 32 are peristaltic pumps to supply a constant flow. If one of the pressure sensor 42 detects an excessively high pressure, the associated pump 32 terminates the loop. The flow rate of the pump 32 and its percentage distribution by time provides a rational indication of the flow velocity in the associated line 30. The flow rate of the compressed during the process to stop when the blockage of any of the channels of the endoscope. Alternatively, the pressure decrease time cycle is complete, the pump 32 may also be used to estimate flow rate, and a faster rate of descent associated with higher flow velocities.

A more precise measurement of the flow velocity in a separate channel may be desirable to detect a small blockage. The measuring tube 136 having multiple sensors 138, movably connected to the inputs of the pump channel 32. One preferred arrangement of the sensors provides an initial connection at the lowest point of the measuring tube and multiple sensors 138 located vertically above it. Through the passage of electric current from the starting point through the liquid to the sensors 138 may be defined, what sensors 138 are shipped and, therefore, determines the level in the measuring tube 136. Here can be applied to other equipment level measurement. By closing valve SI and the opening of the air valve S7 pump channel 32 is drawn exclusively from the measuring tube. The amount of pumped fluid can be very accurately measured, based on the sensors 138. By pumping fluid through them each pump separately, it can be accurately determined based on the time and volume of the liquid spilling from the measuring trunk is.

In addition, all shows the electrical and Electromechanical devices are operatively connected to the input and output devices described above and controlled by the control system 20. Specifically, but not limited to, relays and sensors 42, 59, 76, 84, 90, 98, 114, 116, 132 and 136 provide the input I to the microcontroller 28, which controls the cleaning and other machine operations in accordance with this. For example, the microcontroller 28 includes outputs O, which are operatively connected to the pumps 32, 38, 70, 72, 88, 94, 100, 110, valves S1-S7, and the heater 80, controlling these devices for effective cleaning and other operations.

Returning to FIG. 3, the endoscope 200 has a head part 202, which is formed holes 204 and 206, and in which, during normal use of the endoscope 200, are the air/water valve and the suction inlet valve. To the head part 202 is attached a flexible insertion tube 208, in which the combined air/water channel 210 and a combined channel for suction/biopsy 212.

A separate air channel 213 and the water channel 214, which in place of the connection point 216 are connected to the air/water channel 210, located in the head part 202. In addition, in the head part 202 a separate channel for sucking 217 and the channel for biops and 218, which in place of the connection point 216 are connected to the channel for suction/biopsy 212.

In the head part 202 of the air channel 213 and the water channel 214 is opened in the hole 204 for air-water valve. Channel for sucking 217 opens into the opening 206 to the suction inlet valve. In addition, the flexible feed hose 222 is connected with the head part 202 and holds the channels 213', 214' and 217', which through holes 204 and 206 are connected with the air channel 213, a water channel 214 and a channel for suction 217, respectively. In practice the feed hose 222 is also guiding cladding.

Mutually connecting channels 213 and 213', 214 and 214', 217 and 217' will hereinafter be referred to generally as an air channel 213, the water channel 214 and a channel for suction 217.

Connection 226 to the air channel 213, connections 228 and 228a for water channel 214 and the connection 230 for a channel for suction 217 are located in the end section 224 (the same applies to the connector of the fiber) of the flexible hose 222. When used in connection 226, compound 228a is closed. Connection 232 channel for biopsy 218 is located on the head part 202.

The separator channel 240 is shown inserted into the holes 204 and 206. It includes the main part 242, and plugs 244 and 246, which closed in order apertures 204 and 206. Coax the box 248 on the cover 244 continues inside the holes 204 and terminates in an annular flange 250, which covers part of the openings 204, separating channel 213 on channel 214. By connecting lines 30 with the holes 226, 228, 228a, 230 and 232, the fluid for cleaning and disinfection can flow through the channels of the endoscope 213, 214, 217 and 218 and out of the distal end 252 of the endoscope 200 through channels 210 and 212. The separator channels 240 provides the passage of such fluid flows in all ways through the endoscope 200 leakage through holes 204 and 206 and isolates the channels 213 and 214 from each other, so that each has its own independent route flow. Specialist in the art will understand that different endoscopes having different arrangement of the channels and holes are likely to require modifications in the separator channels 240 to provide such differences during the closing ports in the head part 202 and maintaining channels separated from each other so that each channel can be flushed independently of the other channels. Otherwise, a blockage in one channel can simply redirect the flow attached in a non-blocking channel.

