ENDOSCOPES AND INSTRUMENTS FOR CARDIOVASCULAR SURGERY

Transcription

1 ENDOSCOPES AND INSTRUMENTS FOR CARDIOVASCULAR SURGERY 7th EDITION 1/2011 US

2 Important information for U.S. customers Note: Certain devices and references made herein to specific indications of use may have not received clearance or approval by the United States Food and Drug Administration. Practitioners in the United States should first consult with their local KARL STORZ representative in order to ascertain product availability and specific labeling claims. Federal (USA) law restricts certain devices referenced herein to sale, distribution, and use by, or on the order of a physician, dentist, veterinarian, or other practitioner licensed by the law of the State in which she/he practices to use or order the use of the device. Important Notes: Endoscopes and accessories contained in this catalog have been designed in part with the cooperation of physicians and are manufactured by the KARL STORZ group. If subcontractors are hired to manufacture individual components, these are made according to proprietary KARL STORZ plans or drawings. Furthermore, these products are subject to strict quality and control guidelines of the KARL STORZ group. Both contractual and general legal provisions prohibit subcontractors from supplying components manufactured by order of KARL STORZ to competitors. Any assumptions that competitors endoscopes and accessories are acquired from the same suppliers as the KARL STORZ products are not correct. Moreover, endoscopes and instruments provided by competitors are not manufactured according to the design specifications of KARL STORZ. This means it cannot be assumed that these endoscopes and accessories even if they look identical on the outside are constructed in the same manner and have been tested according to the same criteria. Standardized Design and Labeling KARL STORZ participates both in national and international bodies involved in the development of standards for endoscopes and endoscopic accessories. Standardized design and development therefore have long been implemented consistently by KARL STORZ. The user can rest assured that all products by the KARL STORZ group have been designed and constructed not only in compliance with strict internal quality guidelines, but also with international standards. All data relevant for safe use, such as viewing direction, sizes and diameters, or notes regarding sterilization of telescopes, are applied to the instruments, have been formulated according to international standards, and therefore provide reliable information. As we constantly seek to improve and modify our products, we reserve the right to make changes in design that vary from catalog descriptions. Original or Counterfeit KARL STORZ products are name brand articles renowned around the world and represent the state of the art in important areas of healthcare. A large number of copy cat products are currently being offered in many markets. These products are designed intentionally to resemble KARL STORZ products and use marketing strategies that at least point out their compatibility with KARL STORZ products. These products are by no means genuine products, since genuine KARL STORZ products are sold worldwide exclusively under the name of KARL STORZ, which appears on the packaging and the product. In the absence of such labeling, the product is not from KARL STORZ. KARL STORZ, therefore, is unable to ensure that such products are actually compatible with genuine KARL STORZ products or can be used with them without injury to the patient. All pictures, photos and product descriptions are the intellectual property of KARL STORZ GmbH & Co. KG. Utilisation and copies by third parties have to be authorized. All rights reserved. 5-11

3 Chapter Pages 1 BASIC INSTRUMENT SETS SET 1-8 HOPKINS TELESCOPES FOR 2 CA-VA HO CARDIOVASCULAR SURGERY CARDIOTHORACIC RETRACTORS HTS ENDOSCOPIC VESSEL HARVESTING VE-VS MINIMALLY INVASIVE CARDIAC SURGERY VA-RC LAPAROSCOPIC AORTIC SURGERY AI VISUALIZATION SYSTEM FOR MICROSURGERY CA-VA VIS HOLDING SYSTEMS AND TRAINING MODELS VE-HT HEADLIGHTS AND HEADBANDS VE-J UNITS AND ACCESSORIES CARDIO-UNITS-INTRO, CARDIO-UNITS U SPARE PARTS AND ACCESSORIES CARDIO-VAS-SP SP KARL STORZ OR1 ERGONOMICS, SAFETY AND EFFICIENCY IN THE OR 13 TELEPRESENCE, IMAGING SYSTEMS DOCUMENTATION ILLUMINATION VIDEOCARTS 14 CLEANING, STERILIZATION AND MAINTENANCE, CARRYING CASE

4 KARL STORZ Items Not Available in the U.S. April, 2011 Pending 510(k) / PMA not currently available for sale in the U.S. Description Section Page LUTZ Clip Applicator VE-VS Clip, Titanium LT 200 VE-VS 1 48 Deployable Vascular Clamp, Parallel-Action Jaw AI ENDOCRANE Piezoregulated Holding Arm VE-HT 128 Note: References made herein to specific endoscopic procedures or techniques represent the opinions and/or experiences of the named physician(s). KARL STORZ Endoscopy-America, Inc. neither warrants nor represents the appropriateness or efficacy of said procedures. Physicians are encouraged to consult medical literature regarding techniques, compliances, and hazards prior to performance of any endoscopic procedure. Note: Some items are pending 510(k). Please contact KARL STORZ Customer Services at (800) regarding the current regulatory status of products above.

