Ethicon ECHELON FLEX User manual

Steps for Use
ECHELON FLEX™Powered Vascular Stapler with Advanced
Placement Tip and ENDOPATH ECHELON™Vascular White
Reload for Advanced Placement Tip (35mm, 4 row)
Prior to using the instrument
Using sterile technique, remove the instrument and the battery from their respective packaging and install the battery pack. An
audible click will be heard when the battery pack is fully inserted. It can be inserted in either orientation; there is no up or down.
Nomenclature
Channel jaw
Curved tip anvil jaw
Manual articulation lever
Firing trigger
Red iring trigger lock
Manual closing trigger
Knife reverse switch
Rotating knob
Manual override
Battery pack
Anvil release
button
Articulation joint
9/12mm shaft

Loading the instrument
Closing and opening of the jaws
Articulation and placement
1
4
7
2
5
8A
3
6
8B
Prior to loading, rotate the shaft so the
Curved Anvil Tip is in the upright position for
easier loading. Examine the reload for the
presence of a yellow staple retaining cap.
Prior to insertion through the port rotate the
shaft back so the Curved Anvil Tip is in the
downward position. The shaft will rotate
optimally when the jaws of the device
are open.
To articulate the jaws inside the body cavity,
turn the articulation lever in either direction
until one of the three pre-determined angles
is reached. Articulating while closed does
not provide optimal feedback and control,
and may result in instrument damage.
Insert the reload by sliding it against the
bottom of the channel jaw until the reload
alignment tab stops in the reload alignment
tab slot. Snap the reload securely in place.
Close the jaws of the instrument by
squeezing the closing trigger until a click is
heard. The audible click indicates that the
closing trigger and the jaws are locked.
Position the instrument around the tissue
to be stapled, ensuring that the tissue is
proximal to the cut line markings, which
represent the minimum cut distance.
Remove the yellow staple retaining cap and
discard. Observe the surface of the new
reload to ensure no blue colored drivers are
visible. Visually inspect the stapler to ensure
proper reload seating.
Squeeze the closing trigger, and then
simultaneously push the anvil release button
on the side of the device. Maintain pressure
on the anvil release button and slowly
release the closing trigger.
Ensure that the tissue lies lat and is
positioned properly between the jaws.
Any “bunching” of tissue along the reload,
particularly in the crotch of the jaws, may
result in an incomplete staple line.

No tissue distally Firing the instrument
Stapler lockout
91011
Fully close the closing trigger until it
clicks (audible click will occur).
WARNING: Do not use the instrument if,
upon closing, the tissue extends beyond
the cut line marking, which represents
the minimum cut distance. Firing with
tissue in the tip of the jaws may result
in incomplete cutting action, and/ or
improperly formed staples.
Under certain circumstances the stapler will
lockout, including instances where there is
no cartridge, an incorrect cartridge is used,
or a used cartridge is still in the device. At
any time, if the knife reverse switch does not
return the knife to the home position and
the jaws will not open:
1. Reverse: Slide the knife reverse
switch forward
2. Battery: Check the battery is securely
installed and that the device has power
3. Reverse: Slide the knife reverse switch
forward again
Pull back the red iring trigger lock. Pull the
exposed iring trigger to ire (motor will be
audible). Continue to depress the trigger
until the motor stops, release the iring
trigger to automatically return the knife to
the home position.
Override
If the knife still does not return, use the
manual override (remove the access panel
labeled “Manual Override” on the top of the
handle).
Squeeze the closing trigger, and then
simultaneously push the anvil release button
on the side of the device. Maintain pressure
on the anvil release button and slowly
release the closing trigger. Inspect the staple
line.
Manual override system
The manual override lever will be exposed.
Move the lever forward and backward until it
can no longer be moved. The knife will now
be in the home position. This can be veriied
by viewing the position of the knife in the
knife lockout window.
NOTE: Once the override lever is used
the device becomes non-functional.
Discard the instrument and dispose
of the battery pack.

Reloading the instrument
Battery pack disposal
12 13 14
Push upward (toward the anvil) to
unsnap the reload from the channel jaw.
Discard the used reload.
Disconnect the battery pack by
squeezing the release tabs and pull
the battery pack straight back.
Prior to reloading the instrument, hold the
instrument in a vertical position, with anvil
and reload jaw completely submerged in
sterile solution. Swish vigorously and then
wipe the inside and outside surfaces
to clean any unused staples from the
instrument. Do not use the instrument until
it has been visually inspected to conirm
there are no staples on the anvil and
channel jaw.
Because of the built-in battery drain, it is safe
to discard the battery pack into the battery
recycling bin or normal waste stream*.
* Depending on your local regulations it may be required for the battery pack
to be decontaminated before the lithium batteries are recycled.
©2014 Ethicon, Inc. All rights reserved. 024915141112
For complete product details refer to the relevant package inserts, with particular attention paid to the indications, contraindications, warnings
and precautions, and steps for use of the device.
Follow the same steps outlined earlier in the
“Loading the instrument” section.