Pinhole leaks 254 at the end of section 224 leads into the inner portion 256 of the endoscope 200 and is used to control its physical integrity, as it ensures that not formed leakage between any of the channels and the inner part 256 or from the outer into the inner part 56.

Some channels of the endoscope, such as a channel for suction/biopsy 212, in some endoscopes have internal diameters that are too large to adequately assess the status of their connection with the measuring tube 136. For these channels pulse pressure fluctuations caused by the pump 32 can be verified the correctness of the connection.

Connection is made to the connection 230 to the channel for sucking 217 and 232 connection for a channel for suction/biopsy 212. Each of these compounds is done by one of the flexible tubes 108. By checking the pressure measured by the respective pressure sensor 42, can be checked the state of the join between connections 232, 230 and corresponding output holes flush lines 31.

For example, pulse pressure fluctuations from the pump 32 to the washing line 30 connected to the connection 232 may seem, if the pump 32 to the washing line 30 connected (via one of the tubes 108) to the connection 230, turns off, and the pressure sensor 42 in the same washing line becomes red. Channel for sucking 217 and the channel for suction/biopsy 212 occur within the inner part of the endoscope 200, resulting connection 230 and 232 to the liquid communication with each other. The pumps 32 are peristaltic the definition pumps, which produce a known pressure, fluctuating around 10 Hz, which, of course, will vary with the speed of the pump. For invoking pulse pressure fluctuations or waves can be used other ways, but the pumps 32 are quite suitable. Preferably, the readings from the pressure sensor 42 was filtered electronically, to remove noise above and below the target frequency (in this example, 10 Hz). If a significant signal pressure is not measured at the target frequency, this means that one of the connections is incomplete; the proper connection must be made between the flexible tube 108 and the connection 230, and the opposite end of the flexible tube and the corresponding output 31 as well as between the second flexible tube 108 and the connection 232 and the opposite end of this flexible tube and the corresponding output 31.

To assess the correctness of the connections is not necessary to stop by one of the pumps 32. The pumps will never be in exact synchronization and exactly at the same frequency and therefore with two pumps, pumping through the joints 230 and 232, pulse frequency, defined near the difference in the speed of each pump can be detected by each pressure sensor 42 associated with it. Is necessary to measure only one of the pressure sensors 42.

Sensor Yes the population 42 can also detect incorrect connection to one of the connections 230, 232, or any other connection by intercepting the reflected pressure waves. Here, the pressure sensor 42 in the wash line 30, connected via flexible tubing 108 to the connection 232 could catch the reflection from the pump 32 in this washing line 30. These reflections could come from any breaks in the path between the pump 32 and where the channel of the suction/biopsy 212 extends into the distal end of the insertion tube 208. When the connection is correct, the most reflected signal could come from the open end of the channel 212 at the distal end of the insertion tube 208. Other reflections could come from the connection between the flexible tube 108 and 232 connection, the connection between the flexible tube 108 and the outlet 31, the intersection of the channels 217 and 212, and possibly other surfaces and violations of the compounds. When one end of the tube 108 is not connected, could be represented by various registered characteristics of the reflected signal.

Registered characteristics of the signal reflected from various types of endoscope 200 can be stored in the controller 28 and compared with the measured results, determining whether they fit with the fact that the endoscope is properly connected. The recorded characteristics for violations joining 232 connection or a faulty connection with vhodni the hole 31 could also be saved for comparison. For various types of endoscopes, which could be taken for analysis, can be used in a variety of types and configurations of flexible tubing 108. Similar to the recorded data can be saved for connection 230 or some other connection to the endoscope. Although it is possible the preparation and storage of the recorded characteristics for individual models of endoscopes, there is a sufficient number of related endoscopes to register characteristics could be used for a broad class of endoscopes. If you are saved recorded characteristics for each model endoscopes, they could also be used to confirm that the controller has been entered correctly the endoscope.

