S4 HPS online service training
Basic level, April 2022
Anis Mahmoudi – GEUDER AG
service training
contents
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S4 HPS overview
Graphical user interface
Touch module
Aspiration module
Phaco module
Vitrectomy module
Oil module
Air module
Hardware Test interface
Quiz + certification
2
Purpose of this basic training:
To cover 40% of the possible troubleshootings without opening the device.
The only exception is the touch module incl. S4 HPS PC.
3
S4 HPS overview
4
S4 HPS overview
The Megatron S4/S4HPS is an ophthalmologic device system for using in anterior
and posterior chamber segment. It supports the functions in the essentials:
Aspiration:
Phaco
Diathermy
Vitrectomy:
Air injection
Oil injection
Light module
Dual Pump system: Peristaltic Pump including Venturi-Effect
Venturi- Pump
Cutter control:
Pneumatic cutter control
Additionally to S4HPS: Laser Interface for endoTRON532
5
S4 HPS overview
6
S4 HPS overview
Port 3 and Port 6 are obsolete / not used
7
S4 HPS overview
8
Graphical user interface
9
graphical user interface
start screen
push button
10
graphical user interface
information screen
push button
11
graphical user interface
startup screen
push button
12
graphical user interface
service password screen
enter
service password
FEG_service
Starting with
2020 devices
Ss
PERKEO‐2020
and quit with
13
graphical user interface
14
graphical user interface / extended service
language screen
 German
 English
 French
 Italian
 Spanish
 Portuguese
 Hungarian
 Polish
 Russian
 Arabic
 Chinese
15
graphical user interface
standard footswitch
 Megatron S4 HPS
19 different foot pedal modes
 analog to the different modes of
the Megatron
 footswitch freely programmable
16
graphical user interface
functions
 Function is not implemented.
17
graphical user interface
functions
 Sets the system to the windows
console, but doesn’t switch off
the user interface.
18
graphical user interface
functions
 parameter backup to and from a
flash memory drive
19
graphical user interface
data exchange
divided in two parts
1.
surgeon Megatron S4 HPS
2.
external data memory
20
graphical user interface
data exchange
features
1. Allows to backup complete
and single parameter sets of
one or more surgeons
between Megatron S4 HPS
units.
2. Allows to save parameter sets
of different machines on one
flash memory drive.
3. Allows data management
directly on the flash memory
drive.
21
graphical user interface
data exchange
 allows to create a new
directory on the flash memory
drive
 allows to rename a directory
without changing the saved
data
 deletes the selected directory
22
graphical user interface
data exchange
NOTICE
 deleting of the directory
deletes the parameter
settings saved in this
directory
23
graphical user interface
data exchange
 after creating a new directory
the system is ready to transfer
the data from Megatron S4
HPS to flash memory drive
24
graphical user interface
data exchange
data transfer to flash memory
drive
 select the parameter set and
the destination file and press
the button
 data will be copied from
Megatron S4 HPS to flash
memory drive.
25
graphical user interface
data exchange
data transfer to Megatron
 select the catalog and surgeon
files, which should be
transferred.
 push the button
 data will be copied from
Megtron S4 HPS to flash
memory drive.
26
graphical user interface
data exchange
Settings
 Settings are system
parameters valid for the
device.
 The system parameters are set
in the service and extended
service.
 These settings are copied to
flash memory drive like a
normal surgeon parameters.
27
graphical user interface
data exchange
NOTICE
 Please check the current
settings of the machine
before copying the
settings from flash
memory drive to
Megatron S4 HPS.
28
graphical user interface
functions
 calibration of the Touch
29
graphical user interface
functions
calibration points
30
graphical user interface
functions
 Cursor is not visible.
 Important
If the time expires the
confirmation beep of the touch
screen will not be switched off.
31
graphical user interface
Colour screen
 only Colour Theme 1 is
available for Megatron S4 HPS
 Colour Theme 2 is available for
Megatron S4 HPS (Laser View)
32
graphical user interface / extended service
tubing system
 filling time
• filling time is set to 35 ms
• filling time is set to 55 sec
 tubing test
• enables/disables the test of the
aspiration tube system
 reflux source
• is set to “pump” and cannot be
changed
33
graphical user interface
tubing system
 vacuum release
•
In the vacuum release function the
type of vacuum release is specified
when the footswitch is released.
