OPMI Neuro on NC4 Floor Stand. Instructions for use

Transcription

1 OPMI Neuro on NC4 Floor Stand Instructions for use G en Issue 5.0

2 2 Key to symbols Warning! The warning triangle indicates potential sources of danger which may constitute a risk of injury for the user or a health hazard. Caution: The square indicates situations which may lead to malfunction, defects, collision or damage of the instrument. Note: The hand indicates hints on the use of the instrument or other tips for the user. OPMI is a registered trademark of Carl Zeiss.

3 Contents Functions at a glance 5 Safety 9 Description 21 OPMI Neuro on NC4 floor stand 22 OPMI Neuro surgical microscope 25 NC4 floor stand 40 Preparations for use 57 Transporting the system 58 Attaching the equipment 58 Connections 66 Operation 69 Preparing to use the instrument 70 Procedure 86 What to do in an emergency 88 Relocating the system 92 Maintenance / Further information 95 Index 115

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5 Functions at a glance 5 Functions at a glance NC 4 floor stand with OPMI Neuro 6 OPMI Neuro surgical microscope 7

6 6 Functions at a glance NC 4 floor stand with OPMI Neuro 1 Halogen lamp insert with replacement lamp page 54 2 Maneuvering handle and transport direction page 46 3 Locks with pumping lever page 44 4 Steerable casters and extendable steering casters page 44 5 Wheels page 44 6 Connector panel with line switch and line connection page 48 7 Light guide socket for the xenon illumination page 54 8 Lamp module for the xenon illumination page 54 9 Control panel, includes OPMI and illumination control page OPMI Neuro surgical microscope page Suspension of the surgical microscope page

7 Functions at a glance 7 OPMI Neuro surgical microscope 1 Adjusting the interpupillary distance page 26 2 Adjusting the eyecup and the prescription page 26 3 Securing screw for tiltable tube page 26 4 Tiltable binocular tube page 26 5 Connecting the mouth switch page 26 6 Handgrip panel for control of focus, zoom, page 36 autofocus, brakes, special and switching functions 7 Keypad for navigation applications, without function here 8 Setting the depth of field of the microscope's image page 26 9 Manual magnification setting page Objective lens page Dovetail mount for MM6 micromanipulator page Switching on the auxiliary illumination page Manual focusing page Manual setting of the illuminated field diameter page Image exit port, right page Adjusting the sliding mirror to position 1 or 2 page Tube mount with securing screw page Connecting the light guide page Image exit port, left page

8 8 Functions at a glance

9 Safety 9 Safety Directives and standards 10 Notes on installation and use 11 Safety devices of the suspension system 16 Warning labels and notes 18

10 10 Safety The instrument described in this manual has been developed and tested in accordance with Carl Zeiss safety standards and with national and international regulations. A high degree of instrument safety is thus ensured. We would like to inform you on the safety aspects involved in operating the instrument. This chapter contains a summary of the most important precautions to be observed. Further safety notes are also contained in other parts of this user's manual; they are marked with a warning triangle containing an exclamation mark as shown here. Please pay special attention to these safety notes. Safety is only ensured when this instrument is operated properly. Please read through this manual carefully before turning the instrument on. Also read through the user's manuals of the other equipment used with this instrument. You may obtain further information from our service organization or authorized representatives. Directives and standards The system described in this user manual has been designed in compliance with: EN UL IEC CSA In accordance with Directive 93/42/EEC, the complete quality management system of the company Carl Zeiss, Surgery Products Division, has been certified by the DQS Deutsche Gesellschaft zur Zertifizierung von Managementsystemen GmbH, a notified body, under registration number MP21. The instrument must be connected to a special emergency backup line supply in accordance with the regulations or directives which apply in your country. As per Directive 93/42/EEC, the unit is a Class I instrument. For USA: FDA classification Class I. Please observe all applicable accident prevention regulations.

11 Safety 11 Notes on installation and use Safe working order Do not operate the equipment contained in the delivery package in explosion-risk areas, the presence of inflammable anesthetics or volatile solvents such as alcohol, benzine or similar chemicals. Do not station or use the instrument in damp rooms. Do not expose the instrument to water splashes, dripping water or sprayed water. Immediately unplug any equipment that gives off smoke, sparks or strange noises. Do not use the instrument until our service representative has repaired it. Do not place any fluid-filled containers on top of the instrument. Make sure that no fluids can seep into the instrument. Do not force cable connections. If the male and female parts do not readily connect, make sure that they are appropriate for one another. If any of the connectors are damaged, have our service representative repair them. Potential equalization: The instrument can be incorporated into potential equalization measures. For this purpose, contact our service department. Do not use a mobile phone in the vicinity of the equipment because the radio interference can cause the equipment to malfunction. The effects of radio interference on medical equipment depend on a number of various factors and are therefore entirely unforeseeable. Modifications and repairs on these instruments or instruments used with them may only be performed by our service representative or by other authorized persons. The manufacturer will not accept any liability for damage caused by unauthorized persons tampering with the instrument; this will also forfeit any rights to claim under warranty. Over longer distances (e.g. removal, return for repair, etc), the instrument may only be transported in the original packaging or in special return packaging. Please contact your dealer or the Carl Zeiss service team. Use this instrument only for the applications described.