Returning initially to FIG. 4A and 4B, and FIG. 5, which shows the filter 54, the buffer tank 56 (which forms an air gap, insulating the water source 50 from the rest of the system) and associated water supply network. The proximal portion of the recirculation line 300 is connected by means of connector 302 to the distal part of the recirculation line 304, which returns flows into the buffer tank 56. Similarly the proximal part of the water supply line 306 is connected by means of connector 308 with the distal part 310, which includes a filter 54 and to the which also then fills in the buffer tank 56. The connectors 302 and 308 are connected together by means of a bearing block 312.

The filter 54 requires periodic disinfection. In many reprocessor such a filter is removed from the system and processed in the autoclave. The execution of this routine work is tedious. The system can distribute disinfectant substance 92, while it may not be just inside the lines upstream of the filter 54, which could compromise the integrity of the air gap on the buffer tank 56, which protects the water supply system from fluids outside the system. The authors found a solution to this dilemma with the help of connectors 302 and 308 on the raw bar 312. By pulling the supporting bar 312 and reversing the connectors from their normal mode as shown in FIG. 4A and placing them in the mode samorezentatsija as shown in FIG. 4B, the disinfectant 92 may be fed into the filter 54 without damaging the integrity of the air gap and still having the water source 50 is attached to the buffer Baku 56 whereby the flow of flush water from the filter 54 has been disinfected. Mode samorezentatsija the proximal portion of the recirculation line 300 is connected with the distal part of the water supply line 310 and thus the filter 54 and the proximal part of the water supply line 306 is connected with the distal part of the recirculation line 304.

what exploits operation system mode samorezentatsija in full cycle or shorter cycle, consisting of circulation disinfectant 92 followed by washing with water (after reversing the connections in normal mode) once-through portion of the filter 54 and the distal part of the water supply line 310 are disinfected and then washed. Alternatively, the heated water, preferably above 70°C or 80°C can circulate through the filter 54, when cornagrade to achieve this temperature, coming out of the heater 80.

Magnet 314 on the raw bar 312 and the sensors 316 on the hull 318 that are adjacent to the bearing block 312, when you are connected to provide an indication to the controller 28, in what mode, normal or samorezentatsija is the system, and does not permit normal loop tool mode samorezentatsija and Vice versa. It can also detect when the bearing block 312 is not providing the discovery of two open connections, and will also prevent cycles from functioning in this state. A visual indicator 320 is also provided on the bearing block 312, such as a green pointer for the normal mode and the red pointer mode samorezentatsija. FIG. 5 shows two sets of bearing bars 312, etc. as this setup is repeated for the second block 12.

In one preferred embodiment, not shown in the drawings, prestan the WHC connectors 302 and 308 is automatic. This could be done through controlled engine rotating spool valve having a first pair of passages through it, connecting the proximal portion of the water supply line 306 with its distal part 310 and the proximal portion of the recirculation line 300 with its distal part 304 and, during the rotation of the sleeve having a second set of passages through it, connecting the proximal portion of the water supply line 306 to the distal part of the recirculation line 304 and the proximal portion of the recirculation line 300 with the distal part of the water supply line 310.

Let us return to FIG. 6 and 7, which shows a subsystem of monitoring the concentration of 400. It controls the concentration of disinfecting or sterilizing fluid to the circulating fluid. The preferred active agent is an ortho-phthalaldehyde (OPA). FIG. 6 shows the optical system 402 subsystem monitoring the concentration of 400. It includes a source of light radiation 404, emitting light with a wavelength of 254 nm through a collimator 406, the beam splitter 408, cell 410 containing a sample of the circulating fluid and the sensor 412. The sensor 412 has an input filter that transmits light with a wavelength of 254 nm plus or minus 6 nm. Preferably, the cuvette 410 is formed of optical quartz and has a straight surface for minimal intervention in smirenje pass through the light beam. The output of the sensor 412 is an indication of the level of OPA in the liquid. Part of the light is reflected on normalizing detector 414 regulating the power source 416 source light beam 404 and provides constant output parameters.