5 TERMS AND CONDITIONS KARL STORZ Endoscopy-America, Inc. 1. ORDERS Orders are to be placed with the Customer Support Department of KARL STORZ Endoscopy-America, Inc. ( KSEA ) or with its sales force. However, orders will only be accepted by KSEA s Customer Support Department in El Segundo, California and only on the condition that in the event of any conflicting, inconsistent and/or additional provisions in a customer purchase order, the within Terms and Conditions will supersede and prevail and such conflicting, inconsistent and/or additional provisions shall be of no force or effect. By accepting delivery of products, and/or the performance of services, from KSEA, and/or by paying for same, Customer agrees that notwithstanding anything to the contrary in Customer s own purchase order, Customer accepts and agrees to the within Terms and Conditions, all of which constitute the sole and entire Agreement of KSEA and Customer, unless and to the extent modified and/or superseded by an agreement in writing signed by both Customer and an authorized representative of KSEA. 2. PRICES Prices are subject to change without notice. Nevertheless, prices in effect at the time that an order is accepted will prevail. Written quotations are valid for 60 days unless otherwise specified. All applicable taxes, as well as shipping and/or handling charges, will be added to the invoice. KSEA reports all discounts in accordance with 42 CFR (h). 3. TERMS Shipments are F.O.B. shipping point, freight prepaid by KSEA and added to the invoice. Unless modified in writing, invoices are due and payable upon receipt; net 30 days. A finance charge may be assessed on all unpaid balances over 30 days equal to one and one-half percent (1-1/2%) per month, or the maximum amount allowed by law, whichever is less. Any and all collection expenses, including reasonable attorneys fees, which are incurred by KSEA to secure payment of any sums due from Customer and/or to effectuate repossession of products purchased from KSEA, but not paid for, will be borne by Customer. All controversies, disputes and claims, shall be adjudicated by a court of competent jurisdiction within the County of Los Angeles, State of California or the United States District Court, Central District of California, which courts shall have exclusive jurisdiction of such matters. All transactions by and between Customer and KSEA shall be governed by and construed in accordance with the laws of the State of California. The invalidity or unenforceability of any of the within Terms and Conditions will not effect the validity or enforceability of any other or remaining Term or Condition hereof. The within Terms and Conditions apply to products that are supplied to Customer as samples or loans from KSEA. Amounts payable to KSEA for the purchase, lease, or rent of products and/or services are not subject to withholding, set-off, or counter-claim under any circumstances without prior written consent of KSEA. 4. SECURITY INTEREST Until Customer has paid KSEA in full for all products purchased pursuant to an order, KSEA shall have, and Customer hereby grants to KSEA, a security interest in all products purchased, pursuant to such order, and in all proceeds therefrom (including that which Customer receives as payment from an insurer or third party for or as a result of any damage to or loss of said products), to secure payment of the entire purchase price for all products sold, shipped and delivered to Customer pursuant to such order, and to secure all costs, expenses or other charges relating thereto which are payable by Customer to KSEA. Customer is required to execute and deliver such documents, as required and requested by KSEA, to perfect KSEA s security interest(s) and Customer authorizes KSEA to prepare, execute, deliver, file and/or record, on behalf of Customer, any and all documents that are required, necessary and/or appropriate to protect, preserve and/or enforce KSEA s security interest(s) in the products sold, shipped and delivered to Customer pursuant to such order. 5. SHIPPING Although KARL STORZ products are carefully packed to minimize in-transit damage, all shipments should be carefully examined upon receipt and if a product is damaged, Customer must document the nature and extent of the damage and immediately contact KSEA. If concealed loss or damage is discovered, Customer must retain all packing materials and immediately notify KSEA, requesting an inspection. If shipments are received short, Customer must contact KSEA s Customer Support Department at once. KSEA reserves the right to make partial shipments on any Order. Invoices for partial shipments are payable upon receipt. KSEA is not liable for any damages caused by or attributable to delays and/or non-delivery due to any cause whatsoever. 6. RETURN POLICY A return merchandise authorization (RMA) must be obtained from KSEA s Customer Support Department prior to returning any products. When phoning or writing KSEA, for an RMA, the Customer Support Representative must be provided with: (1) Customer name and number, as it appears on the invoice; (2) the telephone number and the person to contact; (3) the applicable P.O. number; (4) the KARL STORZ catalog number and, if applicable, the serial number for each product; and, (5) the reason for the return. KSEA reserves the right to refuse or return any products sent back to KSEA without prior authorization of its Customer Support Department. Returns must be carefully packed and shipped pre-paid to KSEA, attn: RMA number. KSEA s Customer Support Department will provide the return address and the RMA number. When returning products, Customer should include a copy of the original invoice or packing slip to ensure prompt issuing of credit. Full credit will only be issued for products that are returned within 30 days of invoice date and so long as such items are unused, in resalable condition and in their original product container. All products returned after 30 days from the date of invoice are subject to a 15% restocking fee. Shipping charges will be reimbursed, restocking fees will not be charged and full credit will be given if the return was due to an error on the part of KSEA. The following products may not be returned for credit or exchanged: (1) products held longer than 90 days from invoice date; (2) sterile packaged products where the package is opened and/or damaged; (3) discontinued products; (4) instruments that are etched or engraved by Customer; (5) products damaged by the Customer; (6) products purchased as is or as demo products; and,(7) used products. In order to prevent the transmission of disease to the medical facilities and/or KSEA s personnel, all products must be cleaned and then sterilized and/or disinfected before sending such products back to KSEA, who reserves the right to return unclean and contaminated products to the Customer. Additionally, if any product becomes damaged and is not immediately returned, KSEA assumes no responsibility or liability for Customer s continued use of that damaged product. KSEA does not guarantee the performance, and may decline to repair or accept for repair/exchange, any product that has been repaired, modified and/or altered by any person or entity other than KSEA or an authorized repair facility of KSEA. PI (03/10)