12 12 Safety Only use the instrument with the accessories supplied. Should you wish to use other accessory equipment, make sure that Carl Zeiss or the equipment manufacturer has certified that its use will not impair the safety of instrument. Only personnel who have undergone training and instruction are allowed to use this instrument. It is the responsibility of the customer or institution operating the equipment to train and instruct all staff using the equipment. Keep the user's manuals where they are easily accessible at all times for the persons operating the instrument. Never look at the sun through the binocular tube, the objective lens or an eyepiece. Do not pull at the light guide cable, at the power cord or at other cable connections. This instrument is a high-grade technological product. To ensure optimum performance and safe working order of the instrument, its safety must be checked once every 12 months. We recommend having this check performed by our service representative as part of regular maintenance work. If a failure occurs which you cannot correct using the trouble-shooting table, attach a sign to the instrument stating it is out of order and contact our service representative. Connection of navigation systems (option) The Carl Zeiss components "Surgical microscope on suspension system" can be integrated into an external navigation system. An optional navigation interface is available. The manufacturer of the external navigation system (system supplier) is responsible for the following: Confirmation that his navigation systems have been tested and certified for operation with the respective Carl Zeiss surgical microscope on a suspension system in accordance with the requirements specified in the Carl Zeiss interface description "Navigation Interface for Carl Zeiss Surgical Microscopes". Meeting all requirements (approval, qualifications, etc.) for the medical system created through coupling via the navigation interface. Provision of all accompanying documents required. Ensuring that the navigation system is only connected by personnel who have undergone appropriate training and instruction.

13 Safety 13 Contacting the local Carl Zeiss representative for any inquiries that may arise. Implementation of a procedure that guarantees the calibration of the surgical microscope which is absolutely vital for the use of the Carl Zeiss components "Surgical microscope on suspension system" in combination with a connected navigation system. This allows the calibrated surgical microscope combined with the navigation system to be used like an optical pointer with a variable length (corresponds to the working distance). Conducting complete functional testing, alignment and calibration (landmark test) of the navigation system after every subsequent installation or exchange of navigation system components Incorporation of a regularly changing icon in the data injection display of surgical microscopes equipped with a data injection system, i.e. the "heartbeat" of the navigation system must be constantly visible for the user to permit data transmission errors to be immediately detected. To check the accuracy of the overall system, perform the test specified by the navigation system manufacturer, e.g. the landmark test, also using the surgical microscope. This allows you to ensure that the stereotactic data has been correctly generated and transmitted to the navigation system without errors. Do not use any rotatable tube dovetail mounts when operating the surgical microscope with a connected navigation system. If mounts of this type have been attached to the microscope, they must be carefully locked in their central positions (tighten the knurled screws for rotation). Requirements on the antenna design (non-zeiss antennas) The antenna manufacturer must confirm that his antenna has been tested and certified for operation with the respective Carl Zeiss surgical microscope on a suspension system in accordance with the requirements specified in the Carl Zeiss interface description "Navigation Interface for Carl Zeiss Surgical Microscopes". The following requirements, in particular, apply to the antenna: The surgical microscope with accessories and the antenna must not exceed the admissible total weight (see label or the chapter "Technical data"). The antenna must not project over the bottom edge of the microscope body in the direction of the surgical field.

14 14 Safety The antenna must neither obstruct the movement and adjustability of the accessories which can be used on the surgical microscope (usually a stereo coobservation tube, a camera adapter, a face-toface tube for spinal surgery, MM6 laser micromanipulator) nor collide with these accessories. The antenna configuration must be implemented in such a way that the localizer camera can always "see" the diodes or trackballs when the surgical microscope and its accessories are in their usual positions. When the system's internal antenna wiring is used, the EN standard (electromagnetic compatibility) must be complied with. The output power of the LEDs or infrared LEDs (IRED) must always comply with the IEC laser safety standard, even in the event of cable defects. The failure of one or several LEDs of the antenna may impair navigation or lead to navigation failure. Take the necessary precautions. Requirements for operation Our service representative or a specialist authorized by us will install the instrument. Please make sure that the following requirements for operation remain fulfilled in the future: All mechanical connections (details in the user's manual) which are relevant to safety are properly connected and screw connections tightened. All cables and plugs are in good working condition. The voltage setting on the instrument conforms to the rated voltage of the line supply on site. The instrument is plugged into a power outlet which has a properly connected protective ground contact. The power cord being used is the one designed for use with this instrument. Before every use and after re-equipping the instrument Make sure that all Requirements for operation are fulfilled. Go through the checklist. Re-attach or close any covers, panels or caps which have been removed or opened.

15 Safety 15 Pay special attention to warning symbols on the instrument (triangular warning signs with exclamation marks), labels and any parts such as screws or surfaces painted red. Do not cover any ventilation openings. For every use of the instrument The transport casters must be retracted to ensure that the unit is securely resting on its base (with instruments with retractable transport casters). Avoid looking directly into the light source, e.g. into the microscope objective lens or a light guide. When the illumination is on, the light guide must be connected at both ends. Otherwise there is a risk of fire or burn injuries. Any kind of radiation has a detrimental effect on biological tissue.this also applies to the light illuminating the surgical field. Please therefore reduce the brightness and duration of illumination on the surgical field to the absolute minimum required. When operating on the eye, always use a GG 475 protection filter to ensure that the patient's retina is not exposed to unnecessary (blue) radiation (retinal injury). After every use of the instrument Always use the main power switch of the instrument to turn it off. The main power switch must always be turned off when the instrument is not in use.