•
w/o AVR (automatic vacuum
release)
w/o AVR means that the vacuum
release is done only via the roller
pump turning backwards.
34
graphical user interface
tubing system
 vacuum release
•
small tube valve
"Small tube valve" means that the
vacuum is released via the infusion
bottle. This option is not supported
by the currently available tubing
systems. If this function is activated,
the vacuum is released only by the
roller pump reversing its direction of
rotation.
35
graphical user interface
tubing system
 vacuum release
•
internal AVR valve
Internal AVR valve means that the
vacuum reduction is achieved by
venting over the internal VAA‐valve
/ venturi cassette. This setting
makes use of the automatic venting
feature described in section.
36
graphical user interface
error memory
 deletes the errors of the
selected module
 saves error memories of all
modules to folder “service”
on flash memory drive
37
graphical user interface
error memory
IMPORTANT
 Please first select all the
modules before saving
the whole error memory
of the machine.
 A standard file name will
be created. The next time
you save the error
memory the previously
saved file is overwritten.
38
graphical user interface
error memory
modules
 light
 vacuum
 ultrasound
 vitrectomy
 diathermy
 control
 foot Switch
 communication
39
graphical user interface
Moduls
 An overview for each module of:
•
version number
•
date
•
check sum
40
graphical user interface
remote control
 change MAC‐address
41
Touch module
42
Block diagram touchscreen module
error ‘touchscreen module‘
43
Touchscreen module
backlight inverter
display
touch
EL5436
frame
thunderbird
44
Touchscreen module
S4 HPS old generation
- Thunderbird PC (obsolete)
- Backlight inverter
- PC power cable
- PC adapter board
- Touch module monitor
- Resistive touch
45
touchscreen module
S4 HPS new generation
- Fujitzu PC
- PC power cable
- PC adapter board (new)
- Touch module LDVS monitor
- Resistive touch
46
Touchscreen module
Touch module troubleshooting:
Black screen:
- S4 HPS old generation: Backlight inverter damaged / Backlight inverter cable disconnected
PC 5V power supply cable damaged / connector loose contact
- S4 HPS new generation: Fujitzu PC fun power supply damaged.
Touch module freeze:
- Salt cristalls in the touch silicon seal. The cristalls make a pressure on the touch simulate a touch.
- BSS penetrates in the touch silicon seal. The touch metalic lines are shortcutted. Multi touch simulated.
- Footswitch is not in the zero position.
Touch module beeps:
- PC RAM not detected. It happens when the memory isn‘t plugged properly.
Touch Bluescreen
- Windows software issue. The small harddisc has to be checked / A new windows image is needed.
Touch Reset
- The S4 HPS system detects a hudge consumption of energy. In the most of the cases this issue has a
direct relation with the 24V components inside the system and specially the phaco module. The phaco
handpiece is damaged and has to be removed from the device.
Touch not reacting
- Touch has to be calibrated. / Touch is scatched / Touch is damaged.
47
Aspiration module
... to understand the sensitivity of the
whole system it is very important to get a
quick overview of the (phaco) procedure.
 fluidics
irrigation and aspiration
 aspiration module
pumps in the Megatron S4 / S4 HPS
 user interface (GUI)
settings
48
cataract surgery ‐ technical basics
irrigation
two main principles
 hydrostatic pressure
(bottle height)
• variation in height
infusion holder
(motor or manually operated)
 gravity-based
 air‐controlled irrigation
49
cataract surgery ‐ technical basics
irrigation
 bottle height of 136 cm is conform
to 136 cm H2O (column of water)
and to 100 mmHg
 100 cm bottle height = 73,8 mmHg
G‐30111
50
cataract surgery ‐ technical basics
fluidics
closed system
irrigation
 irrigation with BSS
(balanced salt solution)
 void must be replaced
 BSS replaces the aspirated tissue
and liquid
51
cataract surgery ‐ technical basics
sufficient infusion necessary
 replacement of aspirated
volume
 stabilization of AC
 cooling of tissue and needle
Aspiration
Irrigation
52
cataract surgery ‐ technical basics
sufficient infusion necessary
 replacement of aspirated
volume
 stabilization of AC
 cooling of tissue and needle
 guidance of floating tissue
53
cataract surgery ‐ technical basics
If the incision is too small, the sleeve
will be compressed and the irrigation
will decrease.
