Flexible HD Cysto-Urethroscope Instruction Manual

Important Information for Users of KARL STORZ Instruments

Thank you for your expression of confidence in the KARL STORZ brand name. Like all of our other products, this product is the result of years of experience and great care in manufacture. You and your organization have decided in favor of a modern, high-quality item of equipment from KARL STORZ. This instruction manual is intended to serve as an aid in the proper handling, cleaning and sterilization of the Flexible HD Cysto-Urethroscope. All essential details of the equipment and all actions required on your part are clearly presented and explained. We thus ask that you read this manual carefully before proceeding to work with the instrument. Keep this manual available for ready reference. RxOnly

Federal (USA) law restricts this device to sale by or on the order of a physician. KARL STORZ is constantly working on the further development of all products. Please appreciate that changes to the scope of supply in form, equipment, and technology are possible for this reason. Therefore, no claims may be derived from the information, figures, and descriptions in this manual.

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Contents

Important information for users of KARL STORZ instruments________________________________________________ 2 Illustrated description___________________________________________________________________________________ 5 General information for the safe use of the Flexible HD Cysto-Urethroscope___________________________________ 6 Specifications_________________________________________________________________________________________ 6 Operating conditions___________________________________________________________________________________ 7 Equipment classification________________________________________________________________________________ 7 User qualification______________________________________________________________________________________ 8 Warnings and cautions_________________________________________________________________________________ 8 Definitions____________________________________________________________________________________________ 8 Device description_____________________________________________________________________________________ 9 Indications for use_____________________________________________________________________________________ 9 Contraindications______________________________________________________________________________________ 9 Safety precautions when using the Flexible HD Cysto-Urethroscope_________________________________________ 10 Warnings and cautions________________________________________________________________________________ 10 Unpacking the device_________________________________________________________________________________ 12 Basic equipment______________________________________________________________________________________ 12 Handling instructions__________________________________________________________________________________ 13 Handling_____________________________________________________________________________________________ 13 Operating____________________________________________________________________________________________ 13 Holding the Flexible HD Cysto-Urethroscope correctly_____________________________________________________ 13 Handling the shaft____________________________________________________________________________________ 13 Directions for use_____________________________________________________________________________________ 14 Handling the deflection mechanism_____________________________________________________________________ 14 Handling the accessories______________________________________________________________________________ 15 Compatible camera control units________________________________________________________________________ 16 Connection to the camera control unit___________________________________________________________________ 16 Control buttons_______________________________________________________________________________________ 17 Default button settings_________________________________________________________________________________ 17 Program head buttons_________________________________________________________________________________ 17 Focus_______________________________________________________________________________________________ 17 Inspection prior to use_________________________________________________________________________________ 18 Inspecting the surfaces________________________________________________________________________________ 18 Checking the deflection________________________________________________________________________________ 18 Inspecting the LED function____________________________________________________________________________ 19 3

Contents

Inspecting the instruments and the working channel_______________________________________________________ 19 Cleaning and sterilization instructions____________________________________________________________________ 20 General information___________________________________________________________________________________ 20 Water quality requirements_____________________________________________________________________________ 21 Cleaning equipment and accessories____________________________________________________________________ 22 Bedside pre-cleaning (at point of use)____________________________________________________________________ 22 Leakage testing_______________________________________________________________________________________ 23 Manual cleaning______________________________________________________________________________________ 25 Detergent cleaning____________________________________________________________________________________ 25 Water rinsing_________________________________________________________________________________________ 27 Drying_______________________________________________________________________________________________ 27 Inspection___________________________________________________________________________________________ 28 Sterilization__________________________________________________________________________________________ 28 STERRAD® sterilization________________________________________________________________________________ 29 V-PRO ® maX/60 sterilization____________________________________________________________________________ 30 Reference for cleaning and sterilization__________________________________________________________________ 30 Storage______________________________________________________________________________________________ 31 Endoscope return instructions__________________________________________________________________________ 32 Troubleshooting______________________________________________________________________________________ 33 Shipping_____________________________________________________________________________________________ 34 Return policy_________________________________________________________________________________________ 34 Repair program_______________________________________________________________________________________ 35 Warranty policy_______________________________________________________________________________________ 35 Limitation of liability___________________________________________________________________________________ 36 Software ownership and licensing_______________________________________________________________________ 37 Electromagnetic compatibility___________________________________________________________________________ 38

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Illustrated Description

①

② ②

③ ③

④

⑦ ⑨

⑤

⑧ ⑩

⑥

⑪

13242 XL leakage tester 5

⑫

11025 E pressure compensation cap

General Information for the Safe Use of the Flexible HD Cysto-Urethroscope

①

Connecting cord

Connects to IMAGE1 S CCU.