16 16 Safety Safety devices of the suspension system Mechanical end stops protect the cable and the light guide against kinking and stretching. Safety switch In the event of a break in a spring or cable, the brakes will be activated. You can nevertheless finish surgery, as you can still move the surgical microscope by applying slight force. 1 Backup lamp module The lamp housing contains a backup lamp module with a 12 V 100 W halogen lamp. If the xenon illumination fails, plug the light guide into the halogen lamp socket and set the selector on the front panel to halogen illumination. 2 Transport lock for locking the vertical shaft in position during transportation. 3 Transport locks for locking the horizontal shafts in position during transportation. Caution: To allow transport locks (2 and 3) for the individual shafts to engage, the marks printed on the housing components must always be opposite each other.

17 Safety

18 18 Safety Warning labels and notes Caution: Observe all warning labels and notes! If any label is missing on your instrument or has become illegible, please contact us or one of our authorized representatives. We will supply the missing labels.

19 Safety 19

20 20 Safety

21 Description 21 Description OPMI Neuro on NC4 floor stand 22 Intended use 22 Design 22 OPMI Neuro surgical microscope 25 Intended use 25 Controls and connections 26 Tiltable binocular tube and eyepieces 32 Suspension of the surgical microscope 34 Handgrips on surgical microscope 36 Principle of operation of the auxiliary illumination 38 NC4 floor stand 40 Intended use 40 Design 42 Controls and connections 44

22 22 Description OPMI Neuro on NC4 floor stand Intended use The OPMI Neuro 200 surgical microscope on the NC4 floor stand has been designed to meet the special requirements of microsurgery. The unit is particularly suitable for use in plastic and reconstructive surgery and ENT. The motorized adjustment of weights allows the floor stand to be balanced in such a way that the OPMI Neuro surgical microscope can be positioned almost effortlessly. Electrically activated magnetic brakes lock the surgical microscope in the position required. The OPMI Neuro 200 system on NC4 floor stand can optionally be operated in conjunction with a microscope navigation system, e.g. the STN navigation system from Carl Zeiss. Caution! The OPMI Neuro must not be used in ophthalmic procedures. Design The overall system comprises the following modules: 1 OPMI Neuro Surgical Microscope 2 NC4 Floor Stand

23 Description

24 24 Description

25 Description 25 OPMI Neuro surgical microscope Intended use The OPMI Neuro surgical microscope is an advanced instrument offering great operating convenience. It is ideally suited for the use in microsurgery and, in particular, meets the specific requirements of neurosurgery. Warning! The OPMI Neuro surgical microscope must not be used for ophthalmic procedures. The microscope can be focused on the surgical field within a working distance of 200 to 420 mm. This function can be performed by an autofocus system. At the press of a key, the system focuses on the object. The point of reference is the center of the field of view. The diameter of the illuminated field can be continuously adjusted from a fully illuminated field (approx. ý 91 mm) to spot illumination (approx. ý 16 mm) using a knob. This data is valid for a working distance of 200 mm. The illumination intensity increases as the illuminated field size decreases. Auxiliary illumination from a different angle allows the lightening up of shadows in narrow channels. The intensity of this illumination is approx. 10% of the standard illumination. The magnification ratio of the zoom system is 1:6. The integrated video port is suitable for the use of 3-chip cameras from our MediLive product line. An additional camera for the stereo mode can be retrofitted at any time by our service representative. A double iris diaphragm has been installed for depth-of-field adjustment. An additional tiltable tube (option) can be mounted in a 180 position to the tube for the main surgeon, allowing two surgeons to work face-to-face. A sliding mirror integrated in the beam path permits you to switch from the rear image port to the two image ports on the side (for coobservation or for photographic documentation). Important functions such as focusing and zoom have been motorized and can be controlled by the press of a key on the handgrips. An MM6 micromanipulator can be attached to the OPMI Neuro via the dovetail mount to permit the use of a laser.

26 26 Description Controls and connections 1 Adjusting knob for the interpupillary distance 2 10x push-in widefield eyepieces 3 Securing screw 4 Tiltable binocular tube Swivel range: Adjusting knob for the double iris diaphragm. This diaphragm permits setting of the depth of field of the microscope image. Changing the diaphragm setting also changes the brightness of the image. The diaphragm is effective for all image ports. The data superimposing system remains unaffected. 6 Socket for mouth switch to activate the brake release key for the three microscope shafts X, Y and Z. When the mouth switch is pressed, all shafts can be moved in all directions. When the switch is released, the magnetic brakes simultaneously lock these shafts in position. 7 Magnification setting, manual The magnification ratio of the zoom system is 1:6.

