IsoCord Needle Loading Station - SeeDos, UK

IsoCord ® 

Manual for the 

Needle Loading Station 

BEBIG Isotopen- und 

Medizintechnik GmbH 

Robert-Rössle-Straße 10 

D - 13125 Berlin 

Germany 

Tel.: +49 (0)30 94 10 84 - 130 

Fax: +49 (0)30 94 10 84 - 112 

0044 

70300-1601 

Revision 01, 2004-06-15

IsoCord 



Content 

1. Manufacturer ....................................................................................................... 3 

2. Introduction and Intended Use ............................................................................ 3 

3. Product Description ............................................................................................. 5 

4. Accessories ......................................................................................................... 6 

5. Use...................................................................................................................... 8 

5.1. Preparation................................................................................................... 8 

5.2. Insert the Magazine...................................................................................... 9 

5.3. Insertion of the Drive Knob and Checking of the Seed Chain .................... 10 

5.4. Mounting the Needle .................................................................................. 10 

5.5. Moving the Magazine Holder into the “IsoCord position”............................ 11 

5.6. Dispensing ................................................................................................. 11 

5.7. Cutting of the Seed Chain .......................................................................... 12 

5.8. Moving the Magazine into the “mandrel position”...................................... 13 

5.9. Loading the Trimmed Seed Chain Piece into the Needle........................... 14 

5.10. Removing the Needle................................................................................. 15 

5.11. Loading more Needles ............................................................................... 15 

5.12. End of the Seed Chain ............................................................................... 15 

5.13. End of Loading ........................................................................................... 15 

5.14. Removing Magazine................................................................................... 16 

6. Directions for the Implantation............................................................................17 

6.1. Sealing the Implant Needles ...................................................................... 17 

6.2. Seed Type.................................................................................................. 17 

6.3. Correction of the Implantation Depth.......................................................... 17 

7. Maintenance and Sterilization ............................................................................18 

8. Safety Instructions..............................................................................................22 

9 Trouble Shooting ....................................................................................................23 

9.1 The Seed Chain Does not Move out of the Magazine..................................... 23 

9.2 The Seed Chain Does not Thread into the Positioning System ...................... 25 

9.3 The Seed Chain Piece Gets Stuck in the Guiding System ......................... 26 

9.4 The Strand will not Completely load into the Needle.................................. 26 

9.5 Damage of a Seed ..................................................................................... 27 

IsoCord Needle Loading Station Manual 2 Rev. 01 / 2004-06-15




1. Manufacturer 

BEBIG Isotopen- und Medizintechnik GmbH 

Robert-Rössle-Str. 10, D-13125 Berlin 

Tel.: +49 (30) 94 10 84-130 

Fax: +49 (30) 94 10 84-112 

e-mail: info@bebig.de 

www.bebig.de 

2. Introduction and Intended Use 

Interstitial Brachytherapy is a treatment method for prostate cancer with little side 

effects which is becoming more and more popular. Small completely encapsulated 

radioactive implants, so-called seeds, are introduced into the prostate and remain 

there. The radiation emitted by the seeds destroys the tumor cells. 

The seed implantation can be done in different ways. The device described here is 

used for the so-called “pre-loaded needle“ technique. According to a treatment plan, 

implantation needles are loaded with a certain number of seeds and spacers. Each 

needle is inserted at a certain position, and the loaded number of seeds and spacers 

is implanted into the prostate at a certain track and depth. 

The loading can be done with loose seeds and spacers. The user sorts seeds and 

spacers alternately and slides them into the desired needle. Alternatively one can 

work with a ready-made seed chain, a so-called strand. Therefore, the seed chain 

has to be cut to the appropriate length, for example into a piece containing four 

seeds. This four seeds piece is then inserted into the needle. 

The IsoCord seed chain contains seeds and spacers in an alternating sequence, with 

10 mm distance between the middle of two consecutive seeds. The IsoCord seed 

chain is housed in a magazine due to radiation safety and ease of use requirements. 

A magazine can contain up to 75 seeds. 

Intended Use 

The IsoCord Needle Loading Station is used to move the IsoCord seed chain out of 

its magazine, cut the chain into the defined lengths and move these cut lengths or 

strands into the attached implantation needle. While performing the steps above, the 

user is very well shielded from the emitted radiation of the seeds. 





User 

The use of the IsoCord system is restricted to personnel specially trained in radiation 

safety and the proper use of the provided equipment. 

Bebig provides a certain training to dedicated users when the system is installed in 

the clinic. The successful training is documented by a certificate from Bebig. Only 

personnel holding this certificate is allowed to work with the IsoCord system. 

