Hard tube endoscope is not damaged in the process of operation. Although it will contact and bump with human tissues such as muscles, mucous membranes, bones, etc., these bumps are slight and will not cause damage to the endoscope, because it only plays the role of observation, not the force point of other instruments. However, when using other instruments, especially the forceps and scissors with large bite force, it should be noted that the front end of the mirror tube should not extend into the occlusion area of the instrument, so as to avoid injury to the mirror tube. When using this kind of equipment, sometimes doctors extend the endoscope very close to the tissue in order to see clearly the tissue in the occlusal area. When the equipment is occluded, the endoscope does not return and injures the endoscope by mistake. During the operation, if the occlusal mouth of the instrument is all within the scope of observation of the endoscope, such accidents can be avoided.

有些手術(shù)窺鏡是在鞘管內(nèi)使用，在更換其他角度窺鏡或插拔器械時(shí)，應(yīng)注意動(dòng)作要輕，不可用力過猛。尤其是插拔窺鏡過程中，當(dāng)遇到阻力拔不動(dòng)時(shí)應(yīng)仔細(xì)查找原因，必要時(shí)應(yīng)連同鞘管一起拔取，不要用蠻力。

Some surgical speculums are used in the sheath. When replacing other angle speculums or inserting and unplugging instruments, it should be noted that the movement should be light and the force should not be too strong. Especially in the process of inserting and pulling out the endoscope, when the resistance is encountered, the reason should be carefully found out. If necessary, the endoscope should be pulled out together with the sheath tube, and do not use brute force.

當(dāng)窺鏡配合激光汽化、高頻電切、微波等光電技術(shù)進(jìn)行手術(shù)時(shí)，應(yīng)注意窺鏡前端與治療點(diǎn)的距離，保證窺鏡前端不被電擊或燒灼。使用這些器械時(shí)，主刀醫(yī)生應(yīng)反復(fù)練習(xí)，掌握窺鏡圖像中物距和實(shí)際物距的關(guān)系，確認(rèn)窺鏡前端與治療點(diǎn)的近距離，以便在實(shí)際手術(shù)中應(yīng)用自如。

When the endoscope is operated with laser vaporization, high-frequency electric cutting, microwave and other photoelectric technologies, attention should be paid to the distance between the front end of the endoscope and the treatment point to ensure that the front end of the endoscope is not shocked or burned. When using these instruments for the first time, the surgeon should practice repeatedly, master the relationship between the object distance and the actual object distance in the endoscope image, and confirm the closest distance between the front end of the endoscope and the treatment point, so as to apply them freely in the actual operation.

目前在耳鼻喉科、骨科的臨床手術(shù)中已經(jīng)廣泛使用刨削器來切除病變組織。其刀頭鋒利、硬度高、旋轉(zhuǎn)速度快、力矩大，如果削到內(nèi)窺鏡，窺鏡必?fù)p無疑。在此類手術(shù)中要注意調(diào)整沖洗和吸引的速度，隨時(shí)保證窺鏡圖像清晰不被血污遮擋，控制刀頭的旋轉(zhuǎn)部分始終在窺鏡的觀察范圍內(nèi)，在手術(shù)范圍較大時(shí)，應(yīng)先停止刀頭轉(zhuǎn)動(dòng)，再移動(dòng)窺鏡，然后在窺鏡監(jiān)視下移動(dòng)刀頭，到合適部位后再開機(jī)刨削。當(dāng)感覺到刨刀工作異?；蛘斩韧蝗唤档蜁r(shí)，有可能窺鏡已經(jīng)受損，應(yīng)及時(shí)更換，以免造成更大損失。

At present, in the clinical operation of Otolaryngology and orthopedics, planer has been widely used to remove pathological tissue. It has sharp blade, high hardness, fast rotation speed and large torque. If it is cut to the endoscope, the endoscope will be damaged. In this kind of operation, we should pay attention to adjust the speed of flushing and attraction, ensure the clear image of the endoscope at any time and not be covered by blood stain, control the rotating part of the knife head to always be within the scope of observation of the endoscope, when the scope of operation is large, we should stop the rotation of the knife head first, then move the endoscope, then move the knife head under the supervision of the endoscope, and then start the planing after reaching the appropriate position. When it is felt that the planer is working abnormally or the illumination suddenly decreases, it is possible that the endoscope has been damaged, so it should be replaced in time to avoid greater loss.

一般重要手術(shù)，應(yīng)有一套備用窺鏡和關(guān)鍵器械，在發(fā)現(xiàn)問題時(shí)可以從容地更換；如果使用角度不合適的窺鏡或不配套的器械勉強(qiáng)手術(shù)，也容易造成窺鏡的損壞。

For general important operations, there should be a set of spare endoscopes and key equipment, which can be replaced calmly when problems are found; if the use of the endoscope with inappropriate angle or non matching equipment is forced to operate, it is also easy to cause damage to the endoscope.

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