27 Description

28 28 Description 8 Dovetail mount The dovetail mount is used to lock the MM6 micromanipulator in position. Pos. 2 Pos. 1 Note: You may only use MM6 micromanipulators which have been particularly adjusted for the OPMI Neuro. These MM6 micromanipulators are labelled with "Adjusted for OPMI Neuro". 9 Tilt actuator for the additional illuminator The tilt actuator is used to switch the additional illuminator on and off. See Principle of operation of the auxiliary illumination on page 38. Note: The mechanism is designed in such a way that the additional illuminator switches off automatically when a micromanipulator is used. 10 Adjustment knob for the illuminated field diameter Adjustable from spot illumination (Ø 16 mm) to complete illumination of the entire field of view (Ø 91 mm). This data is valid for a focal length of 200 mm. 11 Focus adjusting knob 12 Image exit port Suitable adapters are available (options) to permit the connection of documentation and coobservation equipment (e.g. 35 mm camera, coobservation tube). 13 Adjustment knob for sliding mirror The sliding mirror has two positions: Pos. 1: The light is directed to the 180 tube mount (14). Pos. 2: The light is directed to the image exit ports (12) and (17). If photography is triggered, the sliding mirror briefly switches to Pos. 2.

29 Description

30 30 Description 14 Tube mount with securing screw A further binocular tube can be attached to allow two surgeons to work face-to-face. 15 Dust cover 16 S-socket for light guide connection Push the S light guide into the socket until it snaps in. 17 Image exit port Suitable adapters are available (options) to permit the connection of documentation and coobservation equipment (e.g. 35 mm camera, coobservation tube).

31 Description

32 32 Description Tiltable binocular tube and eyepieces tiltable tube 2 PD adjustment knob The correct interpupillary distance has been set when both eyepiece images merge into one. 3 Push-in widefield eyepiece Note: When you remove the eyepiece from the tube, please note that this eyepiece is fitted with a magnetic coupling. When mounted, the eyepieces display a very weak magnetic field. For this reason, the usual rules for the handling of magnets must only be observed with eyepieces which have not been mounted on the microscope: Do not place the eyepieces close to instruments where there is any risk of magnetization. Do not place eyepieces on sensitive electronic instruments such as infusion pumps, cardiac pace-makers, measuring instruments or magnetic data carriers such as disks, audiotapes and videotapes or credit cards. Always store the eyepieces in their original packaging when not in use. 4 Eyecup Always adjust the eyecups in such a way that you can see the full field of view. Viewing with eyeglasses: Viewing without eyeglasses: Screw in eyecups all the way. Screw eyecups outward until you can see the full field of view. 5 Diopter setting ring The eyepieces provide ametropia compensation from -8 D to +5 D. If you wear your eyeglasses during work, adjust the ring to 0 D. Turn the ring until you have found the optimum setting. A built-in catch lever locks the ring in the position set. 6 Diopter scale For reading the prescription set.

33 Description

34 34 Description Suspension of the surgical microscope 1 Freely rotatable microscope rotation shaft A flexible steel rope protects the cables against twisting. 2 Microscope rotation shaft A magnetic brake clamps the microscope rotation shaft between the OPMI carrier arm and the support arm. The brake is released by pressing the brake release key on the hand grip of the surgical microscope. 3 Knob for adjusting the balance setting for the laterial tilt of the microscope 4 Knob for adjusting the balance setting for the front-to-back tilt of the microscope. 5 Knobs for adjusting the balance setting of the front-to-back tilt of the microscope. The knobs are located at the ends of a spindle, permitting the balance setting to be adjusted from both sides.

35 Description

36 36 Description Handgrips on surgical microscope The OPMI Neuro is equipped with one handgrip each on the left and right. The functions of the keys of the left and right handgrips are identical. 1 Camera release socket 2 Brake release button (SB) Brake release button (SB) is used for the three microscope axes X, Y and Z. In the OP (Surgery) mode: When the button is pressed, the X, Y and Z axes can be moved in all directions. When you let go of the button, the magnetic brakes simultaneously lock these axes in position. During balancing: Depending on the balancing mode selected, only the axis to be balanced can be moved when this button is pressed. When you let go of the button, the magnetic brake locks the axis concerned in position. 3 Brake release button (AB) Brake release button (AB) is used for all six axes (X, Y, Z axes of suspension system and microscope). When this button is pressed, all axes can be moved in all directions. When you let go of the button, the magnetic brakes simultaneously lock all axes in position. 4 Trigger button (S) Trigger button (S) is used for controlling special functions, e.g. an external video recorder. 5 Trigger button (PH) Trigger button (PH) is used for controlling the still camera. Socket (1) for the camera release is located on the back of the handgrip. 6 Rocker switch for ZOOM The ZOOM rocker switch is used for setting the magnification factor in a range from 0.4x to 2.4x. Three short beeps are emitted when the end positions have been reached. 7 Rocker switch for FOCUS The FOCUS rocker switch is used for continuous focusing within the working range of 200 to 420 mm. Again, three short beeps are emitted when the end positions have been reached. 8 Trigger button (D) for image switchover. (Not assigned, for OPMI Neuro MultiVision only) 9 Trigger button (AF) for the autofocus system

37 Description 37 At the press of this button, the autofocus system focuses on the object. 10 Joystick (for OPMI Neuro MultiVision only) The joystick is used for operating a microscope navigation system (not assigned, for OPMI Neuro MultiVision only) F Z

38 38 Description Principle of operation of the auxiliary illumination 1 Auxiliary illumination 2 Surgical field 3 Main objective lens of OPMI Neuro 4 Main illumination 5 Shadow area of main illumination

