腹腔镜作为外科手术的 “眼睛”，其精密程度堪比微缩版的光学仪器，一旦出现故障，维修过程就像给这台 “神器” 做 “微创手术”，每一个操作都需谨小慎微。从拆解到组装，从清洁到调试，这些关键要点决定了维修的成败与器械的安全性。

　　Laparoscopy, as the "eye" of surgical procedures, has a precision comparable to miniature optical instruments. Once a malfunction occurs, the repair process is like performing a "minimally invasive surgery" on this "artifact", requiring careful attention to every operation. From disassembly to assembly, from cleaning to debugging, these key points determine the success or failure of maintenance and the safety of equipment.

　　拆解：像 “拆钟表” 一样精准定位故障

　　Disassembly: Accurately locate faults like dismantling a clock

　　维修的第一步是精准判断故障源，常见问题如镜头模糊（可能因内部镜片污染或损坏）、光束不亮（光纤断裂或接口接触不良）、器械通道卡顿（异物堵塞或机械结构磨损）。拆解时必须使用专用工具（如微型螺丝刀、镊子），避免蛮力操作 —— 曾有案例显示，非专业人员用普通钳子拆卸镜头，导致螺纹滑丝，原本简单的清洁变成整体更换。对于集成度高的部件（如摄像头接口），需先记录接线顺序和位置，必要时拍照存档，防止组装时出现 “多余零件” 的尴尬。

　　The first step in maintenance is to accurately identify the source of the malfunction. Common problems include blurry lenses (possibly due to internal lens contamination or damage), dim light beams (fiber breakage or poor interface contact), and instrument channel jamming (foreign object blockage or mechanical structure wear). Special tools (such as micro screwdrivers and tweezers) must be used during disassembly to avoid brute force operation - there have been cases where non professionals used ordinary pliers to disassemble lenses, causing thread slippage and turning simple cleaning into complete replacement. For highly integrated components (such as camera interfaces), it is necessary to first record the wiring sequence and position, and if necessary, take photos for archiving to prevent the embarrassment of "extra parts" during assembly.

　　清洁：对抗 “微米级污染” 的持久战

　　Cleanliness: a protracted battle against 'micron level pollution'

　　腹腔镜的光学系统对污染极其敏感，0.1mm 的灰尘就可能导致视野模糊。清洁镜头时，禁用普通酒精或纸巾，需用无尘布蘸取专用光学清洁剂（成分多为异丙醇），沿镜片同心圆方向轻拭，避免来回擦拭产生划痕。光纤束的清洁更需耐心 —— 若发现端面发黑，需用光纤切割刀重新打磨，打磨后需通过显微镜检查端面平整度（合格标准为平面度误差＜5μm）。对于金属鞘管内的血渍或组织残留，不能仅用清水冲洗，需配合酶洗液超声震荡（功率控制在 30-40kHz，时间不超过 5 分钟），再用高压气枪吹干，防止水汽残留导致内部锈蚀。

　　The optical system of laparoscopy is extremely sensitive to contamination, and 0.1mm dust may cause blurred vision. When cleaning the lens, do not use regular alcohol or paper towels. Instead, use a dust-free cloth dipped in specialized optical cleaning agents (mostly isopropanol) and gently wipe along the concentric circles of the lens to avoid scratches caused by back and forth wiping. The cleaning of fiber bundles requires more patience - if the end face is found to be blackened, it needs to be re polished with a fiber optic cutting knife. After polishing, the flatness of the end face needs to be checked under a microscope (the qualified standard is flatness error<5 μ m). For blood stains or tissue residues inside the metal sheath tube, it is not enough to rinse with clean water alone. It is necessary to use enzyme wash solution and ultrasonic oscillation (power controlled at 30-40kHz, time not exceeding 5 minutes), and then dry it with a high-pressure air gun to prevent internal corrosion caused by water vapor residue.

　　零件检修：从 “发丝裂痕” 中发现隐患

　　Parts maintenance: hidden dangers discovered from "hair cracks"

　　镜头镜片组的检修需借助体视显微镜（放大倍数≥10 倍），重点观察镜片是否有脱膜、裂纹或气泡 —— 曾有维修案例中，表面看似完好的镜片在强光照射下，发现细微的径向裂纹，这种隐患在手术中可能因温度变化导致镜片崩裂。金属部件（如穿刺锥、操作钳）的检修需关注关节轴的磨损程度，可用塞尺测量轴孔间隙（正常应＜0.1mm），超过则需更换轴套或销钉。光纤束的断点检测需使用光源检测仪，将光纤一端对准光源，另一端观察光斑均匀性，若出现暗斑或亮度衰减超过 30%，则需更换整束光纤。

　　The maintenance of the lens assembly requires the use of a stereo microscope (magnification ≥ 10x), with a focus on observing whether the lens has detachment, cracks, or bubbles - in previous maintenance cases, seemingly intact lenses were found to have subtle radial cracks under strong light, which may cause lens breakage due to temperature changes during surgery. The maintenance of metal components (such as puncture cones and operating pliers) should pay attention to the degree of wear of the joint shaft. The clearance between the shaft holes can be measured with a feeler gauge (normally<0.1mm). If it exceeds this limit, the shaft sleeve or pin needs to be replaced. The breakpoint detection of fiber optic bundles requires the use of a light source detector. Align one end of the fiber optic cable with the light source and observe the uniformity of the light spot at the other end. If dark spots or brightness attenuation exceeds 30%, the entire fiber optic bundle needs to be replaced.