Further Information 

In the following, the use of the IsoCord Needle Loading Station with IsoCord seed 

chains is described. 

For further information about the IsoCord seed chain itself, especially about the 

physics of the seeds, please refer to the corresponding manual. 

In the following, the term seed chain is used to describe the whole length of the seed 

chain which is still in or connected to its magazine, while the term strand is used to 

describe a cut piece of the seed chain, which will be put into an implantation needle. 





3. Product Description 

IsoCord Needle Loading Station 

The IsoCord Needle Loading Station, BEBIG article NLS.101, is composed of six 

main components which are mounted to a common base plate. 

1: Needle Holder 

Here the implantation needle will be attached. 

2: Movable Magazine Holder 

When the IsoCord magazine is inserted into the magazine holder, the 

transportation lock is automatically disabled. The holder can be moved between 

two positions. In the so-called “IsoCord position”, the outlet of the magazine is 

aligned with the adjacent guiding system so that the seed chain can be moved 

out. In the other position, the so-called “mandrel position”, the built-in mandrel is 

aligned in such a way that the cut strand can be moved with the mandrel into the 

attached needle. 





3: Drive Knob 

The knob is inserted into the magazine. By turning the knob counterclockwise the 

contents of the magazine are propelled forward and the seed chain moves out of 

the magazine. 

4: Positioning Unit with Lighting 

The front of this unit is covered with a sheet of stainless steel which provides 

optimal radiation protection for the user. The seed chain is illuminated to allow a 

safe distinction between seeds and spacers while it is watched in the mirror. The 

power for the light is provided by an external power supply unit. 

5: Cutting System 

The cutting system facilitates an exact cut of the correctly positioned seed chain 

in the middle of a spacer. 

6: Built-in Mandrel 

It is used to move the cut strand into the attached needle. A return spring pulls the 

mandrel back into its starting position. 

4. Accessories 

To load implantation needles with seed chain pieces, the user needs the needles and 

the seed chain itself. More accessories for handling failures are provided. 

IsoCord Chain in Magazine 

The IsoCord Needle Loading Station can and may only be used with an IsoCord 

seed chain in its magazine. 

Implantation Needles 

In principle, any 18 Gauge (ETW, BETW or UTW) prostate implantation needles can 

be used with the IsoCord Needle Loading Station. The only requirements for their 

use with the IsoCord system are that they have a minimum inner diameter of 1.04 

mm and that their connection fits the needle holder. 

This is certainly the case for the needles provided by BEBIG; therefore, we 

recommend to use only these needles, BEBIG article number 000.430. 

IsoCord Sterilisation Tray (NLZ.100) 

This tray has defined positions for the Needle Loading Station and its accessories 

find a dedicated place in the in sterilisation tray. This tray can also be used for storing 

the parts. 





IsoCord Screw Driver (NLZ.101) 

If the drive knob is turned too far into the “Magazine” direction, the seed chain might 

disappear completely into the magazine or even slip out of the drive mechanism. In 

this case the magazine inspection flap has to be opened to re-thread the seed chain. 

A sterilizable hexagonal screw driver is provided for this purpose. 

IsoCord Waste Container (NLZ.102) 

The stainless steel waste container is used to store remaining pieces of the seed 

chain. Since it is sterilizable, it can be used on the sterile workplace. Its wall 

thickness is sufficient shield the radiation from the iodine seeds. 

IsoCord Tweezers (NLZ.103) 

The tweezers have a rounded tip but slightly rough jaws to hold the seed chain 

without damaging it. They can be sterilized, but may not be used for surgical 

procedures. 

IsoCord Scissors (NLZ.104) 

The scissors are used to cut the seed chain precisely at a spacer position when 

required e.g. to divide a strand that has already been cut. They are sterilizable. 

IsoCord Power Supply 

The light inside the Needle Loading Station is powered by an external power supply 

unit. This unit (NLZ.105) and the corresponding power cord (NLZ.106) are available 

as replacement parts. They cannot be sterilized. 

IsoCord Needle Rack (NLZ.107) 

Optionally, a shielded needle rack is available to hold the preloaded needles until 

they are implanted. The needle rack can be sterilized. 





5. Use 

The following describes the preparation and the use of the IsoCord Needle Loading 

Station. 

5.1. Preparation 

The Needle Loading Station and its accessories must be sterilized prior to their use 

according to the instructions given in chapter 7, Maintenance and Sterilization. Also, 

a sufficient number of needles has to be available. 