39 Description 39

40 40 Description NC4 floor stand Intended use The NC4 floor stand is a stable carrier for motorized surgical microscopes. The NC4 floor stand includes all modules required for the power supply of the surgical microscope. A carrier arm system equipped with motor-driven counterweights allows the surgical microscope to be balanced. This makes it possible to effortlessly move the microscope into the position required. Magnetic brakes then lock the microscope in this position. A Superlux 301 high-intensity light source is integrated in the NC4 floor stand. This light source contains a xenon high-pressure lamp providing illumination with a spectrum similar to that of daylight and a 12 V, 100 W halogen lamp as a backup. The FlexiTrac TM base of the NC4 floor stand is provided with two fixed casters for optimum straight-ahead movement and with two extendable steerable casters for precise positioning at the operating table. Note: The extendable, steerable casters of the FlexiTrac TM stand base are ideally suited for positioning the NC4 floor stand at the site of use. However, they are unsuitable for transport of the unit over long distances. Caution: When the extendable casters have been extended, the unit is not standing horizontally level. The NC4 floor stand cannot be balanced in this condition. Any earlier balance setting will only be effective after the casters have been retracted. Press the locking pedal to retract the extendable casters.

41 Description 41

42 42 Description Design The NC4 floor stand comprises FlexiTrac TM base (4), console (3), the parallelogram arms (2), the carrier arm (1) and support arm (6) for the surgical microscope. FlexiTrac TM base (4) is easy to move on its four casters. The base has been designed in such a way that high stability is ensured even with unfavorable loading of the stand. Locking pedal (5) allows the floor stand to be rapidly and reliably secured in position. Console (3) contains all power supply systems for the floor stand and for the control of the motorized functions of the surgical microscope. Parallelogram arms (2) allow the unobstructed movement of the surgical microscope. The entire system can be moved in the X, Y and Z directions and can be rotated about three axes.

43 Description

44 44 Description Controls and connections FlexiTrac TM stand base with extendable steerable casters Note: The extendable, steerable casters of the FlexiTrac TM stand base are ideally suited for positioning the NC4 floor stand at the site of use. However, they are unsuitable for transport of the unit over long distances. 1 Locking pedal Press once to lock the stand in position. At the same time, the steerable casters are retracted. Press a second time to release the locking pedal. 2 Pumping lever The pumping lever is used to retract the steerable casters. Fully press down the pumping lever three to five times. 3 Steerable casters 4 Extendable steerable caster For better maneuverability, the NC 4 floor stand features two extendable steering casters. These are positioned below the base and are not visible in the drawing. Pressing the brake tabs (1) enables you to retract the extendable casters. 5 Wheels The two wheels permit easy and optimum straight-ahead movement.

45 Description

46 46 Description Transport locks 1 Maneuvering handle for relocating the stand 2 Stirrups for drapes Do not use the stirrups to transport the instrument! 3 Transport locks for locking the horizontal axes in position during transportation. 4 Markings 5 Transport lock for locking the vertical axis in position during transportation. Caution: To allow transport locks (3 and 5) for the individual axes to engage, marks (4) printed on the housing components must always be opposite each other. See Relocating the system on page 92.

47 Description 47 Transportposition: Moving position: Position de transport: Posición de transporte: Posizione di transporto: Transportrichtung Transport direction Direction de transport Dirección de transporte Direzione del movimento

48 48 Description Connector panel 1 Connector for control component Possibility of connecting a foot control panel, hand control panel or operating chair with an appropriate footswitch. 2 Connector for the cable to the navigation computer (option) for a microscope navigation system (OPMI Neuro MultiVision only). 3 Potential equalization for connecting the system to the potential equalization contact in the OR. 4 Indicator window for rated voltage The voltage shown here must correspond to the rated line voltage provided on the site of installation. In addition, the voltage shown must correspond to the voltage used by the illumination system. See Electrical connections on page 66. Caution: Please observe the maximum current consumption of power outlets (5) and (6). Only connect medical devices approved by us to outlets (5) and (6). If you use other instruments, make sure that safety is guaranteed regarding admissible ground leakage currents. The admissible limit value of the ground leakage current in the suspension system's power cable must not exceed 500 µa /230 V power outlet for medical devices with a current consumption of max. 2 A. Note: The current of this power outlet is switched on or off with the S1 power switch (11) /230 V power outlet for medical devices with a current consumption of max. 2 A /230 V power inlet

49 Description

50 50 Description 8 Connector for a foot rocker switch 9 Connector for a foot switch, e.g. for triggering the autofocus or a camera. 10 Connector for controlling a video recorder. 11 Power switch When the suspension system is on, the green indicator lamp in the switch lights green. 12 Connector panel for the Zeiss toolbox (option) for operation with a navigation system.