The following consequences will
occur:
 instabile anterior chamber
 anterior chamber collapse
 cornea burn
no moderate fluidic balance
54
cataract surgery ‐ technical basics
fluidics
flow
irrigation
flow
flow
vacuum
flow
flow
55
cataract surgery ‐ technical basics
fluidics
flow
irrigation
flow
flow
vacuum
flow
flow
56
cataract surgery ‐ technical basics
fluidics
irrigation
If the incision is too large, a leakage
flow
around the sleeve
is created. The
irrigation volume is not sufficient
enough to equalise the amount of
aspiration.
flow
The following consequences will
flow
occur:
 instabileflow
anterior chamber
 anterior chamber collapse
57
cataract surgery ‐ technical basics
fluidics
occluded phaco tip
occlusion
no irrigation
58
cataract surgery ‐ technical basics
fluidics
occluded phaco tip
VACUUM increase
occlusion
vacuum increase
up to maximum
59
cataract surgery ‐ technical basics
peristaltic pump
VAC sensor
 pinch rollers compress
phaco tubing and ‚remove‘
fluid
 liquid flows into the
fluid drainage bag
 surgeon controls the speed
of the roller wheel
=> direct flow control
 common type for phaco
systems
60
cataract surgery ‐ technical basics
advantage
VAC sensor
 direct flow control
 maximum vacuum can be
set on control panel
 no external air required
 soft aspiration
 excellent vacuum control
 vacuum increase only after
tip occlusion
 lower „surge“ effect
61
cataract surgery ‐ technical basics
working principle of the peristaltic pump
 soft aspiration
 excellent vacuum control
 vacuum increase only after tip
occlusion
 flow control
 lower „surge“ effect
62
cataract surgery ‐ technical basics
venturi pump
 compressed air is used to
generate a vacuum in the
drainage cassette and the
tubing system
 surgeon controls the
vacuum
 standard in virectomy
systems and other phaco
systems
63
cataract surgery ‐ technical basics
advantage
 immediate increase
and decrease of
vacuum
 strong directional flow
at tip can be used for
„pointing and
grabbing“ tissue
 aggressive aspiration
 excellent holding force
 risc of „surge“ effect
64
cataract surgery ‐ technical basics
working principle of the venturi pump





aggressive aspiration
shorter rise time
excellent holding force
constant vacuum
not flow controlled
65
cataract surgery ‐ technical basics
pump systems
peristaltic
venturi
flow (speed)
controllable, exactly
limitable
uncontrollable, only
limitable by geometry
vacuum (force)
is created by occlusion
is created immediately
control possibilities
flow / vacuum are
independent from one
another
vacuum and flow are not
related
66
surge effect
extended settings
phaco tip
occlusion free
balance between irrigation and aspiration
67
extended settings
surge effect
occluded phaco tip
vacuum increase up to maximum
squeezed silicone tubing
68
extended settings
surge effect
occlusion collapse
immediate flow increase, silicone tubing
opens, additional aspiration is executed
69
cataract surgery ‐ technical basics
additional important terms
70
cataract surgery ‐ technical basics
reflux
 The task of the reflux is to move back the incorrectly
aspirated tissue into previous position, e.g. capsular bag,
iris, etc.
 If the reflux function is activated the second pinch valve
opens and BSS can flow through the shunt hose and
pressures the aspirated liquid and tissue particles back
into the eye.
71
phaco
reflux
reverse action
of the peristaltic pump
peristaltic pump
vacuum sensor
aspiration tubing
72
switchover V / P
phaco
INF
tubing clamp valve for
the infusion
P
pressure sensor for the
peristaltic function
V2 … V4
tubing clamp valve for
the aspiration function
73
phaco
venturi pump
features
aggressive aspiration
short rise time
constant holding power
constant vacuum
no flow control
risk of „surge“ effect
74
extended settings
flow venturi effect
rise time
from 0,5 to 5,0 s
venturi effect
on/off
vacuum pump
on/off
75
aspiration module
specification / detailed description
 suggestions?
 error memory / code?
 pump type?
 damage?
 history?
 parameter?