②

Housing plug Permanently plugs suction valve hole. NOTE: This plug is not removable.

③

Handle Houses the deflection lever, the buttons, and the LED light source.

④ ⑤ ⑥ ⑦

Working channel port Deflection lever Distal tip Connection for leakage tester or pressure compensation cap

Connects to the leakage tester (Part Number: 13242XL) and the pressure compensation cap (Part Number: 11025E).

⑧

Left button

Default setting = Standby

⑨

Right button

Default setting = Zoom

⑩

Select button

Default setting = Menu

⑪ ⑫

Leakage tester Pressure compensation cap

Specifications:

11272 VH-TL/VHU-TL

Direction of view: Field of view: Depth of field: Tip deflection:

0° 100° 3–50 mm 210° up 140° down 5.5 mm 2.33 mm 37 cm Integrated LED Light Source CMOS Technology 1.26 lbs

Working shaft diameter: Working channel diameter: Working shaft length: Illumination: Sensor: Weight:

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General Information for the Safe Use of the Flexible HD Cysto-Urethroscope

Operating Conditions Ambient temperature:

15° - 30° C (59° - 86° F)

Humidity:

15% - 80%

Equipment Classification Type of protection against moisture: Ordinary Degree of protection against electric shocks: CF-type Mode of operation: Continuous Equipment test certificates: Equipment is certified and manufactured in accordance with IEC 60601-1 (3rd Edition), IEC 60601-2-18 (2nd Edition), CSA 22.2 No. 601 (3rd Edition). Electromagnetic compatibility: This instrument has been tested and complies with the EMC limits as per EN/IEC 60601-1-2: 2007 CISPR 11 Class A

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General Information for the Safe Use of the Flexible HD Cysto-Urethroscope

User Qualification The KARL STORZ Flexible HD Cysto-Urethroscope may only be used by persons with an appropriate medical qualification and who are acquainted with the technique of flexible cystoscopy. The information given in these instructions only serves to instruct in the correct handling and preparation of the Flexible HD Cysto-Urethroscope. It is not intended as an introduction to the technique of flexible cystoscopy. Please read these safety instructions carefully before using this instrument and ensure that you are very familiar with its operation and control.

Warning and Cautions Please read this manual carefully and follow the instructions exactly. The words Warning, Caution, and Note convey special meanings. Wherever they are used in this manual, they should be carefully reviewed to ensure the safe and effective operation of this product.

Definitions Warning: A Warning indicates that the personal safety of the patient or physician may be involved. Disregarding a Warning could result in injury to the patient or physician. CAUTION: A Caution indicates that particular service procedures or safety precautions must be followed to avoid any damage to the product.

 Note: A Note indicates special information about operating the product or clarifies important information.

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General Information for the Safe Use of the Flexible HD Cysto-Urethroscope

Device Description The KARL STORZ Flexible HD Cysto-Urethroscope has a working length of 37 cm with an outer diameter of 5.5 mm. The shaft consists of a working channel 2.33 mm in diameter that can be used for insertion of various flexible instruments. The distal tip houses a CMOS imaging sensor for capturing images and videos. The handle encloses a LED light source, deflection lever and control buttons. The LED light source provides the illumination for visualization of the anatomy under examination. The deflection lever deflects the distal tip 210° in an up direction, and 140° in a down direction. The control buttons can be programmed to perform functions such as white balance, image capture, and zoom. The control buttons can also be programmed to provide access to the setup menu. The KARL STORZ Flexible HD Cysto-Urethroscope, when used with the compatible IMAGE1 S Camera Control Units (CCU), forms the KARL STORZ Flexible HD Cysto-Urethroscope System. Please refer to the IMAGE1 S CCU manual for instructions on how to use the CCU. The Flexible HD CystoUrethroscope is an applied part that should only be used with supply units (CCUs) specified for this purpose by KARL STORZ.

