Olympus EVIS EXERA II User manual

CAUTION : Balloons Used with This Product Contain Natural Rubber Latex, Which May Cause
Allergic Reactions.
INSTRUCTIONS
EVIS EXERA II ULTRASOUND GASTROVIDEOSCOPE
OLYMPUS GF TYPE UCT180

Contents
i
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Contents
Symbols......................................................................................... 1
Important Information — Please Read Before Use.................... 3
Intended use ............................................................................................ 3
Applicability of endoscopy and endoscopic treatment ............................. 3
Instruction manual..................................................................................... 4
User qualifications..................................................................................... 5
Instrument compatibility ........................................................................... 5
Reprocessing before the first use/reprocessing and storage after use .... 5
Spare equipment ...................................................................................... 6
Maintenance management ....................................................................... 6
Prohibition of improper repair and modification ........................................ 6
Signal words ............................................................................................. 6
Precautions ............................................................................................... 7
Examples of inappropriate handling ......................................................... 11
Chapter 1 Checking the Package Contents............................ 13
1.1 Standard components..................................................................... 13
1.2 Ultrasonic cable .............................................................................. 15
Chapter 2 Instrument Nomenclature and Specifications ...... 16
2.1 Nomenclature.................................................................................. 16
2.2 Endoscope functions....................................................................... 18
2.3 Specifications.................................................................................. 21
2.4 Attaching the chain for water-resistant cap (MAJ-1739) ................. 25
Chapter 3 Preparation and Inspection .................................... 28
3.1 Preparation of the equipment.......................................................... 29
3.2 Inspection of the endoscope ........................................................... 30
3.3 Preparation and inspection of accessories ..................................... 34
3.4 Attaching accessories to the endoscope ........................................ 39
3.5 Inspection and connection of ancillary equipment .......................... 41
3.6 Inspection of the endoscopic system .............................................. 47
3.7 Preparation and inspection of the balloon....................................... 53

Contents
ii ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Chapter 4 Operation.................................................................. 58
4.1 Insertion .......................................................................................... 60
4.2 Observation of the ultrasound image .............................................. 66
4.3 Using EndoTherapy accessories .................................................... 68
4.4 Withdrawal of the endoscope and inspection of air/water
and balloon channels ...................................................................... 75
4.5 Removal of the balloon ................................................................... 78
4.6 Transportation of the endoscope .................................................... 79
Chapter 5 Reprocessing: General Policy................................ 81
5.1 Instructions...................................................................................... 81
5.2 Importance of cleaning, disinfection, and sterilization..................... 82
5.3 Precautions ..................................................................................... 83
5.4 Reprocessing before the first use ................................................... 86
5.5 Reprocessing and storage after use ............................................... 86
5.6 Reprocessing before patient procedure .......................................... 87
Chapter 6 Compatible Reprocessing Methods....................... 88
6.1 Compatibility summary.................................................................... 88
6.2 List of compatible methods ............................................................. 89
6.3 Detergent solution for manual cleaning........................................... 95
6.4 Disinfectant solution for manual disinfection ................................... 96
6.5 Water .............................................................................................. 96
6.6 Rinse water ..................................................................................... 96
6.7 Alcohol ............................................................................................ 97
6.8 ETD (Endo Thermo Disinfectors) .................................................... 98
6.9 OER-AW (Olympus Endoscope Reprocessor) ............................... 99
6.10 Washer-Disinfector.......................................................................... 100
6.11 Ethylene oxide gas sterilization....................................................... 103
6.12 Steam sterilization (autoclaving) ..................................................... 104
6.13 Signs of degradation from reprocessing and its number of times ... 106
Chapter 7 Cleaning, Disinfection, and Sterilization
Procedures ............................................................... 111
7.1 Required reprocessing equipment .................................................. 111
Chapter 8 Reprocessing Workflow for Endoscopes and
Accessories..............................................................123
8.1 Summary of reprocessing workflow ................................................ 123
8.2 Workflow for reprocessing endoscopes and accessories ............... 124