The sterile workplace is set up according to the local procedures. A sterile area, 70 

cm wide and 50 cm deep, is sufficient. There should be a power outlet close to the 

sterile area and a safe place for the power supply of the positioning unit. 

Place the Needle Loading Station in the lower right part of the workplace facing the 

user. This ensures that the attached needle is completely inside the sterile area. The 

space behind the Needle Loading Station can be used as sterile storage area for the 

prepared needles, the magazine(s) and the needle rack. The sterilized accessories 

including scissors, tweezers, waste container and the hexagonal screw driver, can be 

positioned below the Needle Loading Station. 

Before you start, check that you have all of the equipment required. 





Connect the sterile cable of the Needle 

Loading Station with the nonsterile one of the 

power supply unit, but do it outside the sterile 

area. Pay attention to the orientation of the 

connectors: the tongue of one connector has 

to fit to the groove of the other. Now you can 

connect the power supply unit to an electrical 

outlet. 

Change the sterile gloves afterwards or let someone else handle the unsterile part. 

There might be residue from the steam sterilization on the mirror surface of the 

Needle Loading Station which can disturb the view of the seeds. This residue should 

be wiped using a sterile swap. 

Prepare the needles. Seal the needle tips using common techniques. Take a 

magazine out of its sterile packaging. 

5.2. Insert the Magazine 

After preparing the workplace and equipment as described 

above, the needles can be loaded. Take a magazine and 

unscrew the radiation protection cap. 

Insert the magazine into the corresponding 

holder of the Needle Loading 

Station. Put the left side down first so 

that the connector piece fits into the 

bush of the holder. 

Then press down the right side. If necessary, 

jiggle it a little bit up and down 

until it fits in. The transportation lock of 

the magazine is automatically released 

by the little pin located in the right lower 

corner of the holder. It might seem a little 

tight, but with some practice it is easy to 

do. An accurate fit is necessary for precise 

cutting of the seed chain. 





5.3. Insertion of the Drive Knob and Checking of the Seed Chain 

Insert the drive knob into the magazine. 

Make sure that the orientations of the two 

hexagons coincide. 

Check if the seed chain can be moved 

out now. The magazine holder has to be 

in the so-called “mandrel position” (see 

paragraph 5 and 8 in this chapter). In this 

position the bushing of the holder, where 

the seed chain moves out, is visible. 

Turn the knob counterclockwise by a few 

degrees (identified by the notches at the 

periphery of the drive knob), i.e., in the 

direction indicated by the inscription 

“Needle” on the knob. The knob should 

be easily turned, without much 

resistance, and the seed chain should 

come out of the bushing. If this is not the 

case, do not try to turn the knob forcibly, 

but proceed as recommended in chapter 

9, Trouble Shooting. 

Now turn the drive knob clockwise, i.e., into the direction 

indicated by the inscription “Magazine” on the knob, until 

the tip of the seed chain is flush with the bushing. 

5.4. Mounting the Needle 

Move the hub of the needle over the 

tip of the needle holder until the jaws 

clamp the needle as shown in the 

picture. It is just a little push and 

click. If necessary, turn the needle 

slightly. 





5.5. Moving the Magazine Holder into the “IsoCord position” 

Now move the magazine holder forward into the “IsoCord position”. In this position 

the opening of the magazine in aligned with the guiding system of the positioning unit 

and the needle. 

Both end positions are fixed by a ball catch which initially resists the movement. 

Push, as shown in the picture, with your thumbs against the magazine holder while 

you hold the mounting plate in place with your middle fingers. This will prevent the 

station from sliding on a slippery surface, e.g., a sterile sheet. 

The magazine holder moves between these two positions in a diagonal direction (in 

the picture from the right lower to the left upper corner). The end position is reached 

when the holder fits close to the cutting system and the ball catch is engaged. 

5.6. Dispensing 

To move the seed chain out of the 

magazine, turn the drive knob slowly 

counterclockwise. This direction is 

indicated on the knob by the big arrow 

and the inscription “Needle”. Use the 

mirror to watch the seed chain move into 

the positioning unit while turning the 

drive knob. 

If the seed chain does not appear, do not turn the drive knob any further. Instead, 

follow the directions in chapter 9, Trouble Shooting. 





The non-translucent seeds (dark) are clearly distinguishable from the translucent 

spacers (light). In this window you can see up to six seeds at once. 

If you want to load a needle with a strand 

of, for example, three seeds, turn the drive 

knob only so far, that the first seed is 

located at position “3”. 

Position the seed chain so that the seeds are coincident with the black marks above 

the numbers. Pay special attention to the seed at position “1”, the one right to the 

viewer. Ensure accurate positioning in order to cut the end spacer exactly in the 

middle. Ensure that you view the chain at position “1” at a right angle, as oblique 

perspectives might result in misalignment. 