6 7. REPAIR PROGRAM If repairs become necessary, for other than damages incurred during initial shipment, the Customer must follow the RMA procedure set forth in the "Return Policy" in Section 6, above. Warranty repairs will be made without charge (see "Warranty Policy," section 8 below, for covered repairs). All other repairs are subject to KSEA's applicable standard repair or exchange charges. If requested, Customer will be advised of the estimated cost of the repair work or a product exchange before it is undertaken. All repairs carry a 90 day warranty. Exchange products carry the applicable KARL STORZ product warranty. If the damaged product is not returned within thirty (30) days of receipt of the replacement product, Customer will be invoiced for the full list price of the replacement. KSEA reserves the right to refuse or return any product sent back without prior authorization of KSEA s Customer Support Department. 8. WARRANTY POLICY Except as otherwise provided herein and/or by the applicable warranty information for a specific product or type of product, all KARL STORZbranded products are generally warranted to be in good working order at the date of delivery and free from defects in workmanship and materials for one (1) year from date of delivery. However, since some products carry a shorter or a longer warranty period, Customer should check with KSEA's Customer Support Department or product specific literature, instruction manual and/or labeling for the exact warranty period. Any such product(s) with a defect occurring during the applicable warranty period will be promptly replaced or, at the sole discretion of KSEA, repaired at no charge to Customer. THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESS, IMPLIED AND/OR STATUTORY, INCLUDING, BUT NOT LIMITED TO WARRANTIES OF MERCHANTABILITY, FITNESS AND/OR OF SUITABILITY FOR A PARTICULAR PURPOSE, WITH RESPECT TO ALL KARL STORZ PRODUCTS OR SERVICES. ANY AND ALL OTHER WARRANTIES, REPRESENTATIONS AND/OR GUARANTEES, OF ANY TYPE, NATURE OR EXTENT, BE IT IMPLIED, EXPRESS AND/OR WHETHER ARISING UNDER OR AS A RESULT OF ANY STATUTE, LAW, COMMERCIAL USAGE, CUSTOM, TRADE OR OTHERWISE, ARE HEREBY EXPRESSLY EXCLUDED AND DISCLAIMED. Any contrary course of performance by and between the parties will not modify any representations and/or warranties set forth herein. KSEA neither assumes nor authorizes any person to assume for it any other liabilities in conjunction with and/or related to the sale and/or use of its products. To ensure proper use, handling and care of KARL STORZ products, Customer should consult the product specific literature, instruction manual, and/or labeling included with the product or otherwise available. Repairs, modifications or alterations of KARL STORZ products, performed by any person or entity, other than by KSEA or an authorized repair facility of KSEA, nullifies and otherwise voids all applicable KARL STORZ warranties. Repair or replacement of a KARL STORZ product shall not extend the term of any applicable warranty. The remedies provided herein are Customer's exclusive remedies under this Warranty Policy. 9. LIMITATION OF LIABILITY KSEA is not liable, directly or by way of indemnity, either expressly or impliedly, for: (1) any damages which might arise or be caused, whether by the Customer or by any of the users of the products provided by KSEA, as a result of, in connection with, or otherwise attributable to: (a) misuse, abuse, mishandling and/or improper operation and/or storage; (b) repairs, servicing, modifications and/or alterations performed by any person or entity, other than KSEA or an authorized repair facility of KSEA; (c) use in combination with adaptors, accessories and/or equipment from other manufacturers unless authorized or recommended by KSEA or, (d) use in any manner other than those for which such products are designed and are otherwise intended to be used; and, (2) any special, incidental, consequential, punitive, exemplary or indirect damages, including but not limited to alleged damages for delayed shipment, non-delivery, product failure, product design or production, inability to use such products or services, loss of future business (lost profits), or from any other cause, whatsoever, in connection with or arising from the purchase, sale, lease, rental, installation or use of such KARL STORZ products, even if Customer has been advised of the possibility of such damages. SOME JURISDICTIONS DO NOT ALLOW EXCLUSIONS AND DISCLAIMERS OF CERTAIN WARRANTIES OR LIMITATIONS OF LIABILITY, SO THE LIMITATIONS AND/OR EXCLUSIONS, SET FORTH IN THESE TERMS AND CONDITIONS, MAY NOT APPLY. IN THAT EVENT, KSEA S LIABILITY WILL BE LIMITED TO THE GREATEST EXTENT PERMITTED BY LAW IN THE SUBJECT JURISDICTION. 10. SOFTWARE OWNERSHIP AND LICENSING With respect to products provided by KARL STORZ and containing software components, Customer is granted a non-exclusive, limited, nontransferable license (the License ) to use the programmed logic, computer programs and/or software, including software developed by or on behalf KARL STORZ ( KARL STORZ Software ) and/or software developed by or on behalf of a third party ( Third Party Software ) (collectively, Software ) embedded in, or for use in conjunction with, such products, internally, but only in the form in which delivered to Customer and for the sole purpose of operating in accordance with KARL STORZ' written instructions for the products provided to Customer (and for no other product or purpose). The Software, and all modifications, enhancements and upgrades thereto, will, at all times, remain the property of KARL STORZ or the applicable third party. Customer may not duplicate, copy, reverse-engineer, de-compile, or disassemble the Software or in any way modify the Software. Customer has no right to, and may not, create derivatives of the Software, and Customer may not attempt to copy, create or re-create the source code of the Software. Any and all such modifications or enhancements to the Software by Customer, in contravention of this License, will immediately become the sole property of KARL STORZ. Customer hereby acknowledges and agrees that (i) the purchase, lease or other acquisition of products does not constitute a transfer of the Software, (ii) the Software is the property of KARL STORZ or the applicable third party, (iii) Customer neither owns nor acquires any interest in any copyright, patent or other intellectual property right in or to the Software as a result of such purchase, lease or other acquisition of products, (iv) KARL STORZ, or the applicable third party, retains and owns all right, title, and interest in and to the Software and the ownership rights therein, at all times, regardless of the form or media in or on which the original or other copies of the Software may exist, and (v) by using the products, Customer is subject to, and is bound by, the terms of any separate third-party license agreement relating to the Third Party Software. In the event of a failure of Customer or its agents, employees or representatives, to comply with any terms and conditions of the License herein granted, the License will, without any further action by KARL STORZ or any other party, immediately end and terminate. PI (03/10)

7 BASIC INSTRUMENT SETS CHAPTER

8 Laparoscopic Aortic Surgery Basic Instrument Set CHAPTER 6 Set recommended by Prof. KOLVENBACH FA HOPKINS II Telescope 45, enlarged view, diameter 10 mm, length 31 cm, autoclavable 6x MC Trocar, size 11 mm including: Cannula, without valve, size 11 mm, working length 10.5 cm Trocar only, with conical tip Multifunctional Valve, size 11 mm 3x DB Reduction Sleeve, 11/ S Pistol Grip Handle, for suction and irrigation SC Suction and Irrigation Tube, size 5 mm, length 36 cm LH Suction and Irrigation Tube, with lateral holes, size 10 mm, length 36 cm DF c Dissecting and Grasping Forceps, rotating, without ratchet, with connector pin for unipolar coagulation KW c MATKOWITZ Grasping Forceps, rotating, without ratchet, with connector pin for unipolar coagulation 2x ML c KELLY Dissecting and Grasping Forceps, rotating, without ratchet, with connector pin for unipolar coagulation MA c Scissors, rotating, serrated, curved, spoon-shaped blades, without ratchet, with connector pin for unipolar coagulation P c Potts Scissors, rotating, angled 45, pointed, size 10 mm, length 36 cm including: Metal Handle, without ratchet Metal Outer Sheath Scissors Insert PA c Potts Scissors, rotating, angled 30, blunt, size 10 mm, length 36 cm including: Metal Handle, without ratchet Metal Outer Sheath Scissors Insert 2x ON c Grasping Forceps, rotating, single action jaws, with especially fine atraumatic serration, fenestrated, with ratchet, without connector pin for unipolar coagulation DY c DeBAKEY Grasping Forceps, rotating, single action jaws, atraumatic, with ratchet, without connector pin for unipolar coagulation WS c Scissors, rotating, single action jaws, robust, with cylindrical grinding, diameter 10 mm, length 36 cm including: Metal Handle, without ratchet Outer Sheath Scissors Insert GS c Spoon Forceps, rotating, single action jaws, size 10 mm, length 36 cm including: Metal Handle, without ratchet Outer Sheath Forceps Insert BL c DeBAKEY Grasping Forceps, rotating, jaws curved to left, size 10 mm, length 36 cm including: Metal Handle, with hemostat style ratchet Metal Outer Sheath Forceps Insert DD c Grasping Forceps, rotating, to hold the deployable vascular clamp, size 10 mm, length 36 cm including: Metal Handle, without ratchet Metal Outer Sheath Forceps Insert DA Vascular Clamp Applicator, size 10 mm, length 32 cm, for use with Deployable Vascular Clamps DB and DC including: Inner Rod Outer Sheath DB Deployable Vascular Clamp, single action jaws, length of jaws 5 cm, size 10 mm, total length 11 cm, for use with Vascular Clamp Applicator DA DC Deployable Vascular Clamp, parallel-action jaws, length of jaws 5 cm, size 10 mm, total length 13 cm, for use with Vascular Clamp Applicator DA SET 2