In FIG. 7 shows a system fluidics subsystem 420 monitoring the concentration of 400. Part of the circulating liquid passes through the filter 422. Free from the number of bubbles coming out of the filter 422 and passes through the first valve 424 and the selector valve 424 before passing through the sample cell 410. The flow limiter 428 limits the amount of liquid, preventing excessive losses and limiting the flow through the filter 422. thermistor 430 measures the temperature of the cell 410, allowing you to adjust the temperature reading from the sensor 412. Separating the filter 432 and the valve 434 is provided for the second vessel.

Filter 422 is a filter cross-flow type, using 0.2 μm hydrophilic membrane 436. The maximum pore size of 0.2 μm is sufficient to keep the bubbles from passing through the fluid filter. The fluid flows into the inlet 438 along the membrane 436 and out of the outlet 440. Part of the liquid will pass through the membrane 436 to the outlet for sample 442 and passing the first valve 424. In a conventional filter with the exact inlet and outlet ports, bubbles can accumulate and block the filter, requiring complex ventilation scheme for periodic unlock the filter. Filter 422 avoids this by passing bubbles out through the outlet 440. The removal of bubbles is important, as the presence of bubbles in the cell 410 may lead to erroneous reading by reflection of the light radiation passing through the sample cell 410.

The full cycle of cleaning and sterilization detail includes the following steps.

Step 1. Open tailgate

By pressing on a foot pedal (not shown) opens the lid of the reservoir 16a. There is a separate foot pedal for each side. If the pressure on the pedal is removed, the movement of the cover stops.

Step 2. The placement and connection of the endoscope

The insertion tube 208 of the endoscope 200 is inserted inside the spiral circulation of the tube 64. End portion 224 and the head part 202 of the endoscope 200 is located inside the tank 14a, with the supply hose 222, collapsed inside the tank 14a with such a wide diameter as possible.

Wash line 30, preferably labeled with color, are attached one to each of the holes of the endoscope 226, 228, 228a, 230 and 232. Air line 112 is also attached to the connector 254. Guidance on the unit, provides the background is th information for bulleted color connections.

Step 3. The identification system used endoscope and specialist

Depending on the configuration selected by the user, the control system 20 may prompt the user ID, patient ID, the code of the endoscope, and/or code specialist. This information can be entered manually (via touch screen) or automatically, as by use of the attached device that reads bar codes (not shown).

Step 4. Closing the lid of the tank

Closing the lid 16a is preferably requires the use of pressing equipment and touch screen 22 while providing a reliable mechanism for prevention for preventing the user's hands were clamped or clamped a lid of the reservoir 16a. If any of the hardware buttons and the software is released during how the cover 16A is in the process of closing, the movement stops.

Step 5. The start of the program

The user clicks the touch screen to begin the process of cleaning/disinfection.

Step 6. Creating in the body of the endoscope of high pressure and the measurement of the leak rate

Included air pump and is controlled by the pressure inside the endoscope. When the pressure reaches 250 mbar, the pump stops and the pressure allow a hundred in order to riservata for 6 seconds. If the pressure reaches 250 mbar for 45 seconds, the program stops and the user is notified of the leak. If the pressure is reduced to less than 100 mbar for 6-second stabilization period, the program stops and the user is notified of the condition. When the pressure has stabilized, the pressure reduction is controlled within 60 seconds. If the pressure declines more than 10 mbar for 60 seconds, the program stops and the user is notified of the condition. If the pressure drop is less than 25 mbar for 60 seconds, the system proceeds to the next step. A slight positive pressure is maintained in the body of the endoscope during the remainder of the process, preventing leakage of fluids inside.