Even without the internal lighting all 

elements can be distinguished from each 

other very well. You will, however, get a 

different picture, as shown on the right: 

Now the seeds appear brighter than the 

spacers. The spacers are also 

distinguishable from the seeds by their 

slight “indentation”. 

5.7. Cutting of the Seed Chain 

After positioning the seed chain as 

described above, remove your hand 

from the drive knob to avoid 

unintentional change of the position. 

Now you can cut the chain by pushing 

the knife of the cutting system down and 

releasing it. 

Attention: Before cutting, please re-check the position of the chain! 





5.8. Moving the Magazine into the “mandrel position” 

To load the cut strand into the needle you must move the needle holder into the 

“mandrel position”. In this position the built-in mandrel is aligned with the guiding 

system. Pull the magazine holder back with your index fingers while supporting the 

base plate with your thumbs. 

When the lower ball catch is engaged, the end position is reached. 

A short piece of seed chain is visible at the outlet hole of 

the magazine holder. Correctly cut, this piece is half a 

spacer, so there is minimal radiation coming from the 

next seed still inside the connector piece. 

Turn the drive knob back a bit, into the direction 

“Magazine”, so that the seed chain is just visible at the 

outlet hole. Do not turn any further. This ensures optimal 

radiation protection and trouble-free re-threading of the 

seed chain into the positioning unit the next time you 

confection. 





5.9. Loading the Trimmed Seed Chain Piece into the Needle 

The trimmed strand can now be loaded into the needle. Move the built-in mandrel 

into the direction of the needle by pushing the handle accordingly. 

Move the mandrel only as far as the point where you can see the end of the cut 

strand in the window. Examine the location of the cut to control your positioning. 

In the right picture the spacer was not cut 

excactly in the middle but still acceptably. 

If you have a larger deviation, you have to 

correct your alignment of seeds and 

marks during the positioning procedure. 

Attention: If a seed is damaged accidentally, proceed as recommended in 

chapter 9, Trouble Shooting. Never implant a damaged seed! 

Move the mandrel slowly and carefully to 

the end position. The end of the strand is 

approx. 3.5 cm away from the claws of 

the needle holder. On BEBIG supplied 

needles this position is marked „IIII“ as 

you see in the picture in the next 

paragraph. Carefully return the mandrel 

to its start position. 





5.10. Removing the Needle 

The loaded needle is removed in the 

following way: Hold the needle at its 

hub, as close to the needle holder as 

possible to avoid unnecessary radiation 

exposure from the strand within the 

needle sheath. Activate the release pin 

at the station and remove the needle, 

turning the needle slightly if necessary. 

Store it in a suitable place (ideally the 

Needle Rack NLZ.107) or hand it over 

directly to the surgeon. 

5.11. Loading more Needles 

To load more needles, repeat all steps from attaching the needle to removing the 

loaded needle. Document precisely so that you always know exactly how many 

seeds you have already loaded and how many are still in the magazine. 

5.12. End of the Seed Chain 

For technical reasons, there are a few 

additional spacers in line at the end of the 

seed chain. Of course, these cannot be 

used as active implants. 

The picture on the right shows the end of 

the seed chain, the last seed in position 

“2”. If you cut the seed chain now, you 

would get an incorrect needle loading. 

Therefore, position the seed chain so that the last seed is at position “1” and 

separate this last strand from the residual seed chain. 

When you have reached the final seed, turn the drive knob even further in the 

“Needle” direction. The remaining seed chain will be cut inside the magazine. By 

checking the remainder with an appropriate detector or by a visual inspection, you 

can verify that no seed is left. 

5.13. End of Loading 

If possible, you should empty the magazine completely. If you still have seeds in the 

magazine, you can check the number of seeds remaining by counting them to verify 

your documentation. You can count a chain with up to twelve seeds in the Needle 

Loading Station without any additional accessories. A seed chain with more 

remaining seeds would protrude from the Needle Loading Station. 

If you have more than twelve seeds left, attach a needle to the station and use an 

appropriate shield or keep a sufficient distance from the needle while counting the 

seeds thirteen and more. 





Move the seed chain out of the magazine the same way that you load the needles. 

Count every seed that passes position “1” until the end of the seed chain is reached. 

Afterwards turn the drive knob in the other direction and re-wind the seed chain. 

Ensure that you take the seed chain back so far, so that it just disappears from the 

window. 

5.14. Removing Magazine 

When you have finished the loading remove the magazine from the magazine holder. 