9 Laparoscopic Aortic Surgery Basic Instrument Set MD RoBi KELLY Dissecting and Grasping Forceps, CLERMONT-FERRAND model, rotating, with connector pin for bipolar coagulation SB SATINSKY Laparoscopic Clamp, long version, length of jaws 10 cm, depth of jaws 2.5 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm 2x SS Laparoscopic Vascular Clamp, straight jaws, length of jaws 7 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm 2x VC Vascular Cross Clamp, jaws slightly curved, length of jaws 5 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm RAO KOH Macro Needle Holder, with tungsten carbide inserts, jaws curved to right, with ratchet, size 5 mm, length 33 cm LAO KOH Macro Needle Holder, with tungsten carbide inserts, jaws curved to left, with ratchet, size 5 mm, length 33 cm VR Retractor, dismantling, with variable curvature, blunt, size 10 mm, length 36 cm GH Palpation Hook, hook angled 90, blunt, diameter 5 mm, working length 36 cm DO BERCI Micro Knife, pointed, distendable, size 5 mm, length 31 cm DE Laparoscopic Scalpel, round, size 5 mm, length 30 cm FP Fan Retractor, dismantling, distendable, diameter 10 mm, length 36 cm 2x PT Surgical Sponge Holder, self-retaining, size 10 mm, length 30 cm KGB Holding System, L-shaped CHAPTER 6 / 10 Units and Accessories: 9526 NB 26" KARL STORZ HD Flat Screen Cold Light Fountain XENON 300 SCB 495 NCS Fiber Optic Light Cable, extremely heat-resistant, diameter 4.8 mm, length 250 cm U102 IMAGE 1 HUB HD Camera Control Unit SCB, with SDI module IMAGE 1 H3-Z Three-Chip HD Camera Head KARL STORZ AIDA compact NEO HD Communication HAMOU ENDOMAT SCB Electronic CO 2 ENDOFLATOR SCB, accessories optional AUTOCON II 400 SCB, High-End, accessories optional Neutral Electrode Neutral Electrode Connecting Cable M Unipolar High Frequency Cable LE Bipolar High Frequency Cable Two-Pedal Footswitch LAP Mobile Videocart HFH Double Pedal Holder, suspended, for mounting to normal rails, suitable for two-pedal footswitch of high frequency surgery units AUTOCON II 400 SCB and Erbe Vio HFS Double Pedal Holder, for mounting to videocart side boom, models xx and xx, suitable for two-pedal footswitch, for use with AUTOCON 50/200/350, AIDA, TELE PACK, GASTRO PACK and all KARL STORZ motor systems SET 3 3

10 Laparoscopic Aortic Surgery Basic Instrument Set CHAPTER 6 COGGIA Recommended Set BA HOPKINS II Forward-Oblique Telescope 30, enlarged view, diameter 10 mm, length 31 cm, autoclavable FA HOPKINS II Telescope 45, enlarged view, diameter 10 mm, length 31 cm, autoclavable A Trocar only, with blunt tip LA Trocar, size 11 mm including: Cannula, with insufflation stopcock, working length 10.5 cm Trocar only, with blunt tip Multifunctional Valve, size 11 mm 6x MP Trocar, size 11 mm including: Cannula, with insufflation stopcock, working length 10.5 cm Trocar only, with pyramidal tip Multifunctional Valve, size 11 mm MA Trocar, size 13 mm including: Cannula, without valve, working length 11.5 cm Trocar only, with blunt tip Multifunctional Valve, size 13 mm 2x DB Reduction Sleeve, 11/5 mm 6x DB Reducer, 11/5 mm HB Double Reducer, 13/10, 13.5/10, 13/5 and 13.5/5 mm NG COGGIA Needle Holder, jaws with tungsten carbide inserts, conical and tapered jaws, axial ring handle with hemostat style ratchet, size 10 mm, length 33 cm 2x NC COGGIA Needle Holder, jaws with tungsten carbide inserts, conical and tapered jaws, axial ring handle with hemostat style ratchet, size 5 mm, length 33 cm 2x SS Vascular Clamp, straight jaws, length of jaws 7 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm 3x VC Vascular Clamp, jaws slightly curved, length of jaws 5 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm 2x P c Potts Scissors, rotating, angled 45, pointed, size 10 mm, length 36 cm including: Metal Handle, without ratchet Metal Outer Sheath Scissors Insert ON c Grasping Forceps, rotating, with especially fine atraumatic serration, fenestrated, without ratchet, with connector pin for unipolar coagulation 2x MA c Scissors, rotating, spoon-shaped blades, serrated, curved, without ratchet, with connector pin for unipolar coagulation MA c Scissors, rotating, spoon-shaped blades, serrated, curved, without ratchet, with connector pin for unipolar coagulation ML c KELLY Dissecting and Grasping Forceps, rotating, without ratchet, with connector pin for unipolar coagulation 3x ON c Grasping Forceps, rotating, with especially fine atraumatic serration, fenestrated, without ratchet, with connector pin for unipolar coagulation DO BERCI Micro Knife, pointed, distendable, size 5 mm, length 31 cm KLA Holding System, straight FP Fan Retractor, dismantling, distendable, diameter 10 mm, length 36 cm S Pistol Grip Handle, for suction and irrigation LH Suction and Irrigation Tube, with lateral holes, size 5 mm, length 36 cm SC Suction and Irrigation Tube, size 5 mm, length 36 cm SET 4

11 Laparoscopic Aortic Surgery Basic Instrument Set Units and Accessories: 9526 NB 26" KARL STORZ HD Flat Screen Cold Light Fountain XENON 300 SCB 495 NCS Fiber Optic Light Cable, extremely heat-resistant, diameter 4.8 mm, length 250 cm U102 IMAGE 1 HUB HD Camera Control Unit SCB, with SDI module IMAGE 1 H3-Z Three-Chip HD Camera Head KARL STORZ AIDA compact NEO HD Communication HAMOU ENDOMAT SCB Electronic CO 2 ENDOFLATOR SCB, optional accessories AUTOCON II 400 SCB, High-End, optional accessories Neutral Electrode Neutral Electrode Connecting Cable M Unipolar High Frequency Cable LE Bipolar High Frequency Cable Two-Pedal Footswitch LAP Mobile Videocart HFH Double Pedal Holder, suspended, for mounting to normal rails, suitable for two-pedal footswitch of high frequency surgery units AUTOCON II 400 SCB and Erbe Vio HFS Double Pedal Holder, for mounting to videocart side boom, models xx and xx, suitable for two-pedal footswitch, for use with AUTOCON 50/200/350, AIDA, TELE PACK, GASTRO PACK and all KARL STORZ motor systems CHAPTER 10 SET 5 5