Contents
iii
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Chapter 9 Reprocessing the Endoscope (and related
reprocessing accessories) .....................................127
9.1 Summary of reprocessing the endoscope ...................................... 127
9.2 Preparing the equipment for reprocessing...................................... 128
9.3 Precleaning the endoscope and accessories ................................. 128
9.4 Leakage testing of the endoscope .................................................. 133
9.5 Manually cleaning the endoscope and accessories........................ 138
9.6 Manually disinfecting the endoscope and accessories ................... 158
9.7 Rinsing the endoscope and accessories following disinfection ...... 161
9.8 Sterilization ..................................................................................... 163
Chapter 10 Reprocessing the Accessories .............................. 165
10.1 Summary of reprocessing the accessories ..................................... 165
10.2 Manually cleaning the accessories ................................................. 166
10.3 Manually disinfecting the accessories............................................. 189
10.4 Rinsing the accessories following disinfection ................................ 200
10.5 Sterilizing the accessories .............................................................. 204
Chapter 11 Reprocessing Endoscopes and Accessories
Using an AER/WD.................................................... 206
11.1 Reprocessing endoscopes and accessories using an AER............ 206
11.2 Reprocessing endoscopes and accessories using an ETD............ 206
11.3 Reprocessing endoscopes and accessories using an OER-AW .... 207
11.4 Reprocessing accessories using a WD .......................................... 209
Chapter 12 Storage and Disposal.............................................. 210
12.1 Storage of the endoscope............................................................... 211
12.2 Storage of the balloon..................................................................... 211
12.3 Storage of reusable parts and reprocessing equipment ................. 212
12.4 Storage of the ultrasonic cable ....................................................... 212
12.5 Disposal .......................................................................................... 212
Chapter 13 Troubleshooting ...................................................... 213
13.1 Troubleshooting guide .................................................................... 213
13.2 Withdrawal of the endoscope with an irregularity ........................... 218
13.3 Returning the endoscope for repair ................................................ 220

Contents
iv ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Appendix A: System Chart........................................................... 221
Appendix B: Inspection of the endoscope after cleaning,
disinfection or sterilization in accordance with
IEC 60601-2-37 ......................................................... 228
Appendix C: EMC Information ..................................................... 230
Appendix D: Acoustic Output Information in Accordance
with the FDA Guidance:
“Information for Manufacturers Seeking
Marketing Clearance of Diagnostic Ultrasound
Systems and Transducers” .................................... 236
Symbol key ............................................................................................... 236
Acoustic output table with Hitachi or FUJIFILM Healthcare
diagnostic ultrasound system .................................................................... 238
Acoustic output table when combined with Olympus universal
endoscopic ultrasound center EU-ME1 .................................................... 241
Clinical measurement accuracy with Hitachi or FUJIFILM Healthcare
diagnostic ultrasound system .................................................................... 242
Clinical measurement accuracy when combined with Olympus
universal endoscopic ultrasound center EU-ME1 .................................... 242
Appendix E: Acoustic Output Information Accordance with
IEC 60601-2-37 ......................................................... 243
Acoustic output table with Hitachi or FUJIFILM Healthcare diagnostic
ultrasound system .................................................................................... 243
Acoustic output table with Olympus universal endoscopic ultrasound
center EU-ME1 ......................................................................................... 254

Symbols
1
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Symbols
The meaning(s) of the symbol(s) shown on the package, the back cover of this
instruction manual and/or this instrument are as follows:
Refer to instructions.
Caution
TYPE BF applied part
Serial number
IPX7 Ingress protection rating (except for connectors)
Lock the ultrasound connector
Release the ultrasound connector
Ultrasound endoscope
Single use only
Do not resterilize
Use by (expiration date)
Sterilized using ethylene oxide
Sterilization lot number
Lot number

2
Symbols
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Nonsterile
Keep away from sunlight
Keep dry
Do not use if package is damaged
Contains or Presence of Natural Rubber Latex
Date of manufacture
Manufacturer
Translation
Importer (into European Union)
Authorized representative in the European Community