Step 7. Check connections

The second test leak checks the adequacy of the different connection ports 226, 228, 228a, 230, 232 and correct espositio separator channels 240. In the tank 14a is let up the amount of water to immerse the distal end of the endoscope in the spiral tube 64. The valve SI is closed and the valve S7 is opened and the pumps 32 operate in reverse mode, creating a vacuum and eventually drawing the liquid into the channels of the endoscope 212 and 210. The pressure sensors 42 are controlled, creating confidence that the pressure in any of the channels of the endoscope does not reduce the W by more than a pre-set amount in a specified period of time. If this occurs, it may indicate that one of the compounds was done incorrectly and the air seeps inside the channel. In any case, if there is an unacceptable reduction of the pressure control system 20 will stop the cycle and show possible wrong connection, preferably with an indication of which channel is faulty. For long channels, the correct connection is checked by applying the above method of reading pressure using the pulse rate of the pump 32.

PRE-WASHING

The purpose of this step is to flush the water jet channel to remove residual material before cleaning and disinfection of the endoscope 200.

Step 8. Filling of tank

Tank 14a is filled with filtered water, and the water level is detected by the pressure sensor 59 under the tank 14a.

Step 9. The pumping of water through channels

Water is pumped by pump 32 through the internal channels 213, 214, 217, 218, 210 and 212 directly into the drain tube 74. This water is not circulating around the exterior surfaces of the endoscope 200 during this stage.

Stage 10. Plums

When the water was pumped through the channels, activates the drain pump 72, ensuring that the tank 14a is also emptied. Drain pump 72 will be turned off when the relay drain 76 will find that the process is draining is completed.

Stage 11. Blowing air through the channels

During the discharge process sterile air is blown through the pump 38 through all channels of the endoscope at the same time, minimizing the potential remains.

WASHING

Stage 12. Filling of tank

Tank 14a is filled with warm water. Water temperature is controlled by controlling the mixing of heated and unheated water. The water level is detected by the pressure sensor 59.

Stage 13. Adding detergent

The system adds the enzyme detergents to the water circulating in the system by means of a peristaltic metering pump 88. Volume is controlled by controlling the time of discharge, the pump speed and the internal diameter of the tube of the peristaltic pump.

Stage 14. The circulation of the washing solution

The detergent solution is actively pumped across the inner channel and above the surface of the endoscope 200 within a predetermined period of time, typically from one to five minutes, preferably about three minutes, through the pump channel 32 and the external circulation pump 70. Built-in heater 80 supports a temperature of about 35°C.

Stage 15. The start of the test to the blockage of channels

After the detergent solution circulated within a couple of minutes, change aetsa the flow rate through the channels. If the flow rate through any channel is less than a predefined speed for this channel, the channel is identified as blocked, the program stops and the user is notified of the condition. Peristaltic pumps 32 are operating with a predetermined flow rate, and the loop ends when there is an unacceptably high pressure read by the associated pressure sensor 42. If the channel is locked, a predetermined flow rate will initiate the pressure sensor 42, showing the impossibility of adequately passing with this flow rate. Because the pumps 32 are peristaltic, the operating speed of the flow combined with the proportion of time spent outside the loop, because the pressure will be to provide the actual flow rate. The flow velocity can also be estimated based on pressure drop in that, as the pump 32 does not rotate.

Stage 16. Plums

Drain pump 72 is activated, removing the detergent solution from the reservoir 14a and channels. Drain pump 72 is stopped when the level sensor drain 76 shows that the discharge is completed.

Stage 17. Blowing off the air

During the discharge process sterile air is blown through the channels of the endoscope one is temporarily minimizing any residual detergent or water, which can jeopardize the subsequent stages.

WASHING

Stage 18. Filling of tank

Tank 14a is filled with warm water. Water temperature is controlled by controlling the mixing of heated and unheated water. The water level is detected by the pressure sensor 59.

Stage 19. Washing

Wash water is circulating within the channels of the endoscope (through pump channel 32) and on the outer surface of the endoscope 200 (via the circulation pump 70 and the spray nozzles 60) for 1 minute. Also during this period, the water sample is passed into the cell 410 and the source data is transmitted by the monitoring system 200, setting the zero level.

Step 20. The test continues clogging of channels

Wash water is pumped through the channels, the flow rate through the channels is measured and if it falls lower than a predetermined speed for any taken of the channel, the channel is identified as blocked, the program stops and the user is notified of the condition.