51 Description

52 52 Description Control panel Note: After the system has been switched on, it automatically performs a segment check. This means that all the light segments of the control panel briefly light up one after the other. 1 Mode Mode shown in display (2) Every mode can be selected using the arrow keys. Modes 1 to 4 are used to balance the axes using the balance function (7). CH (Balance Check) checks the balance setting. OP is the work position. 2 Display Mode display: e.g. 1 to 4, CH, OP Error display: e.g. E1... E2. Also see page 98. Motor status display: Segments of the displayed numbers light up one after the other from right to left or vice versa. 3 FOCUS control To set the speed of the focus motion. 4 ZOOM control To set the speed of the zoom motion. 5 AF Automatic key When the ON light-emitting diode lights up (automatic mode switched on): Autofocus is activated after release of the brakes. When the OFF light-emitting diode lights up (automatic mode switched off): Autofocus can be triggered via the AF release key on the handgrips. 6 Footswitch key When the AF diode lights up: Autofocus is activated by pressing the footswitch. When the PHOTO diode lights up: Photo documentation is triggered by pressing the footswitch. 7 Balance to balance the stand and check its balance. See Balancing the NC4 floor stand on page 72.

53 Description

54 54 Description Illumination equipment 1 Control panel The power switch is lit when the unit is on. The keys contain light-emitting diodes (LEDs). These diodes are lit when the respective function is active. The LED goes out when you switch off the function. The keys have the following functions: Switching on/off the backup lamp module The halogen lamp goes on at maximum brightness. When this key has been pressed, all of the other keys on the control panel are inactive. Pressing this key again switches off the backup lamp and all of the other keys are again active. XENON / HALOGEN selector Note: Make sure that the light guide has been inserted in the appropriate socket. Switching on/off the xenon or halogen lamp Reducing brightness. Press this key to reduce brightness. The luminous bar indicates the relative brightness of the lamp. Left: minimum brightness Right. maximum brightness Increasing brightness. Press this key to increase brightness. 2 Halogen lamp module with a light guide socket for halogen illumination. 3 Light guide socket for xenon illumination 4 Housing door for the xenon lamp module Push the lock in the direction of the arrow to open the door.

55 Description 55 Note: The xenon lamp cannot light when the housing door is open. If the xenon lamp has been switched on and you open the housing door, the xenon lamp will automatically go out for safety reasons. When you close the housing door again, the xenon lamp will automatically light again. 5 Xenon lamp module 6 Service-hour counter for reading off the number of service hours of the xenon lamp module. The entire scale represents 500 hours of operation. The scale does not register more than 500 hours. The reading at A in the example shown here corresponds to approx. 100 hours A

56 56 Description

57 Preparations for use 57 Preparations for use Transporting the system 58 Attaching the equipment 58 Mounting the eyepieces 58 Mounting the binocular tube (main surgeon) 60 Mounting the binocular tube (180 position) 62 Attaching documentation / coobservation equipment 64 Connections 66 Electrical connections 66 Checking the connection of the light guide 68

58 58 Preparations for use Transporting the system Over longer distances (e.g. removal, return for repair, etc), the instrument may only be transported in the original packaging or in special return packaging. Please contact your dealer or the Carl Zeiss service team. Attaching the equipment Caution: The maximum weight of the microscope including accessories mounted on the NC4 floor stand must not exceed 14 kg! Re-balance the system every time you re-equip it. Mounting the eyepieces Insert widefield eyepieces (2) into appropriate mounts (1) on the binocular tube as far as they will go. The magnetic coupling reliably secures them in position.

59 Preparations for use

60 60 Preparations for use Mounting the binocular tube (main surgeon) Loosen securing screw (4) by a few turns. Remove cover (3) and store it in a safe place. Attach binocular tube (2) to the microscope body. Secure binocular tube (2) in position by firmly tightening securing screw (4). Insert widefield eyepieces (1) into the appropriate mounts as far as they will go. The magnetic coupling reliably secures them in position. Caution: Before using and after re-equipping the system, always make sure that widefield eyepieces (1) are securely locked and securing screw (4) is firmly tightened.

61 Preparations for use

62 62 Preparations for use Mounting the binocular tube (180 position) Loosen securing screw (4) by a few turns. Remove cover (3) and store it in a safe place. Pos. 2 Pos. 1 Attach binocular tube (2) to the microscope body. Secure binocular tube (2) in position by firmly tightening securing screw (4). Insert widefield eyepieces (1) into the appropriate mounts as far as they will go. The magnetic coupling reliably secures them in position. Set the knob for the sliding mirror to Pos 1. Pos. 1 The light is directed to the 180 tube port. When a camera is released, the sliding mirror briefly switches to Pos. 2. Caution: Before using and after re-equipping the system, always make sure that widefield eyepieces (1) are securely locked and securing screw (4) is firmly tightened.

63 Preparations for use

64 64 Preparations for use Attaching documentation / coobservation equipment Pos. 2 Pos. 1 The camera adapter shown in the illustration is an example of further accessories that can be mounted on the image exit port. The procedure described below can also be used for other accessories (e.g. coobservation equipment). The operating principle of the accessories is described in the relevant user manuals. Loosen knurled ring (1). Note: An arrow with the labeling "open" is located on the shaft next to knurled ring (1). Remove dust cover (2) and store it in a safe place. Insert accessory module (3) in the opening of the image exit port. Make sure that the locating blocks fit in the corresponding grooves of the accessory module. Screw knurled ring (1) onto accessory module (3). Firmly tighten knurled ring (1). Set the knob for the sliding mirror to Pos. 2 if a coobservation tube or 35 mm camera has been mounted on the lateral image exit ports. Pos. 2: The light is directed to the coobservation tube or 35 mm camera on the lateral image exit ports.