Important Information — Please Read Before Use
3
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Important Information — Please Read
Before Use
Intended use
This instrument has been designed to be used with an Olympus universal
endoscopic ultrasound center or a diagnostic ultrasound system (Hitachi, Ltd. or
FUJIFILM Healthcare Corporation), video system center, light source,
documentation equipment, monitor, EndoTherapy accessories and other
ancillary equipment.
This instrument is designed for endoscopic real-time ultrasound imaging,
ultrasound guided needle aspiration and other endoscopic procedures within the
upper gastrointestinal tract and surrounding organs.
Do not use this instrument for any purpose other than its intended use.
Applicability of endoscopy and endoscopic treatment
If there is an official standard on the applicability of endoscopy and endoscopic
treatment that is defined by the healthcare facility’s administration or other official
institutions such as academic societies on endoscopy, follow that standard.
Before starting endoscopy and endoscopic treatment, thoroughly evaluate its
properties, purposes, effects, and possible risks (their nature, extent, and
probability). Perform endoscopy and endoscopic treatment only when its
potential benefits are greater than its risks.
Fully explain to the patient the potential benefits and risks of the endoscopy and
endoscopic treatment as well as any examination/treatment methods that can be
performed in its place, and perform the endoscopy and endoscopic treatment
only after obtaining the consent of the patient.
Even after starting the endoscopy and endoscopic treatment, continue to
evaluate the potential benefits and risks, and immediately stop the
endoscopy/treatment and take proper measures if the risks to the patient
become greater than the potential benefits.

4
Important Information — Please Read Before Use
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Instruction manual
This instruction manual contains essential information for using this instrument
safely and effectively. Before use, thoroughly review this manual and the
manuals of all equipment that will be used during the procedure. Then use the
equipment as instructed.
Keep this and all related instruction manuals in a safe and accessible location. If
you have any questions or comments about any information in this manual,
please contact Olympus.
Terms used in this manual
NBI (Narrow Band Imaging) observation mode:
This is an observation mode using narrow band observation light.
Normal light observation (or WLI (White Light Imaging) observation
mode):
This is an observation mode using the standard white light illumination.
Elastography:
Mode for displaying the relative elasticity information of a tissue using
color images.
For more details, refer to the instruction manual for the ultrasound
instrument for which elastography is available.
AER/EWD/WD:
AER is the abbreviation for Automated Endoscope Reprocessor, which is
used for reprocessing the endoscopes and accessories. EWD is the
abbreviation for Endoscope Washer-Disinfector, which is used for
reprocessing the endoscopes and accessories. EWD refers to AER and
AER is used in this manual. WD is the abbreviation for
Washer-Disinfector, which is used for reprocessing the heat-stable
endoscopes, accessories and medical instruments employing alkaline
cleaning and thermal disinfection.

Important Information — Please Read Before Use
5
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
User qualifications
If there are official standards for user qualifications for performing endoscopy
and endoscopic treatment that are defined by the healthcare facility’s medical
administrators or other official institutions, such as academic societies on
endoscopy, follow those standards. If there are no official qualification standards,
the operator of this instrument must be a physician approved by the medical
safety manager of the healthcare facility or person in charge of the department
(department of internal medicine, etc.).
The physician should be the planned endoscopy and endoscopic treatment
following guidelines set by the academic societies on endoscopy, etc., and
considering the difficulty of endoscopy and endoscopic treatment. This manual
does not explain or discuss endoscopic procedures.
Instrument compatibility
Refer to the “System chart” in the Appendix to confirm that this instrument is
compatible with the ancillary equipment being used. Using incompatible
equipment can result in patient or operator injury and/or equipment damage.
This instrument complies with the EMC standard for medical electrical
equipment, edition 4
(IEC 60601-1-2: 2014).
When connecting to an instrument that complies with a previous edition of the
EMC standard for medical electrical equipment edition, the EMC characteristics
could be vulnerable.
Reprocessing before the first use/reprocessing and
storage after use
This instrument was not cleaned, disinfected, or sterilized before shipment.
Before using this instrument for the first time, reprocess it according to the
instructions given in Chapter 7, “Cleaning, Disinfection, and Sterilization
Procedures”.
After using this instrument, reprocess and store it according to the instructions
given in the endoscope’s companion reprocessing manual. Improper and/or
incomplete reprocessing or storage can present an infection control risk, cause
equipment damage, or reduce performance.
The balloons are disposable, and are intended for a single use only; a new one
must be used for each patient. Do not attempt to reuse or resterilize a balloon.

