IMPORTANT NOTES

 Endoscopes are a very expensive, fragile and

delicate medical instruments; care must be
taken when handling, using and processing
these instruments.
 Repair costs usually high in comparison with
actual price of the endoscope.
 Well trained and qualified personnel only can
carry on repair for endoscopes, so no trying,
guessing or inventing is allowed.
 CONTENTS
 Rigid endoscopes :
 Basic construction.
 Inspection.
 Care and maintenance.

 Flexible endoscopes :
 Basic construction.
 Inspection.
 Description of most common problems.
 Repair schemes.
 Summery.
ENDOSCOPY
FLEXIBLE ENDOSCOPY

SURGICAL ENDOSCOPY
 Basic construction.
 Inspection.
 Care and maintenance.
RIGID ENDOSCOPE
 Basic Construction of Rigid
Endoscopes
 The basic construction of a rigid endoscope : The lenses
of the optical system are arranged in the inner tube, and
held in place with distance pieces. The distal region of
the inner tube is closed by the deflector prism (that
determines the direction of view) and with the eyepiece
at the proximal part. The inner tube is enclosed by the
jacket tube containing optical fiber cable and it’s
connector.
The jacket tube has a covering lens at the distal part and
an ocular at the proximal part. One of its significant
attributes of the jacket tube is the ability to seal against
invading substances.
Construction of a rigid endoscope

Jacket tube enclosing fiber

cable connector for fiber cable
and outer eyepiece

Inner tube with eyepiece

Deflector prism with optical

lenses and distance pieces
Behaviour with Bending Stress
In case of bending stress of the rod, there will be
internal compression and external stretching.
The inner tube lenses are rigid, so in case of
stress, the distance pieces press against the
lenses` margins. In case of strong pressure,
damage of the lenses occurs from the margins.
Damages of the lens margins are often
unnoticed. These damages often lead to a high
costs of repair. A massive lens breakage can be
felt and seen as an up normal and /or foggy
image .
Image with Broken lens
 Test Methods of the Optic System
1- Evaluation of the Visible Image
The most known and widely practiced method is to direct the endoscope
towards a reference object and in conclusion evaluate the quality of the
endoscope.This method requires skilled experts and is only practicable with
relatively serious damages.

2- Testing Method with the Magnifying Glass

endoscope is held against a bright reflective surface in order to inspect the
endoscope through the eye piece.
By varying distance between endoscope and eye (keeping the axial plane),
it is possible to look inside the optical system and inspect every single lens.

3- Measuring of Transmission
This is a method determining light transmission of the endoscope.
A luxmeter is adapted to the eye piece of the endoscope. At the distal part
light is directed through an adapter, the proximal output represents the
data.
4-Test method using Monocular Tube
LUXMETER
 Testing Method with the
Monocular Tube
 The endoscope is inserted into a jacket
tube containing an integrated
magnifying glass at the proximal end.
A distance piece, gliding over the
jacket tube canters the telescope
within this construction.
 By varying the distance between
magnifying glass and the eyepiece,
different depths within the endoscope
can be focused. Variation in distance is
achieved by sliding the endoscope
within the construction.
 CARE OF RIGID ENDOSCOPE

 Rigid endoscopes must be handled with

care; they are very delicate and can be
damaged easily if dropped or hit againest
any hard object.
 Repair costs usually very high in
comparison with the scope price so extra
care must be taken when dealing with
these expensive instruments
 Basic construction.
 Inspection.
 Description of most common problems.
 Repair schemes.
 Summery.
BEFORE STARTING

Gastrointestinal endoscopes are

complex medical instruments
and can be challenging to maintain and
reprocess. We will review the internal and
external structure and function of the endoscope
and will learn to diagnose and troubleshoot the
most major, expensive repairs. Preventive
maintenance measures to minimize the overall
frequency of repairs will be explored.
FIBEROPTIC SCOPE
VIDEOSCOPE
INTRODUCTION TO FLEXIBLE ENDOSCOPE
ENDOSCOPE CROSS SECTION
AIR / WATER SYSTEM
SUCTION SYSTEM
 ANGULATION MECHANISM
 The angulation wires
can stretch and break
if the angulation is
forced.
 Buckling of the
insertion tube can also
stretch and break
wires.
 Play in the angulation
control knobs usually
indicate an angulation
adjustment is needed.
 Flexible Endoscope Inspection

 Endoscope must be inspected before and

after use for the following :
o Insertion and LG Tubes
o Bending mechanism
o Optical system
o General inspection (appearance)
o Endoscope to be leakage tested
Image Inspection Procedures

VIDEOSCOPE FIBERSCOPE
 Image Evaluation

I. Perfect scope
II. Scope with 24 broken fibers
III. Leaky and stained scope

II III
 MOST COMMON PROBLEMS WITH
FLEXIBLE ENDOSCOPES

 Buckeled Insertion Tube

 Buckeled/Leaky Channels (Biopsy)

 Leakage in General.
BUCKLED INSERTION TUBE
BUCKLED INSERTION TUBE
BUCKLED BIOPSY CHANNEL
 BIOPSY CHANNEL DAMAGE
 Kinked, damaged or open biopsy forceps .
 Buckling of the insertion tube can also
cause buckles in the channel.
 Forcing instrumentation through the
channel can cause wear or tears in the
channel material. This frequently occurs in
the bending section when resistance is
met when the scope is angulated.
 Using the noncorrect size cleaning brush
LEAKAGE PROBLEM
BENDING SECTION RUBBER LEAK
 REPAIR SCHEMES

TECHNICAL SUPPORT
PREVENTIVE MAINTENANCE MINOR REPAIR MAJOR REPAIR

INSPECTION BSR ANGULATION CHANNELS

LEAK TEST O-RINGS ADJUSTMENT EYE-PIECE

TRAINING BOOTS,GRIPS BLOCKAGE CCD

HANDLING TIP COVERS SWITCHES B.S

LENSES
. . . And many other repair schemes .
ANGULATION REPAIR
AIR / WATER CHANNEL REPLACEMENT
SUCTION SYSTEM REPAIR
BIOPSY CHANNEL REPLACEMENT
DISTAL COVER
CCD RETERMINATION
REMOTE SWITCHS REPAIR
GOOD HANDLING
 Leakage Test
Endoscopes must be checked against any leak or damage before
use and processing to ensure its efficiency and avoid
instrument malfunction during endoscopy.
Leakage tester is an instrument
which can be attached to endoscope
and blows certain pressure of air-set
by the manufacturer- inside it then
endoscope is immersed in a water
basin and checked against any
leak,if any leak is seen endoscope
must be immediately transferred
for repair and must not been used.
LG PLUG REPAIR
INSERTION TUBE REPAIR
 SUMMARY STATEMENT
This educational activity has
been developed in response to GI
nurses and technicians who have
expressed a need to increasetheir
knowledge base of the endoscope
construction, video system
components, care and
maintenance of flexible
endoscopes and repair reduction
strategies. Attendees will be given
updated information that will
reduce repair costs and improve
unit operations and patient care.