　　组装：“纳米级精度” 的复位艺术

　　Assembly: The art of resetting with "nanoscale precision"

　　组装镜头时，镜片组的轴向间距需严格按原厂参数（通常精确到 0.01mm），可用千分尺配合垫片调整，间距过大或过小都会导致焦距偏移。摄像头与镜体的连接需注意螺纹咬合度，正确的手感是 “轻微阻力但能顺畅旋入”，若过紧可能是螺纹错位，过松则会影响图像稳定性。器械通道的密封件安装是防漏关键，O 型圈需涂抹专用硅基润滑剂（禁用石油基油脂，以防老化），并检查唇边是否外翻，安装后需进行水压测试（0.2MPa 压力下保持 3 分钟无泄漏）。

　　When assembling the lens, the axial spacing of the lens group must strictly follow the original factory parameters (usually accurate to 0.01mm), which can be adjusted with a micrometer and shims. If the spacing is too large or too small, it will cause focal length deviation. The connection between the camera and the mirror body should pay attention to the degree of thread engagement. The correct hand feel is "slight resistance but smooth screwing in". If it is too tight, it may be due to thread misalignment, and if it is too loose, it will affect image stability. The installation of sealing components in the instrument channel is crucial for leak prevention. The O-ring needs to be coated with a special silicon-based lubricant (petroleum based grease is prohibited to prevent aging), and the lip edge should be checked for outward rotation. After installation, a water pressure test should be conducted (maintain a pressure of 0.2MPa for 3 minutes without leakage).

　　性能测试：比 “术前检查” 更严格的验收

　　Performance testing: stricter acceptance than preoperative examination

　　维修后的腹腔镜需通过多层级测试：光学性能测试中，需在分辨率测试板（如 USAF 1951）下，确认能清晰分辨 5-6 组线对（对应分辨率≥100lp/mm）；机械性能测试需模拟手术动作，操作钳开合 50 次无卡顿，穿刺锥穿刺力≤20N；电气安全测试要检测绝缘电阻（≥20MΩ）和接地连续性（接地阻抗＜0.1Ω）。最关键的是密封性测试，将镜体浸入水中，从器械通道注入 0.1MPa 空气，观察气泡量（每分钟气泡数≤5 个为合格），任何细微漏气都可能在手术中导致雾气干扰视野。

　　The repaired laparoscope needs to pass multi-level testing: in optical performance testing, it is necessary to confirm that 5-6 sets of line pairs can be clearly distinguished under a resolution testing board (such as USAF 1951) (corresponding to a resolution ≥ 100lp/mm); Mechanical performance testing requires simulating surgical actions, operating the forceps open and close 50 times without jamming, and the puncture force of the puncture cone is ≤ 20N; electrical safety testing requires detecting insulation resistance (≥ 20M Ω) and grounding continuity (grounding impedance<0.1 Ω). The most crucial step is the sealing test. Immerse the mirror body in water, inject 0.1MPa air from the instrument channel, and observe the amount of bubbles (≤ 5 bubbles per minute is qualified). Any slight air leakage may cause fog to interfere with the field of view during surgery.

　　灭菌与追溯：给 “神器” 上双保险

　　Sterilization and traceability: double insurance for "artifacts"

　　维修后的腹腔镜必须经过低温灭菌（如环氧乙烷或过氧化氢等离子），灭菌前需拆除不耐高温部件（如电子元件），并用专用灭菌袋封装（袋上注明维修日期和部件信息）。建立维修档案是行业规范 —— 记录故障现象、更换零件、测试数据等，这些信息不仅用于追溯，还能为后续维修提供参考。曾有医院因缺失维修记录，在器械出现重复故障时，无法判断是旧伤复发还是新问题，导致手术延误，可见规范记录的重要性。

　　After repair, the laparoscope must undergo low-temperature sterilization (such as ethylene oxide or hydrogen peroxide plasma). Before sterilization, non high temperature resistant components (such as electronic components) must be removed and sealed in a dedicated sterilization bag (with the repair date and component information indicated on the bag). Establishing maintenance records is an industry standard - recording fault phenomena, replacing parts, testing data, etc. This information is not only used for traceability, but also provides reference for subsequent repairs. There have been hospitals where, due to a lack of maintenance records, it was difficult to determine whether repeated equipment failures were caused by old injuries or new problems, resulting in surgical delays. This highlights the importance of standardized records.

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