12 Endoscopic Vessel Harvesting Basic Instrument Set CHAPTER 4 / 10 Endoscopic Radial Artery Harvesting Set recommended by Dr. BISLERI FCZ BISLERI Endoscopic Radial Artery Retractor, for harvesting the arteria radialis, distal width 20 mm, working length 27.5 cm, with U-shaped instrument guiding channel, with integrated channel for smoke evacuation, with integrated guide in the handle for fiber optic light cable, autoclavable, including cleaning adaptor FA HOPKINS II Forward-Oblique Telescope 45, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: black VR Artery Dissector, blunt, distal angled to right, autoclavable, size 3 mm, working length 41 cm VL Artery Dissector, blunt, distal angled to left, autoclavable, size 3 mm, working length 41 cm MS RoBi METZENBAUM Scissors, CLERMONT-FERRAND model, rotating, dismantling, with connector pin for bipolar coagulation, double action jaws, curved jaws, size 5 mm, length 43 cm CS RoBi Grasping Forceps, CLERMONT-FERRAND model, small jaws, size 5 mm, length 43 cm, for dissecting, grasping, and bipolar coagulation of fine structures AE Endo-Loop Ligature, with ROEDER knot, for bleeding stumps, with absorbable synthetic suture, for single use, sterile, USP 0, size 3 mm, length 33 cm, package of HH GILBERT Hand Holder, for fixation of the hand during carpal ligament release FISCH Retractor, articulated, 3x 3 prongs, semisharp, length 17 cm Surgical Handle, Fig. 3, length 12.5 cm Blade, Fig. 10, non-sterile, package of ATRAUMA Atraumatic Tissue Forceps, length 16 cm TOENNIS Dissecting Scissors, fine model, straight, blunt/blunt, length 18 cm Units and Accessories: 9526 NB 26" KARL STORZ HD Flat Screen Cold Light Fountain XENON 300 SCB 495 NA Fiber Optic Light Cable, with straight connector, diameter 3.5 mm, length 230 cm U102 IMAGE 1 HUB HD Camera Control Unit SCB, with SDI module IMAGE1 H3-Z Three-Chip HD Camera Head KARL STORZ AIDA compact NEO HD Communication HAMOU ENDOMAT SCB Electronic CO 2 ENDOFLATOR SCB, accessories optional AUTOCON II 400 SCB, High-End, accessories optional Neutral Electrode Neutral Electrode Connecting Cable M Unipolar High Frequency Cable LE Bipolar High Frequency Cable Two-Pedal Footswitch LAP Mobile Videocart HFH Double Pedal Holder, suspended, for mounting to normal rails, suitable for two-pedal footswitch of high frequency surgery units AUTOCON II 400 SCB and Erbe Vio HFS Double Pedal Holder, for mounting to videocart side boom, model xx and xx, suitable for two-pedal footswitch, for use with AUTOCON 50/200/350, AIDA, TELE PACK, GASTRO PACK and all KARL STORZ motor systems SET 6

13 Endoscopic Vessel Harvesting Basic Instrument Set Endoscopic Saphenous Vein Harvesting Set recommended by Dr. LUTZ FDZ Endoscopic Vein Retractor, FREIBURG model, for harvesting the great saphenous vein, enhanced telescope guiding channel, distal width 25 mm, working length 27 cm, with integrated guide in handle for fiber optic light cable, autoclavable, including cleaning adaptor FA HOPKINS II Forward-Oblique Telescope 45, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: black VD Vein Dissector, blunt, distal angled to right, autoclavable, size 3 mm, working length 41 cm MW RoBi METZENBAUM Scissors, CLERMONT-FERRAND model, rotating, dismantling, with connector pin for bipolar coagulation, double action jaws, curved jaws, slender blades, for cutting and bipolar coagulation, size 5 mm, length 43 cm L LUTZ Clip Applicator, rotating, angled jaws, working length 43 cm, for use with Clips 8665 T 8665 T Clip, titanium LT 200, medium, sterile, 5 mm, package of 36 cartridges with 6 clips each FG RoBi LUTZ Grasping Forceps, rotating, dismantling, with connector pin for bipolar coagulation, double action jaws, width 2 mm, distally angled 45, for grasping and coagulation of vessels, size 5 mm, length 43 cm Surgical Handle, Fig. 3, length 12.5 cm Blade, Fig. 10, non-sterile, package of ATRAUMA Atraumatic Tissue Forceps, length 16 cm TOENNIS Dissecting Scissors, fine model, straight, blunt/blunt, length 18 cm CHAPTER 4 / 10 Units and Accessories: 9526 NB 26" KARL STORZ HD Flat Screen Cold Light Fountain XENON 300 SCB 495 NA Fiber Optic Light Cable, with straight connector, diameter 3.5 mm, length 230 cm U102 IMAGE 1 HUB HD Camera Control Unit SCB, with SDI module IMAGE1 H3-Z Three-Chip HD Camera Head KARL STORZ AIDA compact NEO HD Communication HAMOU ENDOMAT SCB Electronic CO 2 ENDOFLATOR SCB, accessories optional AUTOCON II 400 SCB, High-End, accessories optional Neutral Electrode Neutral Electrode Connecting Cable M Unipolar High Frequency Cable LE Bipolar High Frequency Cable Two-Pedal Footswitch LAP Mobile Videocart HFH Double Pedal Holder, suspended, for mounting to normal rails, suitable for two-pedal footswitch of highfrequency surgery units AUTOCON II 400 SCB and Erbe Vio HFS Double Pedal Holder, for mounting to videocart side boom, model xx and xx, suitable for two-pedal footswitch, for use with AUTOCON 50/200/350, AIDA, TELE PACK, GASTRO PACK and all KARL STORZ motor systems SET 7 7

14

15 HOPKINS TELESCOPES FOR CARDIOVASCULAR SURGERY n HOPKINS TELESCOPES ENDOCAMELEON n FIBER OPTIC LIGHT CABLES 16

16 n HOPKINS II Telescopes Diameter 2 mm, length 26 cm AA AA HOPKINS II Straight Forward Telescope 0, diameter 2 mm, length 26 cm, autoclavable, fiber optic light transmission incorporated, color code: green BA HOPKINS II Forward-Oblique Telescope 30, diameter 2 mm, length 26 cm, autoclavable, fiber optic light transmission incorporated, color code: red Fiber Optic Light Cables 495 NT/NTA recommended Diameter 3.3 mm, length 25 cm AA AA HOPKINS II Straight Forward Telescope 0, enlarged view, diameter 3.3 mm, length 25 cm, autoclavable, fiber optic light transmission incorporated, color code: green BA HOPKINS II Forward-Oblique Telescope 30, enlarged view, diameter 3.3 mm, length 25 cm, autoclavable, fiber optic light transmission incorporated, color code: red FA HOPKINS II Telescope 45, enlarged view, diameter 3.3 mm, length 25 cm, autoclavable, fiber optic light transmission incorporated, color code: black Fiber Optic Light Cables 495 NL/NA/ND recommended For fiber optic light cables for use with HOPKINS II telescopes see page CA-VA HO 2