 equipment / instruments?
aspiration module
specification / detailed description
 surgical step?
 values?
 settings (extended service)?
 handpiece?
 cassette and tubing system?
 footswitch / infusion pole?
aspiration module
block diagram
aspiration module
left side panel
eject button
vacuum plunger
cassette hooks
vacuum sensor (P.)
peristaltic
pump
LEDs filling level
cassette plungers
aspiration module
left side panel
vacuum plunger
infusion plunger
cassette
plungers
vacuum sensor (P.)
motor of
peristaltic pump
aspiration module
emitter LEDs
receiver transistors
filling level
emitter LEDs
receiver transistors
aspiration module
venturi module
vacuum sensor
(V.)
Vit.‐ control valve
vacuum aeration valve
vacuum control
valve
aspiration module
venturi pump
vacuum control valve
aspiration module
1. cassette is not detected
 suggestions?
 error message / code?
 flash test (digi. Cam)?
 cassette (prism & condition)?
 adjustment of filling level?
 history?
aspiration module
aspiration module
filling level
aspiration module
adjustment of vacuum valves
vacuum aeration
valve
vacuum control valve
aspiration module
left side panel
vacuum
sensor (P.)
motor of
peristaltic
pump
vacuum sensor
(P.)
Aspiration module
Troubleshooting
Issue: No vacuum / vacuum too low
- Ask the question: Peristaltic or venturi vacuum?
Venturi vacuum:
- Ask the question: device or accessories issue?
Accessories issue
- What are the accessories to generate venturi vacuum?
1- is the VIP cassette OK? Is the VIP cassette peristalic membrane OK?
Is the cassette tubing system OK? Are the cassette tuning digit values ok?
(see how to check the cassette).
2- Are my aspiration/ irrigation tubes OK? There is a leak in the tubing
system?
3- is the phaco handpiece OK? Are the aspiration/ irrigation connectors
ok? Is the performed filling test successful? (see how to check the phaco
handpiece).
Aspiration module
Troubleshooting
Device issues
1- Are V2 and V3 plunger OK?
Peristaltic issues:
- Make changes in the cassette and
close the V2 corresponding tube (see
picture). This action is simulating a
correct working V2 plunger
If the peristaltic vacuum is
working, the V2 plunger is
defective.
If the peristaltic vacuum is
not working, the V2 plunger
is OK.
Aspiration module
Troubleshooting
Device issues
1- Are V2 and V3 plunger OK?
Venturi vacuum issues:
- Make changes in the cassette and
close the V3 corresponding tube (see
picture). This action is simulating a
correct working V3 plunger
If the venturi vacuum is
working, the V3 plunger is
defective.
If the venturi vacuum is
not working, the V3 plunger
is OK.
Aspiration module
Troubleshooting
Device issues
1- If the V2 and V3 plungers are OK
Peristaltic vacuum issues:
- Peristaltic motor / rolling system has to be checked.
Venturi vacuum issues:
- Venturi vacuum system inside the device has be checked.
- This system consists of: venturi control valve, venturi aeration valve,
venturi internal tubing system, venturi dual sensor, venturi pump and
mainboard. This kind of trouble shooting are not part of the basic service
training.
worth knowing
The pressure inside the eye is 12 ‐ 21
mmHg (1 mmHg = 0,00133 bar).
mmHg means “mm barometic column”
(an old measurement unit).
for comparison
The average blood pressure is between
80 and 140 mmHg.
93
phaco
test / preparation of the system
choosing surgeon(s),
operation(s) and
surgical step(s)
to surgery
94
phaco
test / preparation of the system
95
phaco
test / preparation of the system
Short US test
connect the luer adapter of the tubing system and fill
the tubes without handpiece (tube filling)
connect the tubes on the handpiece and choose ‚Short
US test‘
or
tubes are already filled:
choose ‚Short US test‘
Do not activate the footswitch
during test and preparation cycle!
96
phaco
test / preparation of the system
Short US test
Connect the tubings on
the handpiece and
choose ‚Long US test‘.
97
ultrasound
phaco
fragmentation of the nucleus
through the jackhammer effect
frequency range
27 – 55 KHz
power (lin., exp., fixed)
0 – 100 %
pulsation (adjustable)
1 – 60 Hz
pulsation term (adjustable)
2 – 900 ms
98
phaco
ultrasound
How to emulsify the nucleus?