6
Important Information — Please Read Before Use
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Spare equipment
Be sure to prepare another endoscope to avoid interruption of the examination
due to equipment failure or malfunction.
Maintenance management
The probability of failure of the endoscope and ancillary equipment increases as
the number of procedures performed and/or the total operating hours increase.
In addition to the inspection before each procedure, the person in charge of
medical equipment maintenance in each healthcare facility should inspect the
items specified in this manual periodically. An endoscope with an observed
irregularity should not be used, but should be inspected by following Section
13.1, “Troubleshooting guide” on page 213. If the irregularity is still observed
after inspection, contact Olympus.
Prohibition of improper repair and modification
This instrument does not contain any user-serviceable parts. Do not
disassemble, modify, or attempt to repair it; patient or operator injury and/or
equipment damage can result. Equipment that has been disassembled,
repaired, altered, changed, or modified by persons other than Olympus’ own
authorized service personnel is excluded from Olympus’ limited warranty and is
not warranted by Olympus in any manner.
Signal words
The following signal words are used throughout this manual:
Indicates a potentially hazardous situation which, if not
avoided, could result in death or serious injury.
Indicates a potentially hazardous situation which, if not
avoided, may result in minor or moderate injury. It may also
be used to alert against unsafe practices or potential
equipment damage.
Indicates additional helpful information.

Important Information — Please Read Before Use
7
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Precautions
Follow the warnings and cautions given below when handling this instrument.
This information is to be supplemented by the warnings and cautions given in
each chapter.
• After using this instrument, reprocess and store it according
to the instructions given in Chapter 7, “Cleaning, Disinfection,
and Sterilization Procedures”. Using improperly or
incompletely reprocessed or stored instruments may cause
patient cross-contamination and/or infection.
• Before endoscopy, remove any metallic objects (watch,
glasses, necklace, etc.) from the patient. Performing
high-frequency cauterization treatment while the patient is
wearing metallic objects may cause burns on the patient in
areas around the metallic objects.
• Move the elevator control lever slowly in the opposite
direction of the “ U” direction until it stops and visually
confirm that the portion of the elevator wire extending from
the distal end of the insertion section is not broken or bent. If
the elevator wire is broken or bent, patient injury, bleeding,
and/or perforation could result.
• Do not strike, hit, or drop the endoscope’s distal end,
insertion tube, bending section, control section, universal
cord, or endoscope connector. Also, do not bend, pull, or
twist the endoscope’s distal end, insertion tube, bending
section, control section, universal cord, or endoscope
connector with excessive force. The endoscope may be
damaged and could cause patient injury, burns, bleeding,
and/or perforations. It could also cause parts of the
endoscope to fall off inside the patient.
• Never perform angulation control forcibly or abruptly. Never
forcefully pull, twist, or rotate the angulated bending section.
Patient injury, bleeding, and/or perforation may result. It may
also become impossible to straighten the bending section
during an examination.
• Never insert or withdraw the endoscope’s insertion section
while the bending section is locked in position. Patient injury,
bleeding, and/or perforation may result.

8
Important Information — Please Read Before Use
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
• Never operate the bending section, feed air, perform suction,
insert or withdraw the endoscope’s insertion section, or use
EndoTherapy accessories without viewing the endoscopic
image. Patient injury, bleeding, and/or perforation may result.
• Never operate the bending section, feed air, perform suction,
insert or withdraw the endoscope’s insertion section, or use
EndoTherapy accessories while the image is frozen. Patient
injury, bleeding, and/or perforation may result.
• Never insert or withdraw the insertion section abruptly or with
excessive force. Patient injury, bleeding, and/or perforation
may result.
• Do not touch the light guide of the endoscope connector
immediately after removing it from the light source because it
is extremely hot. Operator or patient burns can result.
• That before each use or after a change of viewing
modes/settings, check to ensure the view observed through
the endoscope provides a live image (rather than a stored
one) and has the correct image orientation. Patient injury,
bleeding, and/or perforation could result.
• When the endoscopic image does not appear on the monitor,
the CCD may have been damaged. Turn the video system
center OFF immediately. Continued power supply in such a
case will cause the distal end to become hot and could cause
operator and/or patient burns.
• Turn ON the diagnostic ultrasound system only when the
ultrasonic cable is connected to both the diagnostic
ultrasound system and the ultrasonic cable connector on the
endoscope. In particular, confirm that the diagnostic
ultrasound system is OFF before connecting or detaching the
ultrasonic cable from the ultrasonic cable connector on the
endoscope. Operator injury may result and/or equipment
damage may result.
• Do not rely on the NBI observation mode alone for primary
detection of lesions or to make a decision regarding any
potential diagnostic or therapeutic intervention.
• Never withdraw the endoscope while the balloon is still
inflated. Otherwise, the balloon may burst or detach from the
distal end of the endoscope. If the balloon cannot be
deflated, insert the single use single-ended cleaning brush
(BW-400L) into the balloon channel. Using slow, short
strokes, carefully feed the brush to remove debris.