Indications for Use The Flexible HD Cysto-Urethroscope system is used to provide visualization and operative access during diagnostic and therapeutic endoscopic procedures of urinary tract, including the urethra, bladder, ureters, and kidneys.

Contraindications The Flexible HD Cysto-Urethroscope system is contraindicated whenever urological endoscopic procedures are contraindicated.

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General Information for the Safe Use of the Flexible HD Cysto-Urethroscope

Safety Precautions When Using the Flexible HD Cysto-Urethroscope The Flexible HD Cysto-Urethroscope must be used according to the recognized medical rules and procedures of endoscopy. The patient leakage current limit of the CF-applied parts may be exceeded if CF-applied parts (application on  Note: heart) are used in combination with other BF-applied parts. In this case, the patient leakage current can be reduced by using only CF-applied parts. Note: The video endoscope does not offer any electric insulation against high frequency (HF) currents. Protection against high frequency currents should be ensured through the use of correct HF instruments. Please read the instructions for use in the instruction leaflet supplied with the HF-applied part for more information. Note: The Flexible HD Cysto-Urethroscope is not intended to be inserted into the ureters. The Flexible HD CystoUrethroscope is intended to be used for visualization of the ureteral orifice to aid in the placement and removal of devices within the ureters.

Warnings and Cautions Warning: Every time the Flexible HD Cysto-Urethroscope is used, you must first check that it, and any accessories used in combination with it, is in perfect condition. A damaged Flexible HD Cysto-Urethroscope or damaged accessories must not be used. Warning: Combinations of medical devices can only be considered safe if: • They are identified as such in the respective instruction manual. • The intended purpose and the interface specifications of the devices used in combination permit this. Pay careful attention to the instructions and interface specifications of medical devices used in combination. Warning: The Flexible HD Cysto-Urethroscope is delivered non-sterile and must be cleaned and sterilized according to validated reprocessing instructions before the initial use as well as before any further application. Warning: Do not point the light beam of the Flexible HD Cysto-Urethroscope into the eyes. Looking into the light beam may cause eye damage. Warning: Only use accessories (guide probes, cleaning brushes, etc.) that are specifically intended for use with the Flexible HD Cysto-Urethroscope and can be operated in line with generally-accepted technical standards and occupational safety guidelines.

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General Information for the Safe Use of the Flexible HD Cysto-Urethroscope

Warning: Danger of explosion if flammable gases are used in the immediate proximity of the Flexible HD CystoUrethroscope. The Flexible HD Cysto-Urethroscope must not be used in the presence of flammable or combustible media. Warning: As a result of the light emitted by the Flexible HD Cysto-Urethroscope, the tip of the latter may heat up. Prolonged direct contact of the light-emitting surfaces on tissue can lead to burns, and must therefore be avoided at all cost. Warning: Always unplug the Flexible HD Cysto-Urethroscope before carrying out any maintenance and cleaning work on it. Warning: If a malfunction should occur during application on a patient, stop the application immediately. Place the distal tip of the Flexible HD Cysto-Urethroscope in the neutral, non-deflected position, and remove the Flexible HD Cysto-Urethroscope slowly and carefully from the patient. Warning: The Flexible HD Cysto-Urethroscope may only be repaired by personnel authorized by KARL STORZ. Unauthorized repairs may impair functioning and safety, and are therefore strictly forbidden. KARL STORZ gives no warranty for Flexible HD Cysto-Urethroscope that are repaired by unauthorized personnel. Warning: The pressure compensation cap must be in place on the vent port for: • Hydrogen peroxide gas sterilization. • Shipping. Warning: Thermal hazards may exist from high temperatures radiated by the Flexible HD Cysto-Urethroscope’s illumination system. Do not use this product at maximum light intensity from the light source. When this product operates at maximum light intensity for longer than 30 minutes, temperature at the distal end may exceed 41° C (105.8° F). Prolonged use of the product can cause burns to the patient, user, and operating accessories. CAUTION: The pressure compensation cap must be removed from the vent port for: • Endoscopic interventions. • Immersion in liquids. CAUTION: Do not expose the Flexible HD Cysto-Urethroscope to direct sunlight or excessive heat, to avoid damage to the device. CAUTION: Flexible HD Cysto-Urethroscope must never be exposed to X-rays to avoid damage. CAUTION: Do not steam sterilize (autoclave) the Flexible HD Cysto-Urethroscope. CAUTION: The maximum permissible temperature for decontamination, sterilization, transport, and storage is 65° C (149˚ F). 11

General Information for the Safe Use of the Flexible HD Cysto-Urethroscope

CAUTION: Do not hit the distal tip of the Flexible HD Cysto-Urethroscope against hard objects, and never use a sharp object to remove dirt. CAUTION: Never lay heavy objects on the Flexible HD Cysto-Urethroscope.

