Updated on 02.26
10 Common Failures in Endoscopic Surgery and Their Solutions
The structure of an endoscope is more precise, and intraoperative failures are often more troublesome than those of flexible endoscopes, as they directly affect the surgical field and instrument operation. Once a breakdown occurs, it poses a greater threat to surgical safety.
Based on years of frontline experience, I have summarized the 10 most common failures of intraoperative endoscopes, as well as emergency solutions to help you quickly resolve risks.
1. Sudden Darkening or Complete Blackout of the Visual Field
• Common causes: Burnout of the cold light source bulb, breakage or loose connection of the light guide beam, contamination of the endoscopic optical components.
• Emergency treatment:
1) Immediately switch to the standby cold light source, or quickly replace the backup bulb (some devices support hot swapping).
2) Check the connectors at both ends of the light guide beam, re-plug and tighten the locking ring, and observe whether there are obvious creases on the light guide beam.
3) If the light guide beam is broken, replace the standby light guide beam immediately; if the lens is contaminated, rinse and dry it with sterile normal saline together with the nurse.
2. Circular Shadows or Blurred Edges in the Image
• Common causes: Abrasion on the surface of the endoscopic objective lens, displacement of the prism, or poor coupling between the light guide beam and the endoscope interface.
• Emergency treatment:
1) First clean the surface of the objective lens to eliminate contamination.
2) Rotate the light guide beam interface slightly to adjust the coupling position and observe whether the shadows disappear.
3) If the fault persists, replace the standby endoscope immediately to avoid surgical misoperation caused by unclear vision.
3. Jamming or Inability to Insert the Endoscope
• Common causes: Bending or deformation of the endoscope body, burrs on the worn outer tube, or intraoperative tissue debris attached to the endoscope shaft.
• Emergency treatment:
1) Pause insertion, gently wipe the endoscope shaft with sterile gauze to remove attached tissue or blood clots.
2) Check whether there is visible bending or deformation of the endoscope body; if present, forced insertion is strictly prohibited, and a standby endoscope should be replaced.
3) If jamming is caused by narrow access, a dilator can be used with the doctor’s assistance, or adjust the endoscope angle to attempt insertion.
4. Blockage of the Irrigation/Aspiration Channel
• Common causes: Bone chips, stone fragments or blood clots blocking the channel, or insufficient irrigation fluid pressure.
• Emergency treatment:
1) Use a syringe to draw normal saline and perform reverse pressure irrigation on the channel from the irrigation interface.
2) If the blockage is severe, a special thin probe (sterilized) can be used to gently unblock it to avoid damaging the inner wall of the channel.
3) Check the irrigation pump pressure and switch to the operating room central water supply system if necessary.
5. Loose Connection Between the Endoscope Body and the Light Source/Camera
• Common causes: Wear of the locking buckle, or loose interface caused by intraoperative collision.
• Emergency treatment:
1) Immediately turn off the light source, tighten the interface locking ring or fasten the buckle to prevent strong light from burning the endoscopic optical components.
2) If the buckle is damaged, sterile gauze can be used to temporarily wrap and fix the interface, and replace the new locking component after surgery.
6. Ghosting or Loss of 3D Effect in 3D Rigid Endoscope Images
• Common causes: Calibration offset of binocular prisms, damaged polarizer, or coaxial deviation between the camera and the endoscope.
• Emergency treatment:
If debugging and calibration are ineffective, immediately switch to 2D mode to continue the operation, and arrange for professional engineers to calibrate the prisms and polarizer after surgery.
7. Rupture and Water Leakage of the Endoscope Body
• Common causes: Accidental impact by instruments during surgery, or weld cracking due to aging of the endoscope body.
• Emergency treatment:
1) Once water leakage is detected, use must be stopped immediately to prevent liquid from entering the optical system and causing permanent damage.
2) Quickly replace the standby endoscope, mark the damaged endoscope body, and send it back to the factory for air tightness inspection and maintenance after surgery.
8. Camera Overheating or Automatic Shutdown
• Common causes: Excessively high operating room temperature, blocked camera cooling vents, or internal power module failure.
• Emergency treatment:
1) Check whether the camera cooling vents are covered by sterile drapes, remove the obstructions for ventilation and cooling.
2) If overheating still occurs, replace the standby camera immediately to avoid equipment shutdown affecting the operation.
9. Large Areas of Noise or Streaks in the Image
• Common causes: Electromagnetic interference from operating room high-frequency electrotomes, ultrasound equipment, or damaged camera cables.
• Emergency treatment:
1) Adjust the routing of camera cables to keep away from interference sources such as high-frequency electrotomes.
2) Check whether the cable surface is worn; if damaged, it can be temporarily wrapped with anti-interference tape, and the entire cable should be replaced after surgery.
10. Malfunction of the Operation Handle
• Common causes: Internal gear wear, broken connecting steel wire, or poor contact of handle buttons.
• Emergency treatment:
1) If the angle adjustment fails, try to move the handle slightly to determine whether it is mechanical jamming or steel wire breakage.
2) If the buttons are faulty, the host panel buttons can be used temporarily instead, or replace the standby handle.
3) If it is completely out of order, replace the standby endoscope immediately.
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