This should be done in the “mandrel position”. 

Firstly, the remaining seed chain should be turned back into the magazine. 

Turn the driving knob clockwise, as indicated by the inscription “Magazine” on the 

knob, so that the end of the seed chain remainder is flush with the bushing. Now turn 

about 3–4 notches on the knob further. This ensures the complete return of the seed 

chain into the magazine, with the possibility of moving the seed chain out of the 

magazine again, if necessary. 

Take the drive knob out of the magazine. Remove the magazine using the “last in - 

first out” priciple: First lift up the right lower corner (at the locking pin) a bit and then 

the right upper corner. After the right side is out, take the magazine completely out of 

the holder. Screw on the radiation protection cap. 

If there are seeds left in the magazine, document their number on the label with date 

and signature. The magazine has to be treated according to the radiation protection 

laws, so store it in a suitable safe until you return it to BEBIG. Please return also 

empty magazines. 

For the BEBIG return service; please contact our customer support. 





6. Directions for the Implantation 

6.1. Sealing the Implant Needles 

There is no need for a special sealing material when using IsoCord. The spacers 

within the IsoCord strands provide sufficient rigidity to easily penetrate a bone wax 

seal. 

6.2. Seed Type 

The IsoCord seed chains utilize BEBIG IsoSeeds of the type I25.S06. Choose this 

type in your planning software. 

6.3. Correction of the Implantation Depth 

The Configuration of the IsoCord strand loaded needle differs from a needle loaded 

with loose seeds because of the construction of the IsoCord seed chain and the 

operation mode of the Needle Loading Station. 

While a loose seed configuration starts with a seed, an IsoCord configuration always 

starts with half a spacer. 

Please bear that in mind when you implant an IsoCord strand loaded needle. 





7. Maintenance and Sterilization 

Cleaning 

After use the Needle Loading Station needs to be cleaned from residue of the cut 

seed chain using a damp swap. Please ensure that no material gets into the guiding 

system. A commercially available cleaning agent for surgical instruments can be 

used for heavier dirt. Please ensure that you carefully follow its instructions for use 

and avoid all cleaning agents containing acid or alkalines. 

Maintenance 

Check that all moveable parts are still 

functional, in particular the built-in mandrel. It 

should be moved completely forward and 

slowly backward to recoil its return spring. 

Lubricate this spring with a biocompatible 

instrument spray. 

The ball catch which holds the magazine holder in place has to be treated the same 

way. It is positioned under the magazine holder. 

The magazine holder should be in the 

“mandrel position”. Hold the station 

upright and spray the lubricant onto the 

ball as shown in the picture. 





Similarly, the guide of the release pin of 

the needle holding mechanism should be 

lubricated. This is especially important 

because this mechanism has no bearing. 

Push the pin forward, spray the axis and 

move backwards and forwards a couple 

of times so that the oil is well distributed. 

Repeat if necessary until the pin can be 

moved easily. 

Also, the axes and the release mechanism of the needle holder need to be 

maintained with instrument spray. 

Water spots from the steam sterilization should be wiped with a damp cloth. 

Also check and maintain the accessories. The tip of the screw driver should be 

lubricated from time to time to avoid corrosion. 

Service 

The Needle Loading Station should be sent back to the manufacturer once a year. 

Please Co-ordinate with BEBIG’s customer support and you will receive an exchange 

unit in advance. You can then use the transport case of the exchange unit to return 

your station. 

Exchange of the Lighting Unit 

The durability of the lighting unit is limited by the number of sterilization cycles. It will 

be exchanged at the annual service by the manufacturer. Should your lightening unit 

fail before the annual service, you can easily exchange the unit yourself. 





If you do not already have an exchange lighting unit, request one from BEBIG. The 

exchange itself is very easy, all you need is a 2 mm hexagonal wrench. Place the 

Needle Loading Station face down onto the table using some form of cushion or 

supporting objects to avoid any damage to its moving parts. 

Unscrew the two outer screws of the lighting unit. Then you can remove the unit. 

Replace it with the new unit and tighten the screws again. 

Sterilization 

The whole of Needle Loading Station with the exception of the external power supply 

unit and its power cables can be steam sterilized. The external power supply unit and 

its power cables must not and need not be sterilized at all. All accessories and the 

Needle Loading Station can be inserted into the special sterilization tray and fixed to 

it. 





Place all accessories – drive knob, 

scissors, tweezers, screw driver and 

waste container (container and lid 

separated) – into the corresponding 

supports, as shown in the picture. 