Stage 21. Plums

The drain pump is activated, removing the wash water from the reservoir and channels.

Step 22. Blowing off the air

During the discharge process sterile air produve the Xia through all channels of the endoscope at the same time, minimizing any residual water that may jeopardize the subsequent stages.

Step 23. Repeated washing

Steps 18 through 22 may be repeated for maximum rinsing with a solution of enzyme detergent surfaces of the endoscope and the tank.

DISINFECTION

Step 24. Filling of tank

Tank 14a is filled with very hot water (53°C). Water temperature is controlled by controlling the mixing of heated and unheated water. The water level is detected by the pressure sensor 59. During the process of filling the pump channels 32 are turned off, properly ensuring that the disinfectant in the tank is used in concentration before circulation through the channels.

Stage 25. Adding disinfectant

A measured amount of disinfectant 92, preferably CIDEX OPA concentrate solution of ortho-phthalaldehyde, available from Advanced Sterilization Products division Ethicon, Inc., Irvine, CA, is drawn from the measuring tube of disinfectant 96 and fed into the water in the tank 14a by means of a measuring pump 100. The amount of disinfectant is controlled by the sensor filling 98 relative to the lower part of the transfer tube. The measuring tube 96 is filled to Vernigora relay, detecting liquid. Disinfectant 92 is drawn from the measuring tube 96 to the level of the disinfectant in the measuring tube, which is slightly below the upper end of the distributing tube. After the release of the required amount, the measuring tube 96 is replenished from the disinfectant 92. Disinfectant is not added before filled the tank, so that in case of problems with water supply concentrated disinfectant will not remain on the endoscope without water for rinsing. While the disinfectant is added, pumps, channels 32 are turned off, properly ensuring that the disinfectant in the tank is applied concentration before circulation through the channels.

Step 26. Disinfection

The solution of the disinfectant concentration is actively pumped throughout the inner channel and on the surface of the endoscope, ideally for a minimum of 5 minutes by means of pumps, channels and external circulation pump. The temperature is controlled via a built-in heater 80 to about 52,5ºC. During this process the sample of the circulating fluid is extracted and tested for proper concentration, is used monitor the concentration of 400. If the concentration which is low, can be added disinfectant and again set the timer for this stage.

Step 27. Check the thread

During the disinfection process flow through each channel of the endoscope is checked by calculating the time discharge the measured quantity of the solution through the channel. The valve SI is closed and the valve S7 is opened and each pump channel 32 pumps the pre-determined amount to the connected channel of the measuring tube 136. This volume and the time spent on his discharge, provides a very accurate flow rate through the channel. Variations in flow rate from the expected channel diameter and length are indicated via the control system 20 and the process stops.

Stage 28. The test continues to the obstruction of the channel

While the solution of the disinfectant concentration is pumped through the channels, the flow rate through the channels is measured as in step 15.

Step 29. Plums

Drain pump 72 is activated by removing the disinfectant solution from the reservoir and channels.

The stage 30. Blowing off the air

During the discharge process sterile air is blown through the channels of the endoscope at the same time, minimizing possible losses.

FINAL RINSE

Stage 31. Filling of tank

The tank fill shall tsya sterile hot water (45ºC), passed through a 0.2 nm filter.

Stage 32. Washing

Wash water circulates inside the channels of the endoscope (through pump channel 32) and on the outer surface of the endoscope through the circulation pump 70 and the spray nozzles 60) for 1 minute.

Stage 33. The test continues clogging of channels

Until the wash water is pumped through the channels, the flow rate through the channels measured in step 15.

Stage 34. Plums

Drain pump 72 is activated by removing the disinfectant solution from the reservoir and channels.

Stage 35. Blowing off the air

During the discharge process sterile air is blown through the channels of the endoscope at the same time, minimizing possible losses.

Stage 36. Repeated washing

Steps 31 to 35 are repeated twice (final postdetection lavage), providing maximum removal of disinfection of the endoscope 200 and surfaces reprocessor.

The FINAL TEST FOR TIGHTNESS

Stage 37. Creating high pressure in the endoscope and

measurement of leak rate

Repeat step 6.