Jackhammer Effect
Cavitation bubbles
ultrasonic handpiece
phaco
seal
ultrasonic tip
sleeve
stainless titan case
piezoceramic
elements
aspiration
connection
irrigation
connection
flexible
tubing
electrical cable
100
phaco
ultrasonic handpiece
oscillation transfer of the piezoceramic elements to
the phaco tip
small strokes to the tip (~100 µm)
up to 50.000 oscillations / min.
101
phaco
ultrasonic energy
frequence
fixed parameters
42-43 kHz for most of the GEUDER®
handpieces
automatical tuning (handpiece tip) to improve
the oscillation lenghts
102
phaco
ultrasonic tips
G-24110
or
G-24120 G-24111
103
phaco
ultrasonic power
amplitude
linear
proportional to
footswitch grade
fixed
preset and
constant
pulsating
intermittend
according to preset
rate
control
over
104
sleeve
phaco
protects the texture against
overheating
greater stroke possible
ultrasonic tip is cooled by the infusion
longer working time possible
105
extended settings
sleeve
incision size
106
phaco module
phaco sockets
phaco module
front panel fixing
Diathermy module
diathermy
80 V
0.6 µs
1.5 MHz
diathermy module
device
Air module
Air module
functional diagram
vitrectomy
UNO colourline
fiber optics
only Uno colourline fiber optics can be used with
Xenotron III
114
vitrectomy
vitrectors
aspiration inlet
aspiration tubing
cutting edge
scroll spring
plastic case
rubber membrane
aspiration inlet
pneumatic air inlet
115
vitrectomy
vitrectors
working principle
aspiration
pneumatic air
116
vitrectomy
vitrectors
irrigation / aspiration
during vitrectomy
aspiration
pneumatic air
irrigation
117
vitrectomy
basic settings / surgeon standard
module
vitrectomy
vacuum
rise time
diathermy
air
irrigation
light
pump
118
vitrectomy
air/oil injection
incorrect / third-party accessories (air injection) may
lead to failure of the air injection
liquid entry into air injection socket
operating error (liquid inside air tubing, too high air
pressure, incorrect syringe holder)
failure of the oil injection by connecting incorrect /
third-party accessories
potential risk due to incorrect programming of the
preset pressures for 2000 vcs and/or 5000 vcs
119
Vitrectomy module
120
vitrectomy module
121
vitrectomy module
front panel fixing Megatron S4 HPS
122
oil injection
SUB module of vitrectomy
123
compressor module
compressors of
cutter/oil Pressure
vacuum pump
electrically
Connector
filter of compressor of
cutter/oil Pressure
vacuum
cutter/oil
Pressure
filter of vacuum
pump
124
compressor module
3 Fixing Positions on Each Side
125
endoillumination
USP ‐ ocuLED
 ocuLED can be operated by using the
MEGATRON S4 System as a power
source
 intensity can be selected from 10 %
to 100 % (15 steps)
 ocuLED can selectively be switched
on/off
126
Footswitch
127
Footswitch
2 zero positions: vertical and horizontal
3 positions forward: A , B and C
1 position backward: F (reflux)
1 position left: D
1 position right: E
4 switches (programmable)
Footswitch rules:
1- After any footswitch manipulation, it has to come
back to the zero position (check your screen).
2- The device can‘t boot normally if the footswitch ins‘t
plugged.
3- Don‘t twist the footswitch cable.
4- Don‘t misshandel the footswitch cable.
5- Red X on the screen means the footswitch cable is
broken.
6- Test your footswitch switches. They habe to come
back to the initial position (check your screen). 128
Footswitch
If the footswitch is released
We should have the zero
position displayed in the
operation menu.
129
Footswitch
If the footswitch is released
and the position A or B are
displayed, the operator
will not be able to press
any button in the screen.
The footswitch is blocked
and has to be checked.
The operator has the
feeling the the screen
is freezing.
130
Hardware Test Interface
131
How to enter to the Hardware Test Interface
-
Connect your external USB Keyboard to the USB port in the rear
of the device.
Switch your S4 HPS device ON.
Observe the booting phase of the device.
The arrow will appear. Be ready to press the space button on
your keyboard.