Now place the Needle Loading 

Station, in the “IsoCord position”, on 

top of it. Position the base plate at 

the side of the needle holder into the 

notch of the support and the station 

in such a way that the opening in the 

base plate is exactly matching the 

support with the threaded hole. 

Now, with the plastic screw provided, 

screw the Needle Loading Station 

onto the support. The connection 

cable should be coiled around the 

designated supports. 

Secured this way, the whole tray can be sealed into a sterilization bag or wrapped in 

sterilization paper. 

The steam sterilization has been validated in a device according to DIN EN 285 using 

the following set of parameters: 

Temperature 

Pressure 

Time 

134° C 

3 bar 

5 min 

The use of these parameters does not automatically guarantee sterility. The user 

must ensure that sterility is obtained by using approved methods, e.g., bio indicators. 

If you have further questions, contact the manufacturer of your sterilization device. 

Other Sterilization methods are not approved by BEBIG. 





8. Safety Instructions 

• Before you start loading needles, familiarize yourself again with the procedure. 

• Do not turn the magazine drive outside the Needle Loading Station. The transport 

lock will prevent this anyway, but using too much force could damage the 

magazine drive. 

• Make sure you turn the knob in the right direction, e.g., counterclockwise, in the 

„Needle” direction, to move the seed chain out of the magazine. 

• Move the magazine holder only in the described way. Please do not touch the 

drive knob while shifting the magazine, otherwise unintentional movement of the 

knob and therefore movement of the seed chain can cause damage of the latter. 

• Before you cut the seed chain, please re-check and ensure that it is in the correct 

position. Pay special attention to the seed at mark “1”. 

• Do not touch the driving knob while you finally check the position of the seed 

chain nor while you cut it. It is advisable to press the cutter with the hand used to 

turn the knob. 

• Check the position of the cut by moving the built-in mandrel forward a little so that 

you can see the end of the cut strand. If the cut is not in the middle of the spacer, 

adjust your positioning accordingly before the next cut. 

• Always finalize the loading of a needle before you take a break! Leave the Needle 

Loading Station in the “mandrel position”. In this way you can be sure to start 

again from a defined point, and you do not have to remember what you did last. 

• Do not use too much force if problems occur (adhering, jamming) while trying to 

move the seed chain out of the magazine into the guiding system. Instead, 

analyze the underlying failure and follow the instructions in chapter 9, Trouble 

Shooting. 

• Never implant a damaged seed! 

• If you cut the seed chain using the IsoCord scissors, make sure that both ends of 

the seed chain are held securely, so that no piece can spring away. For example, 

you can grab one end with the IsoCord tweezers while the other end is still 

inserted in a needle. 

• The external power supply and its power cable must not be sterilized. 

• The traceability of the IsoCord seed chain is guaranteed by its serial number. This 

serial number is written on the label of the magazine and the corresponding 

packages. Include the serial number of the magazines 

you used for implantation in your documentation of the 

patient data. 





9 Trouble Shooting 

9.1 The Seed Chain Does not Move out of the Magazine 

You insert a magazine into the holder of the Needle Loading Station and turn the 

knob to move out the seed chain, but the seed chain does not appear at the bushing. 

This may have one of the following reasons: 

• Make sure you did not insert an empty magazine by mistake. 

• Make sure you really turned the knob into the “Needle” direction. 

After you excluded these failures, there are still the following possibilities: 

The connection piece of the magazine and the bushing of the magazine holder are 

not aligned properly. 

To correct this, take the magazine out of the Needle Loading Station and examine it 

to see if the seed chain has been damaged while trying to move it out. If this is not 

the case, insert the magazine again and try it once more. If this is unsuccessfull, you 

will have to thread the seed chain by hand into the bushing: 

Take the magazine out of the Needle Loding Station 

and release the transportation lock with the help of the 

IsoCord screw driver. This is achieved by pulling the 

lock in the direction of the right lower corner, away 

from the middle of the magazine. 

With the help of the drive knob, move the seed chain 

approx. 2 cm out of the magazine. Put the screw 

driver you just used for releasing the lock aside. 

Now guide the piece of the seed chain you just moved 

out through the bushing and insert the magazine as 

normal. 





If the seed chain is already damaged, you have to cut off the damaged part. Release 

the magazine lock by hand as described above and turn the seed chain out so far 

that the first undamaged spacer is completely visible. Put the magazine down, grip 

the end of the seed chain with the tweezers and cut the first undamaged spacer with 

the IsoCord scissors right in the middle. Retry to insert the magazine or try to thread 

the seed chain by hand through the bushing as described above. Be aware of the 

additional exposure to radiation from seeds already outside the magazine. 