Unpacking the Device Check for missing items and evidence of shipping damage. File any complaints immediately with KARL STORZ or the supplier.

Basic Equipment Flexible HD Cysto-Urethroscope 11272 VH-TL/VHU-TL with the following accessories: 1

Instruction manual Z23875US

1

Leakage tester 13242 XL

1

Pressure compensation cap 11025 E

1

Channel brush 110910

1

Flat cleaning brush 27652

1

Luer plug 29100

1

Short cleaning brush 9990

Optional Accessories

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1

Grasping forceps 5 Fr. 27023FE

1

Biopsy forceps 5 Fr. 27023ZE

1

Self-sealing cap 27550ZAG

Handling Instructions

Handling Damage to the Flexible HD Cysto-Urethroscope resulting from incorrect operation is not covered by the manu Note: facturer’s warranty.

Operating The following instructions outline the correct operation of the Flexible HD Cysto-Urethroscope and the corresponding accessories. Suitable accessories for your Flexible HD Cysto-Urethroscope, such as biopsy forceps, can be found in the general surgery catalog or extracts from this catalog.

Holding the Flexible HD Cysto-Urethroscope Correctly Grip the handle of the Flexible HD Cysto-Urethroscope in your left or right hand, as shown in the picture. With this kind of control grip, the Flexible HD Cysto-Urethroscope can be operated with one hand.

Handling the Shaft Warning: Applying lubricant to the lens may cloud the image and interfere with normal scope operation. Use a suitable water-soluble lubricant (e.g. Surgilube) for the distal section of the insertion shaft. Observe the lumen the whole time during use. If you lose your orientation, pull the shaft back slightly in the neutral position until vision is restored. If, during use, the image fails, is disturbed, or becomes blurred, or if vision in general is impeded, put the deflection mechanism into the neutral position and slowly pull the shaft of the Flexible HD Cysto-Urethroscope out of the patient’s body. If the Flexible HD Cysto-Urethroscope is used in the patient after the image has failed or when there is interference, this may result in a serious injury to the patient. CAUTION: Do not carry the Flexible HD Cysto-Urethroscope by the shaft. Do not pull, clamp or twist the shaft of the Flexible HD Cysto-Urethroscope. CAUTION: The shafts of the Flexible HD Cysto-Urethroscope must never be kinked or coiled up too tightly. It is best to suspend the shaft of the Flexible HD Cysto-Urethroscope by securely holding the handle in a vertical position.

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Directions for Use

Handling the Deflection Mechanism Warning: Before each use, the functionality of the deflection lever and the connected distal tip must be checked. A defective Flexible HD Cysto-Urethroscope must not be used. Warning: When inserting the Flexible HD Cysto-Urethroscope into the patient, the distal tip of the Flexible HD CystoUrethroscope must be in the straight, non-deflected position. Warning: Accessories must only be inserted into the working channel of the Flexible HD Cysto-Urethroscope with the distal tip in the neutral, non-deflected position. The deflection lever must never be operated with force or abruptly to avoid injuring the patient or damaging the device. Warning: Before removing the Flexible HD Cysto-Urethroscope from the patient, the distal tip must be put into the neutral position, as otherwise injuries to the patient or damage to the instrument may occur. Warning: If the distal tip can no longer be properly controlled via the deflection lever, or if the deflection mechanism develops any other fault, the Flexible HD Cysto-Urethroscope must not be used. Warning: If a functional defect occurs during use on the patient, discontinue use immediately. Put the distal tip of the Flexible HD Cysto-Urethroscope into the neutral, non-deflected position and remove the Flexible HD CystoUrethroscope slowly and carefully from the patient. Warning: Do not use force to turn the deflection lever to avoid either injuring the patient or damaging the instrument. CAUTION: The resistance that can be felt when deflecting the tip using the deflection lever increases as the angle of deflection increases. Actuate the deflection gently and carefully, without any sudden or jerky movements, only as far as the limit stop.