When a hand replaces the arrow on the screen, press the space
button.
A quickstart menu will appear on the screen.
Press the button „H“ on the keyboard to select the Hardware
Test Interface.
The Hardware Test Interface window appears.
132
How to enter to the Hardware Test Interface
- Here is the quickstart menu.
- This window appears after pressing the space button.
- The „H“ button has to be pressed to open the
Hardware Test Interface window.
133
How to enter to the Hardware Test Interface
- Here is the Hardware Test
Interface window.
134
How to check the VIP cassette
1- Start the Hardware
Interface Test window
135
How to check the VIP cassette
2- Press „Read All“ button.
- All device modules are
Activated.
- All microcontroller are
reacting.
- If a microcontroller has an
Issue, the corresponding
message will be displayed
In red.
136
How to check the VIP cassette
3- Power on the 24V
compressors power supply
137
How to check the VIP cassette
4- Select „ASP“ tab.
- Aspiration module is
selected.
138
How to check the VIP cassette
5- Press the „ON“ button.
- Aspiration module is
activated.
139
How to check the VIP cassette
6- In the tab „Port“, select
„Vacuum Actual Value“ in the
menu.
- Select the „Start“ icon
- After selecting the „start“ icon
the digit value of the persitaltic
sensor appears.
- This value has to be between
600 and 610 digits.
- The recommended value should
be 605.
- This value is the initial zero
value of the persitatic sensor.
- If you have a value out of this
tolerance, the zero position has to
be adjusted.
140
How to check the VIP cassette
7- Insert the VIP cassette.
- Observe the digit value. If after
the insertion of the cassette,
the peak value is above 550,
the cassette membrane is
Damaged.
- If after the insertion of the
cassette, the peak value is under
550, the cassette membrane is OK
- The final digit value has to be
between 510 and 514 digits.
- The cassette docking phase to
the peristaltic sensor is successful.
141
How to check the VIP cassette
8- Perform the VIP cassette /
sensor tuning
- The final digit value has to be
between 510 and 514 digits.
- The cassette is ready to be used.
142
How to check the phaco handpiece
1- Start the Hardware
Interface Test window
143
How to check the phaco handpiece
2- Press „Read All“ button
144
How to check the phaco handpiece
3- Activate the 24V.
- The 24V DC is the phaco
input power supply.
145
How to check the phaco handpiece
4- Select the phaco module
tab.
146
How to check the phaco handpiece
5- Activate the phaco
module.
147
How to check the phaco handpiece
6- Connect the phaco
handpiece to the device
148
How to check the phaco handpiece
7- Press „Tuning“ button.
- The phaco handpiece is
Idenfified.
- The phaco hanpiece
Tuning is performed.
149
How to check the phaco handpiece
- We recommand to insert the phaco
handpiece in a isopropanol solution
-
We recommand during the phaco test
to connect the aspiration with the
irrigtion channel.
If the tube is connected in this way, you
will avoid using expensive material to
perform troubleshooting.
150
How to check the phaco handpiece
8- Select „Diagram“ tab
151
How to check the phaco handpiece
9- Press „Read Value“
button.
152
How to check the phaco handpiece
9- Press „Read Freq.“
button.
153
How to check the phaco handpiece
10- Press „Maximize“
button.
154
How to check the phaco handpiece
11- Press „Draw“ button.
155
How to check the phaco handpiece
12- Press „Save“ button to
save the drawing in a USB
Stick.
- The system is looking for the
resonance frequence during
the tuning.
- If the resonance frequence is
not found, the handpiece or
the handpiece needle is
damaged.
- If the phaco operating voltage
Is above 460V, the handpiece
Lifecycle reached the end and
it has to be replaced.
- The voltage in the diagram
has to be mutiplied by 10.
156
How to save the device errors
1- Start the Hardware
Interface Test window
157
How to save the device errors
2- Press „Read All“ button
158
How to save the device errors
3- Press „EEprom“ Tab
159
How to save the device errors
4- Press „Service“ button
160
How to save the device errors
4- Press „Read All“ button.
- Connect a USB stick and
press „save as TXT“ button
to save the errors.
- It‘s recommanded to delete
The errors after saving them.
161
Quiz
162
THANK YOU VERY MUCH
for your kind
attention.