There is also a possibility that the seed chain is no longer being propelled forward. 

This failure can be caused by turning the seed chain too far back into magazine 

(about a 60° turn of the drive knob, calculated from that position where the end of the 

seed chain levels with the bushing). 

Re-threading of the seed chain 

Keep the magazine inserted in the Needle Loading 

Station. Open the inspection flap by removing the two 

upper screws with the IsoCord screw driver. 

To take off the flap, turn the third screw on the left side 

counterclockwise to lift the flap. 

Grip the flap with the tweezers and take it off. 

Identify the end of the seed chain in the 

window. If necessary, turn the knob clockwise 

until the end of the chain appears. Grip it with 

the tweezers and pull it taut. 





Feed the chain through the tube towards the 

friction wheel by turning the knob slowly in the 

“Needle” direction. While doing so, guide the 

seed chain with the tweezers at the upper 

wall of the casing until the seed chain comes 

out of the bushing. 

Now grip the end coming out of the bushing at the spacer behind the first seed and 

turn the knob back until the chain clings tight to the wheel. Make sure the coils do not 

cross each other and correct, if necessary. 

Keeping hold of the end of the seed chain without pulling, take off the knob and 

reposition the lid of the magazine. After you verified that everything is in the correct 

position and the seed chain can be easily moved, screw on the lid. 

Altogether, this procedure involves a slightly increased radiation exposure. Hence, 

you should work accurately and efficiently, but without hurry. If possible, use a 

shielding screen made out of lead perspex. 

9.2 The Seed Chain Does not Thread into the Positioning System 

The seed chain can be moved out of the bushing of the magazine holder but does 

not thread into the guiding system of the positioning unit. This failure occurs when the 

seed chain has been moved too far out of the bushing before the magazine holder 

has been brought into the “IsoCord position”. Therefore, the seed chain hits the 

positioning unit at the side of the inlet hole and is bent. This bent end piece has to be 

cut off . 

Put the magazine holder into the “mandrel position” and move the seed chain further 

out of the magazine by turning the knob until the first undamaged spacer is 

completely visible. 

Grip the damaged end of the seed chain with the 

tweezers, hold the drive knob with your hand and 

pull the chain slightly until it is taut. Now grip the 

damaged end with the tweezers and cut it in the 

middle of this first undamaged spacer. Make sure 

that no seed is damaged and dispose the cut 

piece properly using the waste container. 





9.3 The Seed Chain Piece Gets Stuck in the Guiding System 

Do not use force at all to push a seed chain piece or strand further if it cannot be 

moved forward and is stuck in the guiding system of the positioning unit. Instead, try 

to push it backwards. In order to do this move the magazine holder back into the 

“mandrel position” and remove the attached needle. Now feed the stylet of one of the 

needles into the tip of the needle holder of the Needle Loading Station. Push the 

strand back carefully until it appears at the other end of the positioning unit, the 

cutting knife. Now grip it with the tweezers and take it out completely. Check if a seed 

is damaged. You can still use this piece for implantation if no seed is damaged and 

the seed chain is sufficiently intact. Just load it with the tweezers into a needle 

manually. If the strand is damaged at both ends in a way that it cannot be loaded into 

a needle, you have to cut off the affected parts. Use the IsoCord scissors and secure 

both ends while cutting. Only cut at the spacer positions with enough clearance to the 

seeds. Do not damage a seed. 

9.4 The Strand will not Completely load into the Needle 

If the BEBIG provided implant needles are not used then there is a possibility that the 

strand will not load completely into the needle. This is because the design of the 

needle holder of the station is optimized for the BEBIG provided needles. With other 

needles (e.g., MDTECH REF 500618200X) the strand is not guided all the way down 

the needle. The built-in mandrel does not sit directly behind the strand, but slightly off 

and blocks further movement of the strand into the needle. In this case you must 

remove the needle and fully load the strand using the stylet of the needle. 





9.5 Damage of a Seed 

If you incorrectly position the seed chain and accidentally cut through a seed instead 

of a spacer then you have a contamination incident from a damaged seed. In this 

case you are no longer handling a sealed radiation source, but open radioactivity. 

This is an incident which requires notification of the authorities if your license does 

not include the handling of open radioactivity. 

How you proceed, depends on the requirements of your license and the local 

regulations. In particular, the question if the already started implantation of a patient 

can be finished has to be answered. This is the responsibility of the persons in 

charge in the clinic, possibly in consultation with the responsible authorities. 

The following discusses the risks which arise for the patient and the user if the 

treatment is continued and how these risks can be minimized. 