Stage 38. Marking the completion of the program

Successful completion of the program is indicated on the touch screen.

Step 39. Normalization of pressure in the endoscope

Between the time of completion of the program and the time when the and the lid is opened, the pressure in the shell of the endoscope is normalized to atmospheric pressure by opening the outlet valve S5 for 10 seconds every minute.

The stage 40. User authentication

Depending on customer configuration, the system can protect the cover from opening until such time as a legitimate user enters an identification code.

The stage 41. Information preservation program

Information about the complete program, including the user ID, the ID of the endoscope, the ID specialist and patient ID is stored in accordance with the sensor readings obtained during the program.

The stage 42. Print registered program data

If the printing device is connected to the system, and if the user requires, the registered data of the program of disinfection can be printed.

Stage 43. Removing the endoscope

If you enter an identification code of a legitimate user, the cover can be opened (using the foot pedal as in step 1, above). Then the endoscope is disconnected from the washing lines 30 and removed from the tank 14a. The lid can then be closed using the two buttons " equipment and touch screen, as described in step 4 above.

The invention has been described with reference to preferred options for implementation. Obviously, when chteniia understanding the preceding detailed description of the other obvious modifications and changes. Imply that the invention is constructed as including all such modifications and changes, insofar as they are included in the scope of the attached claims of the invention or its equivalents.

1. A processor for medical instruments, in particular for an endoscope, comprising:
the camera for fastening tool;
the distribution system fluid for delivery of the liquid containing a sterilizing agent, to the instrument inside the chamber;
subsystem measurement of the concentration of sterilizing agent containing:
filter bubbles connected to the distribution system fluid;
the camera for the sample, attached to the outlet to filter samples for bubbles;
the source of light radiation for passing the light beam of known intensity and wavelength through the sample fluid in the sample chamber;
a sensor for measuring the light radiation passing through the sample;
control system for determining the concentration of sterilizing agent in the sample based on the light radiation arriving at the sensor;
when this filter bubbles contains a cross-flow filter, and the fluid flow passes along the membrane and part of the liquid passes through the membrane, providing the sample, whereby prevents the accumulation of bubbles in front of the membrane.

2. The process is R tool according to claim 1, in which light radiation has a wavelength of approximately 254 nm.

3. Processor tool according to claim 2, in which the membrane has a maximum pore size of 0.45 ám.

4. Processor tool according to claim 1, additionally containing the control system is programmed to interrupt the loop tool in the processor of the instrument, if the concentration is at least one of (1) 0,059% or less, and (2) approximately 0.1%.

5. The method of measuring the concentration of ortho-phthalaldehyde processor for medical instruments, comprising the steps are carried out:
the direction of flow of the liquid containing a sterilizing agent through the filter for the bubbles to ensure free from bubbles of liquid sample;
the direction of sample fluid into the chamber for a sample having a transparent wall;
the passage of light radiation of known intensity and wavelength through the chamber and the sample therein, the detection light beams passing through them, with the help of the sensor and, based on its output, the concentration of sterilizing agent in the sample;
when this filter bubbles contains a cross-flow filter, and the fluid flow passes along the membrane and part of the liquid passes through the membrane, providing the sample, whereby prevents the accumulation of Pazyryk is in front of the membrane.

6. The method according to claim 5, in which the length of the light radiation is approximately 254 nm.

7. The method according to claim 5, in which the membrane has a maximum pore size of 0.45 μm and the liquid stream passes along the membrane, transferring the bubbles away from the opposite edge of the membrane.



 

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14 cl, 1 dwg, 17 tbl, 8 ex

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2 ex

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FIELD: medicine.

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2 cl, 5 dwg

FIELD: medicine.

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18 cl, 4 dwg

FIELD: medicine.

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1 ex, 5 dwg

FIELD: medicine.

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18 cl, 12 dwg

FIELD: medicine.