 Note: The neutral position of the distal tip is straight, without any deflection whatsoever. The distal tip can be deflected 210° upward or 140° downward by continuously actuating the deflection lever slowly and carefully. The distal end will deflect in accordance with the direction of actuation. Before use, the user must always have full control over the deflection and must develop a sure feel for the deflection mechanism and in particular for the neutral position. Deflection functions as follows with the type 11272 VH-TL endoscope: • If the lever is pushed upwards, the tip is lowered. • If the lever is pushed downwards, the tip is deflected upwards. This mechanism is inverted with model 11272 VHU-TL.

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Directions for Use

Handling the Accessories Warning: When HF electrodes or laser probes are used, it must be ensured that power is not applied until the active parts have emerged from the working channel and are in the user’s field of view, and the site of the operation is clearly recognizable. Activation in the working channel may lead to serious injury to the patient and damage to the Flexible HD Cysto-Urethroscope. Warning: When HF electrodes or laser probes are used, it must be ensured that power is only applied when there are no flammable gases in the operating field or in the proximity of the Flexible HD Cysto-Urethroscope. CAUTION: Only use flexible accessories (forceps, cleaning brushes, etc.) from KARL STORZ. Accessories from other manufacturers may damage the Flexible HD Cysto-Urethroscope. CAUTION: Only introduce the instruments into the proximal port of the Flexible HD Cysto-Urethroscope. CAUTION: Do not force accessories through the working channel, to avoid damaging the device. It should be possible to move the accessory easily, without any hindrance, and with closed jaws through the entire channel. CAUTION: Do not introduce any accessory into the Flexible HD Cysto-Urethroscope when the distal tip is deflected. CAUTION: Inserting sharp-tipped accessories into the working channel may damage the Flexible HD Cysto-Urethroscope. CAUTION: The working channel is not designed for removal of tissue and/or foreign bodies. Remove the tissue or foreign bodies from the patient by removing the entire Flexible HD Cysto-Urethroscope.

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Directions for Use

Compatible Camera Control Units Camera Control Unit

IMAGE1 S CCU

Light Source

Integrated LED in the Flexible HD Cysto-Urethroscope

Warning: The KARL STORZ Flexible HD Cysto-Urethroscope should not be used in combination with CCUs from other manufacturers. The use of non-compatible units may cause injury to the patient or damage to the instrument. It must be ensured that parts of the endoscope that are not electrically insulated do not come into contact with conductive surfaces or live parts of other units, at any time. Please refer to the IMAGE1 S CCU instruction manual for complete instruction on how to use the CCUs.

Connection to the Camera Control Unit Warning: The keyboard of the IMAGE1 S must not come into contact with patients or be placed in the vicinity of patients. CAUTION: Ensure proper connector alignment before connection to avoid damage. The Flexible HD Cysto-Urethroscope is connected to the CCU for operation. For operation, an IMAGE1 S system with an IMAGE1 S Connect and an IMAGE1 X-Link are required. Both camera modules must be connected to each other. The Flexible HD Cysto-Urethroscope is then connected to the IMAGE1 X-Link.

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Directions for Use

⑧

⑨

⑩

1.

Install the CCU on a firm, level surface.

2.

Plug the power cord into the specified power socket.

3.

Plug the Flexible HD Cysto-Urethroscope supply cable into the HD socket of the CCU.

4.

Turn on the CCU to power up the endoscope imager and the integrated light source.

Control Buttons The Flexible HD Cysto-Urethroscope has three control buttons which can be assigned specific functions in the CCU’s device menu. The assignment is retained after switching off and on again. • Left (Up) ⑧

• Right (Down) ⑨ • Select ⑩

Default Button Settings The factory default button settings are: • Select = Menu • Left = Standby • Right = Zoom

Program Head Buttons Refer to the CCU Instruction Manual for instructions on programming the head buttons.

Focus The image focus is adjusted automatically via CMOS technology. Manual focusing is not possible/necessary.

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Directions for Use

Inspection Prior to Use Warning: Every time the Flexible HD Cysto-Urethroscope is used, it, and any accessories used in combination, must be inspected to ensure that they are in perfect condition. A damaged Flexible HD Cysto-Urethroscope or damaged accessories must not be used.