17 HOPKINS II Telescopes n Diameter 5 mm, length 24 cm BA AA HOPKINS II Straight Forward Telescope 0, enlarged view, diameter 5 mm, length 24 cm, autoclavable, fiber optic light transmission incorporated, color code: green BA HOPKINS II Forward-Oblique Telescope 30, enlarged view, diameter 5 mm, length 24 cm, autoclavable, fiber optic light transmission incorporated, color code: red Fiber Optic Light Cables 495 NL/NA/ND recommended Diameter 5 mm, length 29 cm AA AA HOPKINS II Straight Forward Telescope 0, enlarged view, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: green BA HOPKINS II Forward-Oblique Telescope 30, enlarged view, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: red FA HOPKINS II Telescope 45º, enlarged view, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: black Fiber Optic Light Cables 495 NL/NA/ND recommended Container for sterilization and storage of telescopes see catalog ENDOPROTECT1 CA-VA HO 3 11

18 HOPKINS II Telescopes n Diameter 10 mm, length 31 cm AA AA HOPKINS II Straight Forward Telescope 0, enlarged view, diameter 10 mm, length 31 cm, autoclavable, fiber optic light transmission incorporated, color code: green BA HOPKINS II Forward-Oblique Telescope 30, enlarged view, diameter 10 mm, length 31 cm, autoclavable, fiber optic light transmission incorporated, color code: red FA HOPKINS II Telescope 45, enlarged view, diameter 10 mm, length 31 cm, autoclavable, fiber optic light transmission incorporated, color code: black Fiber Optic Light Cables 495 NB/NCS/NE recommended Units and accessories see chapter 10, UNITS 12 CA-VA HO 4

19 ENDOCAMELEON n CA-VA HO 5 13

20 n ENDOCAMELEON Telescope with variable direction of view Until now, surgeons had to choose in advance which telescope or direction of view to use in a procedure. However, surgeons were restricted to the selected direction of view throughout surgery or had to perform an intraoperative telescope change during the procedure. To prevent this predicament in the future, we developed the ENDOCAMELEON : a telescope that allows you to adjust the desired direction of view also during surgery between 0 and 120. The ENDOCAMELEON combines the user comfort of the proven 0 HOPKINS telescope with the advantages and potential of a telescope featuring a variable direction of view offering you the quality you expect from KARL STORZ telescopes. The innovative ENDOCAMELEON technology is not difficult to use and, due to the external moving parts, does not take up extra intracorporal space. Handling remains straightforward and ergonomic. Image alignment is the same as rigid telescopes: the direction of view is selected by simply turning the adjustment knob, making the system very intuitive to use. As the ENDOCAMELEON is equipped with a standard eyepiece, the variable direction of view benefits all standard camera systems. Thanks to the HOPKINS rod lens system, ENDOCAMELEON also offers image quality that enables a useful application of three-chip cameras or HD camera systems. To have the direction of view best suited for each situation available at all times offers the surgeon a higher degree of safety. With the ENDOCAMELEON visual inspection of the entire surgical field is easily achieved. Control over instrument movement is possible throughout the entire procedure and hemorrhages can be visualized and controlled even in previously inaccessible areas. With a simple turn of the adjusting knob, the ENDOCAMELEON enables the user to easily select the direction of view between 0 and 120 to suit all OR requirements. ENDOCAMELEON with variable direction of view, lateral view ENDOCAMELEON with variable direction of view, isometric view CA-VA HO 6

21 ENDOCAMELEON n Diameter 10 mm, length 32 cm Special Features: Variable direction of view HOPKINS telescope with unique rod lens system Easy-to-use adjusting knob for selecting the direction of view Rigid sheath with a diameter of 10 mm AE AE ENDOCAMELEON HOPKINS Telescope, diameter 10 mm, length 32 cm, autoclavable, variable direction of view 0 120, with adjusting knob for selecting the direction of view, fiber optic light transmission incorporated, color code: gold Mitral valve reconstruction Fiber Optic Light Cables 495 NB/NCS/NE recommended CA-VA HO 7 15

22 Fiber Optic Light Cables Light Cable and Endoscope Combined Fiber Optic Light Cables with Straight Connectors 495 NT Fiber Optic Light Cable, diameter 2.5 mm, length 180 cm 495 NTA Fiber Optic Light Cable, diameter 2.5 mm, length 230 cm 495 NL Fiber Optic Light Cable, diameter 3.5 mm, length 180 cm 495 NA Fiber Optic Light Cable, diameter 3.5 mm, length 230 cm 495 ND Fiber Optic Light Cable, diameter 3.5 mm, length 300 cm 495 NB Fiber Optic Light Cable, diameter 4.8 mm, length 180 cm 495 NCS Fiber Optic Light Cable, extremely heat-resistant, diameter 4.8 mm, length 250 cm 495 NE Fiber Optic Light Cable, diameter 4.8 mm, length 300 cm Endoscope diameter mm Endoscope diameter mm Endoscope diameter mm Please note: The high light concentration at the end of the light cable causes heat to be generated in the focal point. The end of the light cable should never be placed on the patient's drape or skin as long as the cold light fountain is turned on, since the light intensity could cause burns in the patient or set the drape on fire. Sterilization and Disinfection: The fiber optic light cables can be sterilized in the autoclave at 273 F (134 C). Gas sterilization is recommended and chemical disinfection is possible. Adaptors for connecting KARL STORZ fiber optic light cables with endoscopes and light sources from other manufacturers see catalog TELEPRESENCE CA-VA HO 10

23 CARDIOTHORACIC RETRACTORS SCHÖLLHORN MULTI-RETRACTOR MIDCAB RETRACTOR n 28 SCHÖLLHORN VARIO-RETRACTORS RIB SPREADERS 32