65 Preparations for use

66 66 Preparations for use Connections Electrical connections Warning! The wall socket to which the system is connected must have a properly connected protective earth contact. Only insert or remove the power plug when the units have been switched off. Insert or remove the other connectors only if power switches (1) and (3) on the stand and the light source have been turned off. The stand is set in the factory to the rated voltage used in the country of destination.the rated voltage shown in indicator window (2) must correspond to the line voltage available on the site of installation. If not, our service representative or a person authorized by us must readjust the voltage to the voltage available, as the rated voltages must be adjusted separately for the stand and the light source. Re-adjusting the voltage at the stand only can damage the light source. Connect the stand using the power cord intended for it.

67 Preparations for use

68 68 Preparations for use Checking the connection of the light guide Make sure that the light guide has been inserted into the light guide sockets of the illumination system and the surgical microscope as far as it will go. Make sure that the light guide is routed in such a way that the carrier system and the surgical microscope are not obstructed, and that they can be moved in their entire range of movement without stretching, extreme kinking or twisting of the light guide.

69 Operation 69 Operation Preparing to use the instrument 70 Switching on the system 70 Positioning the hand grips 70 Balancing the NC4 floor stand 72 Checklist 84 Procedure 86 What to do in an emergency 88 Failure of the zoom function 88 Failure of the automatic focusing function 88 Xenon lamp failure 90 Failure of the magnetic brakes 90 Relocating the system 92

70 70 Operation Preparing to use the instrument Switching on the system Use the power switch to turn the system on. Note: After the unit has been switched on, it automatically performs a self-test. The self-test is completed after approx. ten seconds. This is indicated by a short beep. Positioning the hand grips Note: You can position the hand grips (2) as required. You can adjust each hand grip both vertically and in inclination and turn it through 180 about its vertical axis. Please note the following points: Choose the position of the hand grips which is most convenient for the surgical procedure to be performed. Make sure that there is enough room between the grips and the accessories mounted on the OPMI microscope. Loosen the clamping effect of the lever (1) by pushing it away from you. Bring the hand grips into the position required. Re-tighten the clamping lever (1) by pulling it towards you.

71 Operation

72 72 Operation Balancing the NC4 floor stand Caution: To ensure that you can guide the microscope almost effortlessly, you must correctly balance four of the six axes of the system. Re-balance the system every time after you have re-equipped the microscope. With the casters extended, the stand is not standing horizontally level. It is not possible to balance the NC4 floor stand in this state. An earlier balance setting will only be active if the casters have been retracted. Notes: AB brake release keys: After pressing the "AB" release keys you can move all six axes (suspension system and microscope axes) at the same time. When you let go of the AB keys, the magnetic brakes will lock all axes in position at the same time. SB brake release keys: In the Surgery mode: when you press the keys, you can move the microscope in three directions (X, Y and Z). When you let go of the SB keys, the magnetic brakes will simultaneously lock all axes in position. During balancing: depending on the mode selected, you can only move the axis to be balanced while pressing the keys. When you let go of the SB key, the magnetic brakes lock the axis concerned in position. When you press the brake release key (AB or SB), you can always turn the stand and/or the microscope about their axes of rotation. When you let go of the keys, the magnetic brakes lock the axis in position as described above. Preparation First loosen all 3 transport locks (1-3). Press locking pedal (4) until it snaps in. This locks the NC4 floor stand in position.

73 Operation

74 74 Operation Mode 1 Set mode "1" on the control panel of the suspension system. Press the "AB" brake release key on the handgrip of the surgical microscope and move the stand out of the transport position until the carrier arm is approximately horizontal (see the illustration on the previous page). Press the "SB" brake release key on the handgrip of the surgical microscope and hold it down while adjusting the balance setting. Bring the microscope into position 1 (see illustration) and adjust the balance of the front-to-back tilt using knob (4). Note: When you reach the range where the knob is easy to turn, the microscope has been properly balanced. If you continue to turn the knob beyond this range, you will leave the balanced position and the effort required to tilt the microscope will increase. If the microscope tilts backward, turn the knob clockwise. If the microscope tilts forward, turn the knob counterclockwise. Tilt the microscope through 90 into position 2 (see illustration). Use knob (5) to adjust the balance setting of the tilt motion in the same way as described above for knob (4). The surgical microscope is fully balanced if it remains stationary in every position within the front-to-back tilt range.

75 Operation 75 Pos. 1 4 Pos. 2 5

76 76 Operation Mode 2 Set mode "2" on the control panel of the suspension system. Press the "SB" brake release key on the handgrip of the surgical microscope and hold it down while adjusting the balance setting. Use knob (1) to adjust the balance setting of the lateral tilt. Note: If the microscope tilts to the right, turn the knob to the left. If the microscope tilts to the left, turn the knob to the right. The surgical microscope is fully balanced if it remains stationary in every position within the lateral tilt range.