Important Information — Please Read Before Use
9
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
• When withdrawing the endoscope, make sure that the
balloon is completely deflated, using the ultrasound image
and endoscopic field of view. Withdrawing the endoscope
while the balloon is inflated could result in patient injury.
• If it is difficult to insert the endoscope, do not forcibly insert
the endoscope; stop the endoscopy. Forcible insertion can
result in patient injury, bleeding, and/or perforation.
• If any irregularity in the ultrasound image is observed, turn
the ultrasound center OFF immediately. Continued
ultrasound radiation will cause the distal end to become hot
and could cause operator and/or patient burns.
• Elastography*1 uses the pulsation of a living body.
Intentional pressurization is not necessary. Compression
onto the tissue by operating the bending section, inserting or
withdrawing the endoscope may cause tissue damage,
bleeding or perforation.
• Electromagnetic interference may occur on this instrument
near equipment marked with the following symbol or other
portable and mobile RF (radio frequency) communications
equipment such as cellular phones. If electromagnetic
interference occurs, mitigation measures may be necessary,
such as reorienting or relocating this instrument, or shielding
the location.
• After using the endoscope reprocess it according to the
instructions given in Chapter 7, “Cleaning, Disinfection, and
Sterilization Procedures”. Using improperly or incompletely
reprocessed, the endoscope’s distal end damage may result.
• Do not pull the universal cord during an examination. The
endoscope connector will be pulled out from the output
socket of the light source and the endoscopic image will not
be visible.
• Do not coil the insertion tube or universal cord with a
diameter of less than 12 cm. Equipment damage can result.
∗1 Elastography is not available with the diagnostic
ultrasound system (Hitachi, Ltd. or FUJIFILM
Healthcare Corporation) in Canada.

10
Important Information — Please Read Before Use
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
• Do not attempt to bend the endoscope’s insertion section
with excessive force. Otherwise, the insertion section may be
damaged.
• Do not touch the electrical contacts inside the videoscope
cable connector. CCD damage may result.
• Do not apply shock to the distal end of the insertion section,
particularly the ultrasound transducer and the objective lens
surface at the distal end. Visual abnormalities may result.
• Do not hold the ultrasonic transducer when holding the
insertion tube. The ultrasonic transducer damage can result
and/or the ultrasonic image will be abnormal.
• Do not twist or bend the bending section with your hands.
Equipment damage may result.
• Do not squeeze the bending section forcefully. The covering
of the bending section may stretch or break and cause water
leaks.
• Turn the video system center ON only when the videoscope
cable is connected to both the video system center and the
videoscope cable connector on the endoscope. In particular,
confirm that the video system center is OFF before
connecting or detaching the videoscope cable from the
electrical connector on the endoscope. Failure to do so can
result in equipment damage, including destruction of the
CCD.
• The endoscope’s remote switches cannot be removed from
the control section. Pressing, pulling, or twisting them with
excessive force can break the switches and/or cause water
leaks.
• If remote switch 1 does not return to the OFF position after
being pressed strongly from the side, gently pull the switch
upwards to return it to the OFF position.
• Do not hit or bend the electrical contacts on the endoscope
connector. The connection to the light source may be
impaired and faulty contact can result.
• Do not touch the electrical contacts in the ultrasonic cable
connector. Equipment damage can result.
• Do not pull, twist or tightly coil the ultrasonic cable. Noise can
develop in the ultrasound image.