Avoiding the distribution of the contamination 

By cutting a seed the Needle Loading Station is contaminated, particularly, close to 

the cutting system. First of all it is important to avoid any distribution of the 

contamination. 

The radioactive iodine in the IsoCord seeds is bound to a ceramic body which will 

crumble into several small pieces and some dust. Most of these pieces and dust will 

be located around the cutting system on the base plate. This dust must not be 

distributed in the room (e.g., a strong air draft). Hence, pull the magazine holder back 

into the “mandrel position” very carefully and pick up the pieces and dust with a damp 

sterile swap. Deposit them with the swap in a suitable container, e.g., the IsoCord 

waste container. 

Next, cut the damaged seed from the seed chain 

which is still in the magazine. Turn the knob into the 

direction “Needle” only so far that the next but one 

spacer comes out. Now hold the first spacer following 

the damaged seed with the tweezers and cut the 

second spacer with the scissors. This seed chain 

piece with the damaged seed has also to be deposited 

into the container. Make sure you do not produce any 

further contamination by handling the open seed. Turn 

the seed chain back into the magazine far enough so that the end of the chain just 

disappears in the bushing. Wipe the surface of the bushing with a sterile damp swap 

to minimise possible contamination. 





Now the seed chain piece with the other part of the cut seed will be disposed. The 

accidental cutting of a seed is already noticeable through its distinct higher cutting 

resistance and a slightly metallic cutting sound. At the latest it should be detected 

during the control of the position of the cut, certainly before the strand is loaded into 

the needle. It can therefore be assumed that the seed chain is still in the glass tube 

of the positioning system. Remove the needle and feed the stylet of an implant 

needle, starting at the needle holder, into the guiding system of the Needle Loading 

Station. Now carefully push the seed chain piece with the damaged seed back until it 

comes out of the opening of the cutting system. Do not grip it with the tweezers on 

the open seed but at the next spacer and deposit it into the container. 

Warning: 

Under no circumstances implant a strand with a damaged seed! 

Assessment of the remaining contamination and the risk for the patient 

According to our tests, a maximum of 4% of seed activity is released when cutting a 

seed. The main part is in small pieces and dust, which should have been removed 

already. The remaining contamination is located on the knife of the cutting system, at 

the bushing and in the guide tube of the positioning unit. If you continue with the 

needle loading in a normal manner, you will pick up some of this contamination with 

every following seed chain piece. It is evident that the first piece is contaminated by 

far the most. It is recommended that you dispense and cut a first strand of 3 seeds, 

remove it backwards, as described above, and discard it. In this way the 

contamination is reduced even further. 

Following these measures a maximum contamination of only 0.2% of the original 

seed activity remains, i.e., for an apparent activity of a seed of 0.7 mCi the remaining 

contamination is approx. 67 kBq. For further risk evaluation one assumes that this 

contamination is transmitted completely to the patient, which is actually not the case. 

In fact, the following strands definitely pick up and transmit less contamination to the 

patient. 

If the remaining contamination is passed completely to the patient and in the 

assumption that it passes completely into the blood stream, the patient will have an 

additional radiation exposure of about 1mSv effective, respectively 18mSv thyroid 

dose. 

This anticipated maximum value of the effective dose exposure is just within the 

limits of the allowed radiation exposure for the population according to German law. 

Thus, continuing the implantation of the patient is not an unjustifiable risk for the 

health of the patient. In the end, the responsible physician has to make the decision if 

this is tolerable for the patient. 





Decontamination 

It is highly unlikely to completely decontaminate the Needle Loading Station at the 

clinic. It is therefore necessary to securely package all contaminated components. 

The easiest way is to carefully wrap the Needle Loading Station, including the 

magazine and all accessories, in the sterile sheet you placed under the Needle 

Loading Station, put everything into a sterilization bag and seal it thoroughly. 

Package the bag in a way so it cannot be damaged accidentally, e.g., in a stable 

cardboard box cushioned with shock absorbing fillers. 

Finally, check your complete work place with a contamination monitor. 

Please contact the BEBIG customer support (contact see below) to arrange the 

return shipment and to get further information. 

For the return shipment you need packaging according to the dangerous goods 

transportation laws. 

Please notify your local authority about this incidence according to the 

requirements of your license. 

Please give also notice to BEBIG: 

BEBIG Isotopen- und Medizintechnik GmbH 

Robert-Rössle-Str. 10, D-13125 Berlin 

Tel.: +49 (30) 94 10 84-130 

Fax: +49 (30) 94 10 84-112 

e-mail: info@bebig.de

IsoCord Needle Loading Station - SeeDos, UK

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