77 Operation 77 1

78 78 Operation Mode 3 Set mode "3" on the control panel of the suspension system. Press the "AB" brake release key on the handgrip of the surgical microscope and bring the vertical arms of parallelogram arm (1) into a vertical position. Press the "SB" brake release key on the hand grip of the surgical microscope and hold it down while adjusting the balance setting. Move the carrier arm including the microscope up or down to find out in which direction the system is pulling. Note: If the carrier arm moves upward, press the balancing key on the control panel. If the carrier arm moves downward, press the balancing key on the control panel. You can use the two arrow keys to move additional weights by motor, thus balancing the carrier arm including the microscope. Continue the balancing process until the carrier arm including the microscope no longer moves upward or downward by itself. Check the balance setting in several positions and readjust, if necessary. The surgical microscope is fully balanced if it remains stationary in every position within the lifting range. The effort required to move it up or down should be the same.

79 Operation 79 1

80 80 Operation Mode 4 Set mode "4" on the control panel of the suspension system. Press the "SB" brake release key on the handgrip of the surgical microscope and hold it down while adjusting the balance setting. Move the carrier arm including the microscope horizontally to the right and left to find out in which direction the system is pulling. Note: If the carrier arm moves to the right, press the balancing key on the control panel. If the carrier arm moves to the left, press the balancing key on the control panel. You can use the two arrow keys to move additional weights by motor, thus balancing the carrier arm including the microscope. Continue the balancing process until the system no longer moves by itself. Check the balance setting in several positions and readjust, if necessary. The surgical microscope is fully balanced if it remains stationary in every position. The effort required to move it to the left and right should be the same.

81 Operation 81

82 82 Operation CH mode (balance check) Set the "CH" mode on the control panel of the suspension system. Warning! If the suspension system has not been fully balanced or not balanced at all, it may happen that the carrier arm and the surgical microscope move uncontrollably upward or downward. To check this, briefly press both balancing keys at the same time. When you release the keys, the magnetic brakes lock all axes in position. Simultaneously press the and balancing keys on the control panel. If fully balanced, the microscope should remain stationary in all positions while you are pressing the two balancing keys. The effort required to position the microscope should be approximately the same in all directions. OP (surgery) mode Set the OP mode on the control panel. You can now drape the system. Caution: Do not cover any ventilation slits or grids with drapes, otherwise the unit will overheat. This will cause the thermal cutout to activate and the unit to switch off. Always use the guard brackets supplied in the delivery package for draping. The system is now ready for use.

83 Operation 83

84 84 Operation Checklist Always check the following points before surgery (without the patient!): OPMI Neuro surgical microscope 1 Pos. 2 Pos. 1 Check the ergonomic position of the handgrips. Make sure that there is enough room between the instrument and the accessories installed and that protective cover (1) is removed from the objective lens. Turn on the system at the power switch of the suspension system. Note: After the system has been switched on, it automatically performs a selftest. The self-test is completed after approx. ten seconds. This is indicated by a short beep. Illumination: The surgical field is evenly illuminated. The S light guide has been connected. Zoom / Focus: Proper function has been tested by operating the relevant keys on the handgrips. Autofocus: The AF function has been tested by operating the relevant keys on the handgrips. Eyepieces / Tiltable binocular tube: Make sure that the tiltable binocular tube is in a position convenient for you. Check that the correct interpupillary distance has been set. Check that the eyecups have been adjusted in such a way that you can see the full field of view. Check that the correct prescription has been set on the diopter scale. Accessories Check that the accessories are functioning correctly. Sliding mirror Set the adjusting knob for the sliding mirror to Pos. 1 if a second binocular tube has been mounted on the 180 tube port. (When a camera is released, the sliding mirror briefly adopts position 2).

85 Operation 85 Set the sliding mirror to Pos. 2 if a coobservation tube or 35 mm camera has been mounted on the side ports. Video / Photo: Check that the handgrip buttons for triggering video or photographic documentation are functioning correctly. NC4 floor stand Always check the following points (without the patient!) before surgery: Balance: The stand has been balanced. See Balancing the NC4 floor stand on page 72. The image quality is excellent throughout the entire magnification range. Using the relevant user's manuals, you have checked that the other equipment (illumination system, video system, etc.) is working properly. Warning! If a function fails, you must not use this instrument for safety reasons. Correct the fault (see the "Troubleshooting table ) or contact our service dept.

86 86 Operation Procedure Switch on the units (the suspension system and the illumination system must be switched on separately). Adjust the brightness of the surgical field illumination on the illumination system as required. Check the system using the checklist. See also page 84. Move the surgical microscope over the surgical field and bring it into a convenient position within the working distance ( mm). Use knob (2) for manual focusing or press the AF key on the hand grips to trigger the autofocus system. Set the magnification as required. Look through both eyepieces and adjust them in such a way that you can see both the edge of the field of view and the image itself sharply. Cover the system with sterile drapes. Adjust illuminated field diameter (3) as required. Switch on auxiliary illumination (1), if necessary. Switch the unit off at the power switch of the carrier system when it is not in use. Warning! Avoid looking directly into the light source, e.g. into the microscope objective lens or into the light guide! Due to the high luminous intensity of the surgical field illumination and the autofocus (laser class 1), the OPMI Neuro microscope must not be used in ophthalmology. The auxiliary illumination must be off if a micromanipulator is used. Otherwise, reflections can occur in the microscope image. The mechanism has been designed in such a way that the auxiliary illumination is automatically switched off when a micromanipulator is connected.