24 SCHÖLLHORN Multi-Retractor The Modular Retractor System for Modern Heart Surgery During recent years, great strides have been made in cardiac surgery. Techniques used today would have been inconceivable just a few years ago. Who would have thought some time ago that coronary revascularization would be possible in a beating heart without a heart-lung machine? Using suitable stabilizers, newly established techniques are now used in this field to locally immobilize the beating heart for suturing anastomoses. This permits coronary revascularization without the use of a heart-lung machine. This is especially beneficial for specific indications; for example, to reduce the increased neurological risk associated with the use of heart-lung machines in patients with arteriosclerotically altered aortas. Another possible indication would be cosmetically improved outcomes achieved with a lateral approach via an anterolateral thoracotomy for treating the anterior sidewall. But this method can also be used to address specific problems. If, for example, after prior surgery with intact bypasses to the anterior wall, the posterior wall must be revascu-larized, an isolated revascularization of the posterior wall can also be performed here via a lateral thoracotomy of the beating heart. The heart hereby need not be completely detached from its adhesions, which would jeopardize the intact bypasses. The general name used to describe these procedures is OPCAB (or Off-Pump Coronary Artery Bypass). OPCAB is therefore the general term for all procedures in which coronary arteries are revascularized without using a heart-lung machine. The more specific term MIDCAB (or Minimal Invasive Direct Coronary Artery Bypass) describes the technique in which the smallest incisions in conjunction with an anterolateral approach, as described above, are able to deliver favorable cosmetic outcomes. This technique has been established as an option for treating the anterior sidewall; for example, in cases where an interventional technique like PTCA (or Percutaneous Transluminal Coronary Angioplasty) would pose a higher risk. All of these techniques require new retractor systems, since they would be impossible to perform with a conventional, standard retractor. The retractor systems available on the market so far are in most cases rather complicated and, due to market policy in the initial phase of these techniques, only can be used once since they cannot be cleaned or sterilized. These techniques therefore in most cases do not reduce costs, but rather increase them. Another important trend in modern coronary bypass surgery is the use of arteries as bypass grafts. While the left internal mammary artery (LIMA) has commonly been used for this purpose for many years, the right internal mammary artery (RIMA) could be used very advantageously also. In order to provide the same harvesting quality for the LIMA as for the RIMA, it would be reasonable to use a retractor system for harvesting the RIMA that is an exact mirror image of the one used for harvesting the LIMA. Since a RIMA harvest with a retractor designed for LIMA harvest is possible, but in most cases will result in compromises with inadequate outcomes, the trend towards a routine revascularization using mostly or even completely arterial grafts appears to make rather slow progress. So far, no retractor designed specifically for harvesting the right IMA has been available on the market. As already suggested above, cosmetic outcomes also rightfully play a major part in current surgery. The retractor system therefore should be able to adapt to the incision length necessary for the planned procedure, not vice versa. This is the only way that a retractor system can also be used for small skin incisions, such as for example for a mini-sternotomy in which only half of the sternum length is distracted. A retractor system also should be able to permit an atraumatic, minimally invasive distraction in order to prevent bone or soft tissue damage. This also can only be achieved if the retractor system can be adapted to the existing conditions. The standardized retractor system is rounded off with what we believe to be a very innovative way of exposing the mitral valve the adjustable angle of inclination of the mitral hook allows the atrium to be held on the hook. What's more, when the angle is set accordingly, an optimal view of the entire mitral valve is provided HTS 2

25 SCHÖLLHORN Multi-Retractor The Modular Retractor System for Modern Heart Surgery These diverse tasks require an equivalent number of different retractor systems. To limit the number of different instruments required, we have attempted to develop a concept able to solve all of these tasks with one common retractor system. Its modular construction makes it possible to push the required elements onto the retractor system in order to customize it for the specific requirements of each surgical field. This retractor system also makes it possible to use all described modern surgical techniques under optimum conditions. The individual components can be combined into the types of retractors presented on the following pages. Dr. J. SCHÖLLHORN, Chirurgische Universitätsklinik, Abteilung Herz- und Gefäßchirurgie, Freiburg, Germany Fig. 1: IMA extension Fig. 2: Mitral valve extension Fig. 3: OPCAB extension Fig. 4: MIDCAB extension HTS 3 19

26 SCHÖLLHORN Multi-Retractor Basic Model Standard Retractor To assemble a standard retractor, freely movable blades are pushed onto the retractor platform, whereby the blade positions can be continuously adjusted. The fixation of the blades is a result of the application of the retractor in combination with the contact surface of the blade with the tissue to be retracted. The offset construction of pivot point and movement axis of a blade holder made it possible to design the blade holder with an advantageous low profile, and the retractor platform is somewhat offset laterally. Given the best possible placement of the blade elements on the retractor platform, the retractor thus moves into the background and provides optimum, unhindered, free access to the surgical field. The fact that the blade elements can be placed freely and adjusted continuously also makes it possible to distract the sternum for the most part in the caudal half. In this way, the cranial half is subject to less distraction, which protects the plexus brachialis. In order to accommodate both slim and obese patients, blades are available not only with a standard height of 4 cm, but also with a height of 3 cm and 5 cm. The blades each are 4 cm wide. This basic retractor therefore can be used gently and is ideally customized for the required conditions B B SCHÖLLHORN Standard Retractor including: Retractor Frame, 25 x 22 cm, including Lever BS Lever, spare part 4x Moveable Blade, freely adjustable, height 30 mm 4x Moveable Blade, freely adjustable, height 40 mm 4x Moveable Blade, freely adjustable, height 50 mm 7-04 Components see chapter 11, SPARE PARTS AND ACCESSORIES 20 HTS 4

27 SCHÖLLHORN Multi-Retractor Extension IMA Retractor The critical advantage of the IMA retractor is that this retractor system can be assembled in the manner of a mirror image and therefore allows the same good adjustment conditions for harvesting both the LIMA and the RIMA. With respect to technology this was achieved by ensuring that the retractor key is able to engage with both sides of the retractor platform, and that the necessary retractor elements can be pushed onto this platform in a reversed manner. The required surgical field can be well exposed simply based on the construction of the suspension mechanism of the IMA Retractor plate in combination with the counter pressure plate. An especially provided rack for this purpose makes it possible to provide further elevation, if necessary. Suitable surface properties ensure a stable seat of the elements in the positioned retractor system, both with respect to the elevating plate and the blades LIMA D RIMA D IMA Extension including: IMA Elevating Plate IMA Holding Device, for Elevating Plate DE Rack, for Holding Device DH IMA Counter Pressure Plate Components see chapter 11, SPARE PARTS AND ACCESSORIES HTS 5 21

28 SCHÖLLHORN Multi-Retractor Extension Mitral Valve Retractor Hooks were developed with hook surfaces that can be bent by using the retractor lever. The contact surface length of the hooks also is available in lengths of 4 and 5 cm. This also realizes the basic concept of the retractor system, i.e., to be able to adapt the retractor to specific existing conditions. Depending on the desired pulling direction, these atrium hooks then can be inserted into a holding device provided for this purpose. Once inserted in the holding device, they can still be adjusted in height as desired K K Mitral Valve Extension 1 2 including: Holding Device, for mitral valve retractors 2x Mitral Valve Retractor, hook length 40 mm 2x Mitral Valve Retractor, hook length 50 mm 7-04 Components see chapter 11, SPARE PARTS AND ACCESSORIES 22 HTS 6