Inspecting the Surfaces Warning: The surface of the flexible shaft must be inspected visually and by carefully feeling it, to detect any cracks, cuts, dents, foreign bodies or other forms of damage. CAUTION: Do not squeeze the distal tip of the Flexible HD Cysto-Urethroscope too tightly. Every time the Flexible HD Cysto-Urethroscope is used, you must check all surfaces to confirm that they are in perfect condition i.e. no sharp edges, dents, protrusion, holes, or other irregularities that may trap debris. Inspect the supply cable for damage (cut, dents, scratches, etc.) and the supply connector for loose connections.

Checking the Deflection Warning: Actuate the deflection lever gently and carefully as far as the limit stop. The deflection lever must never be operated with force or abruptly, to avoid injuring the patient or damaging the device. Move the deflection lever smoothly and slowly. Warning: Before use, always check that the deflection lever and the distal tip connected to it function correctly. A defective Flexible HD Cysto-Urethroscope must not be used. The distal tip is deflected by means of the deflection lever. Turn the deflection lever slowly; the end piece should move downward. Turn the deflection lever in the opposite direction to produce an upward movement.

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Directions for Use

Inspecting the LED Function CAUTION: The CCU must be switched off before connecting the Flexible HD Cysto-Urethroscope. Prepare the IMAGE1 S CCU as described above and connect to the Flexible HD Cysto-Urethroscope. Emission of light at the distal end should be recognizable. Light intensity is automatically regulated by the CCU. Verify that the scope will focus on objects at 3 mm and 50 mm away by pointing the Flexible HD Cysto-Urethroscope at a nearby object (3 mm from the distal tip) and verify that the image on the monitor is a clear, high-quality image. Move the distal tip to a distance of approximately 50 mm and verify that the image clarity and brightness on the monitor remains constant. Warning: If the image fails or there is interference during use in the patient, put the distal tip into the neutral position and remove the Flexible HD Cysto-Urethroscope from the patient’s body gently and carefully. If the Flexible HD CystoUrethroscope is used in the patient after the image has failed or when there is interference, this may result in serious injury to the patient.

Inspecting the Instruments and the Working Channel CAUTION: Accessories-such as biopsy forceps that are bent or twisted-may no longer function properly, are difficult to pass through the channel, and may cause serious damage to the channel. They must therefore be replaced. Check the working channel by introducing the appropriate instrument.

Visual may not be an exact representation of the endoscope

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Cleaning and Sterilization Instructions

General Information Warning: A flexible endoscope intended for percutaneous use must be sterilized. Do not high-level disinfect. Warning: HLD is only intended for flexible endoscopes that are used/indicated for use in the urethra and bladder. Warning: The flexible endoscope is delivered non-sterile, and must be thoroughly cleaned and sterilized before initial and subsequent uses. Warning: Occupational safety guidelines must be observed and applied when cleaning a contaminated flexible endoscope and instruments. Ensure appropriate Personal Protective Equipment (PPE) is used by all staff during reprocessing. Warning: Sterilization can only be performed successfully if: • The instruments are freed of organic materials and residues of pharmaceutical products and cleaning products (i.e. thoroughly cleaned). • The recommended sterilization parameters are maintained. • Sterilization equipment is properly maintained and calibrated. • When preparing cleaning solutions, the manufacturer’s instructions for proper exposure time, dilution, and temperatures are followed. Warning: The flexible endoscope must not be used during the discharge of a cardiac defibrillator. Remove the flexible endoscope from the operation area before discharge takes place. CAUTION: The maximum permitted temperature is 65° C (149° F) for decontamination and sterilization. CAUTION: Personal Protective Equipment (PPE) is required to ensure safety of the operator when cleaning any contaminated medical device. Follow occupational safety guidelines and your institution’s policies for PPE requirements. CAUTION: The flexible endoscope must be protected from objects that could cause damage to the device such as wire bristle brushes, sharp objects etc. Soft, lint-free cloths and/or sponges along with ONLY the correct KARL STORZ cleaning brushes should be used to clean the flexible endoscope. CAUTION: To prevent biofilm formation, it is critical that the flexible endoscope be thoroughly dried prior to storage. Biofilm formation will interfere with sterilization of the flexible endoscope and could lead to infection transmission. The lint-free cloths should be disposed of after a single use (i.e. use separate cloths for the detergent cleaning,  Note: water rinsing, and drying phases).

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