G-flex MultibandLigator Mode D'emploi page 8

If after inserting the handle of the device into the working channel entry port
the handle is not stable enough or can move with soft movements of the
scope, please remove the biopsy valve along with the handle of the device by
2cm up from the endoscope. Then press the handle further into the biopsy
valve and place both handle and biopsy valve together into the endoscope
working channel entry port again.
Procedure
Ligation of oesophageal varices
1. Lubricate the scope and exterior part of the band barrel ensuring that no
lubricant has entered the barrel.
2. Roll back the big wheel 180˚ to permit that the tracking wires is not fully
straightened so that no band is shot while inserting the endoscope into the
patient.
3. When in place, tension again the tracking wire using the small wheel to prepare
for the shooting (be sure that the alignment arrows on the handle are facing
each other).
4. Locate the selected varix and aspirate it into the band barrel.
5. To fire the band, slowly rotate 180º forward the big wheel. More than one ligation
band for each varix might be needed to control acute bleeding.
6. Release the suction button of the scope, insufflate air and then withdraw the
scope slightly to release the ligated varice.
7. Repeat the procedure until the last varix is banded.
The luer-lock connection is available to ensure irrigation of the scope biopsy
channel if required. After removing the blue cap, attach the luer-lock
connector to a syringe filled with sterile water and irrigate.
After irrigation put back the blue cap to ensure good suction.
In case additional bands are needed, remove the scope and attach a new
Multiband Ligator starting back from the mounting steps.
Removing the Multiband Ligator
1. Once the ligation procedure is completed, remove the scope from the patient.
2. Dismantle the the Multiband Ligator as follows:
a. If any unused bands are still on the barrel shoot all remaining bands
b. Remove the Multiband Ligator handle from the biopsy channel by pulling it,
the remaining tracking wire attached with the handle should be removed
also.
c. Remove the band barrel from the scope tip.
d. Dispose all parts per institutional guidelines for biohazardous medical
waste.
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