Important Information — Please Read Before Use
11
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
• To check the electromagnetic interference from other
equipment (any equipment other than this instrument or the
components that constitute this system), the system should
be observed to verify its normal operation in the configuration
in which it will be used.
• To prevent unnecessary patient exposure to ultrasound
radiation, follow the ‘as-low-as-reasonably achievable’
(ALARA) principle when using ultrasound equipment. Freeze
the image whenever you are not actively viewing the “live”
ultrasound image. When the equipment is in the FREEZE
mode, no ultrasound energy is emitted.
• It is highly recommended that a backup ultrasonic cable be
available to continue clinical procedures in case of a
malfunction.
• This endoscope contains a memory chip that stores
information about the endoscope and communicates this
information to the video system center CV-160 and CV-180.
Examples of inappropriate handling
Details on clinical endoscopic technique are the responsibility of trained
specialists. Patient safety in endoscopic examinations and endoscopic treatment
can be ensured through appropriate handling by the physician and the medical
facility. Examples of inappropriate handling are described below.
• Over-insufflating the lumen may cause patient pain, injury, bleeding,
and/or perforation.
• Applying suction with the distal end in prolonged contact with the
mucosal surface, with higher suction pressure than required, or with
prolonged suction time may cause bleeding and/or lesions.
• The endoscope has not been designed for use in retroflexed
observation in parts of the body other than the stomach. Performing
retroflexed observation in a narrow lumen may make it impossible to
straighten the angle of the bending section and/or withdraw the
endoscope from the patient. Retroflexed observation in parts of the body
other than the stomach should be performed only when the usefulness
of doing so is determined to be greater than the risk that is posed to the
patient.
• Inserting, withdrawing, and using EndoTherapy accessories without a
clear endoscopic image may cause patient injury, burns, bleeding,
and/or perforation.

12
Important Information — Please Read Before Use
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
• Inserting or withdrawing the endoscope, feeding air, applying suction, or
operating the bending section without a clear endoscopic image may
cause patient injury, bleeding, and/or perforation.
• For reasons described below, do not rely on the NBI∗1 observation mode
alone for primary detection of lesions or to make a decision regarding
any potential diagnostic or therapeutic intervention.
−NBI has not been demonstrated to increase the yield or
sensitivity of finding any specific mucosal lesion including
colonic polyps or Barrett’s esophagus.
−NBI has not been demonstrated to aid in differentiating
establishing the presence or absence of dysplasia or
neoplastic changes within mucosa or mucosal lesions.
Natural rubber latex medical alert
Balloons used with this instrument contain natural rubber
latex that may cause allergic reactions.
Do not use the balloon on a latex-sensitive patient. Instead,
perform the procedure using “The sterile deaerated water
immersion method” described in Section 4.2, “Observation of
the ultrasound image” on page 66, in Chapter 4, “Operation”.
∗1 NBI stands for Narrow Band Imaging. For more details,
refer to the instruction manual for the video system
center CV-180.

Chapter 1 Checking the Package Contents
13
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Chapter 1 Checking the Package
Contents
1.1 Standard components
Match all items in the package with the components shown below. Inspect each
item for damage. If the instrument is damaged, a component is missing, or you
have any questions, do not use the instrument; immediately contact Olympus.
This instrument was not disinfected or sterilized before shipment. Before using
this instrument for the first time, reprocess it according to the instructions given
in Chapter 7, “Cleaning, Disinfection, and Sterilization Procedures”.
Ultrasound endoscope

14
Chapter 1 Checking the Package Contents
ULTRASOUND GASTROVIDEOSCOPE GF-UCT180
Balloon 3
(MAJ-249 sterile, 20 pcs.)
Mouthpiece
(MB-142, 2 pcs.)
Single use single-ended
cleaning brush
(BW-400L, 3 pcs.)
Water-resistant cap
(MH-553, 2 pcs.)
Washing tube
(MH-974)
Chain for water-resistant cap
(MAJ-1739)
Air/water channel cleaning
adapter (MAJ-629)
Instruction manual
Suction cleaning adapter
(MH-856)
Balloon applicator
(MAJ-675)
Biopsy valve
(MAJ-853, nonsterile,
10 pcs.)
Cleaning adapter for
instrument channel port
(MAJ-350)
Injection tube
(MH-946)
Channel plug
(MAJ-621)
Cleaning brush
(MAJ-1534)
Single use combination
cleaning brush
(BW-412T, 3 pcs.)
Instructions
(Suction valve (MAJ-1443),
Air/water valve (MAJ-1444))