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3 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medicine and aims at differential diagnosing of hypertrophic and catarrhal chronic rhinitis. A tongue holder is applied on a patient's tip of the tongue and moderately pressed for three seconds; a concha lumen width is measured and compared with the references; a form of chronic rhinitis is shown by the manifestations of compression reaction and decreased volume to determine a degree of hypertrophy and diagnosing a form of chronic rhinitis.

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2 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, gynecology, oncology. High-speed optical coherence tomography (HOCT) is performed by means of probe under control of colposcopy at video frame rate, with the study of kinematic functional characteristics of cervical tissue: intensity of reverse signal dispersion, rate of signal extinction, change of value and number of subepithelial formations, characterising uniformity and variability of tissue vascularisation and vessel elasticity, mobility of whole image, motion of subepithelial formations. Examination is performed at central wavelength 1280 nm, power on object 0.75 mW, resolution 15-30 mcm, scanning depth 2 mm, by smooth movement of OCT-device probe on entire surface of cervix from cervical canal to periphery on 12 vectors of 12-h conventional clock face. If image with constant change of value and number of subepithelial rounded formations of small diameter with low capability of reverse dispersion, straight horizontal basal boundary of bottom layer of whole image is obtained, healthy cervical tissues are diagnosed, in case of presence of mobile subepithelial structures of large size with low capability of reverse dispersion, constant change of their shapes, low rate of signal extinction, indefinite shape of basal bottom boundary of lower layer, diagnosed is viral cervicitis, in case of absence of structural changes and presence of fluctuating movements of whole hOCT-image and broken basal boundary, precancer is diagnosed, if in zone of interest structural and dynamic changes and fluctuations of entire volume of whole hOCT-image are, malignant neoplasm is diagnosed.

EFFECT: method makes it possible to increase accuracy of diagnostics, reduce examination time and trauma of manipulations.

2 cl, 3 ex

FIELD: medicine.

SUBSTANCE: invention relates to medicine, gynecology, oncology. High-speed optical coherence tomography (HOCT) is performed by means of probe under control of colposcopy at video frame rate, with the study of kinematic functional characteristics of cervical tissue: intensity of reverse signal dispersion, rate of signal extinction, change of value and number of subepithelial formations, characterising uniformity and variability of tissue vascularisation and vessel elasticity, mobility of whole image, motion of subepithelial formations. Examination is performed at central wavelength 1280 nm, power on object 0.75 mW, resolution 15-30 mcm, scanning depth 2 mm, by smooth movement of OCT-device probe on entire surface of cervix from cervical canal to periphery on 12 vectors of 12-h conventional clock face. If image with constant change of value and number of subepithelial rounded formations of small diameter with low capability of reverse dispersion, straight horizontal basal boundary of bottom layer of whole image is obtained, healthy cervical tissues are diagnosed, in case of presence of mobile subepithelial structures of large size with low capability of reverse dispersion, constant change of their shapes, low rate of signal extinction, indefinite shape of basal bottom boundary of lower layer, diagnosed is viral cervicitis, in case of absence of structural changes and presence of fluctuating movements of whole hOCT-image and broken basal boundary, precancer is diagnosed, if in zone of interest structural and dynamic changes and fluctuations of entire volume of whole hOCT-image are, malignant neoplasm is diagnosed.

EFFECT: method makes it possible to increase accuracy of diagnostics, reduce examination time and trauma of manipulations.

2 cl, 3 ex

FIELD: medicine, pulmonology.

SUBSTANCE: one should perform lovage in three stages:during the 1st stage one should carry out lovage of tracheoalveolar tree for 3-4 min with 60-80 ml 0.08%-sodium hypochlorite solution, at the 2nd stage one should introduce 5-7 ml 10%-fluimucyl solution into tracheobronchial tree for 4-6 min, and at the 3d stage one should perform lovage of tracheobronchial tree for 3-4 min with 60-80 ml 0.11%-sodium hypochlorite solution. The present innovation favors secreta release of decreased viscosity into large bronchi that simplifies its evacuation and this, in its turn, simplifies the access of antiphlogistic and antibacterial preparations towards tracheobronchial tree's mucosa that leads to interrupting inflammatory process in more shortened terms.

EFFECT: more prolonged period of remission.

2 ex

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