29 SCHÖLLHORN Multi-Retractor Extension OPCAB Stabilizer The stabilizer can be attached to the retractor s platform system as desired to stabilize the target region of the heart for coronary anastomosis. Two stabilizer systems are available: one system achieves stabilization through moderate compression to the epicardial surface whereas the other system uses a heart holding device to ensure that the heart remains in the required position. This means that both the anterior sidewall and the posterior wall can be appropriately stabilized OPCAB Extension SD OPCAB Stabilizer Arm, compression-based H Heart Holding Device, with three malleable blades, with central fixation mechanism HTS 7 23

30 SCHÖLLHORN Multi-Retractor Extension MIDCAB Retractor The lateral approach for coronary bypass surgery with the internal mammary artery also requires a special retractor system for harvesting this artery. To accomplish this, a special retractor that can be pushed onto the retractor platform in the same way as the other elements was developed, making it possible to perform even such a specialized task with the same retractor system. The same stabilizer system described for the OPCAB technique above then can be used for the following coronary anastomosis M M MIDCAB Extension including: MIDCAB Elevating Frame Holder MIDCAB Elevating Frame, for Elevating Plate MP MIDCAB Elevating Plate MIDCAB Counter Blade, height 30 mm MIDCAB Counter Blade, height 40 mm 7-04 Components see chapter 11, SPARE PARTS AND ACCESSORIES 24 HTS 8

31 SCHÖLLHORN Multi-Retractor Extension Fiber Optic Light Carrier Especially when an anterolateral approach is chosen for harvesting the mammary artery or when replacing or repairing a mitral valve, the surgical field must be properly illuminated. Because of the small surgical field, this can only be achieved with a head lamp or a light source inside the surgical field. This led to the development of a special, fiber optic light carrier connected to a matching light source. This light carrier can be introduced directly into the surgical field, ensuring optimum illumination of the surgical conditions. This additional lighting can be inserted in any position and therefore is able to also optimize the illumination of the surgical field under different circumstances LS LS Fiber Optic Light Carrier Extension including: 1 2 Fiber Optic Light Carrier, malleable, for illumination of the operating field Universal Holding Device, for Fiber Optic Light Carrier L, for use with rectangular retractor frames with profile min. 5 x 15 mm to max. 8 x 34 mm and round components with profile min. 10 to max. 16 mm 7-04 Components see chapter 11, SPARE PARTS AND ACCESSORIES HTS 9 25

32 SCHÖLLHORN Multi-Retractor Extension Extension Frame In certain cases, there is not enough space on the opposite side of the retractor frame to attach the OPCAB stabilizer, the fiber optic light carrier or other components. Therefore an extension frame was designed which can be easily attached to the retractor frame which, fixed in position with 2 screw fittings, acts as a stable fourth side enabling further components to be introduced to the operative site W W Extension Frame, attachable to Retractor Frame BR HTS 10

33 SCHÖLLHORN Multi-Retractor Set SCHÖLLHORN Multi-Retractor, complete set including: B SCHÖLLHORN Standard Retractor including: Retractor Frame, 25 x 22 cm, including Lever BS Lever, spare part 4x Moveable Blade, freely adjustable, height 30 mm 4x Moveable Blade, freely adjustable, height 40 mm 4x Moveable Blade, freely adjustable, height 50 mm D IMA Extension including: IMA Elevating Plate IMA Holding Device, for Elevating Plate DE Rack, for Holding Device DH IMA Counter Pressure Plate SD OPCAB Stabilizer Arm, compression-based H Heart Holding Device, with three malleable blades, with central fixation mechanism K Mitral Valve Extension including: Holding Device, for mitral valve retractors 2x Mitral Valve Retractor, hook length 40 mm 2x Mitral Valve Retractor, hook length 50 mm M MIDCAB Extension including: MIDCAB Elevating Frame Holder MIDCAB Elevating Frame, for Elevating Plate MP MIDCAB Elevating Plate MIDCAB Counter Blade, height 30 mm MIDCAB Counter Blade, height 40 mm LS Fiber Optic Light Carrier Extension including: Fiber Optic Light Carrier, malleable, for illumination of the operating field Universal Holding Device, for Fiber Optic Light Carrier L, for use with rectangular retractor frames with profile min. 5 x 15 mm to max. 8 x 34 mm and round components with profile min. 10 to max. 16 mm W Extension Frame, attachable to Retractor Frame BR 7-04 Components see chapter 11, SPARE PARTS AND ACCESSORIES HTS 11 27

34 MIDCAB Retractor for use in MIDCAB interventions Considerable advances have been made in minimally invasive cardiac surgery in recent years. In addition to atraumatic and minimally invasive distraction, another indication is the further improvement of the cosmetic outcome via a lateral approach. Favorable cosmetic results can be achieved with the aid of the MIDCAB or Minimally Invasive Direct Coronary Artery Bypass technique with an anterolateral approach via a 5 7 cm incision. This techique requires a retractor system that can adapt to anatomical conditions, enabling satisfactory distraction of the operating site and providing the surgeon with greater freedom of movement. The MIDCAB retractor is a smaller version of the SCHÖLLHORN standard retractor and is used in conjunction with MIDCAB Extension M. Alternatively, the MIDCAB retractor with two movable blades can be used for minithoracotomy. Tissue distraction is atraumatic to prevent bone or soft tissue damage. Special Features: Shorter retractor frame for thoracic approach For use with MIDCAB Extension M For use in minithoracotomies with two movable blades 30, 40 or 50 mm in conjunction with OPCAB Stabilizer Arm SD Detachable retractor key Autoclavable BS BRM BRM Retractor Frame, 17.5 x 15.4 cm, especially for MIDCAB interventions, for use with MIDCAB Extension M, optional with two Blades VM, VK or VL in conjunction with OPCAB Stabilizer Arm SD BS Lever, only HTS 12 A

35 Vario-Retractors Children and Babies The SCHÖLLHORN Vario-Retractors Children and Babies for Cardiac Surgery In pediatric cardiac surgery, the variability of the retractor plays a major role as it must be optimally adapted to the various sizes of the pediatric thorax as well as the unique anatomy of babies. This is why this innovative retractor system is called the varioretractor. The babies vario-retractor is characterized by a special technical feature. The fact that, following sternotomy, the thoraces of infants and/or neonates swing open due to the softness of the bones was given special consideration during construction and design. The use of an articulated blade enables the retractor to optimally adapt to the sternotomized thorax. The retractor stays in the background, providing the surgeon with the best possible access to the operative site. This special feature posed a technical problem as it neutralized the additional forces necessary to ensure the blades and the retractor frame remain in position. Integrating a lattice structure between the blade bracket and the retractor frame proved to be an ideal solution. The lattice structure locks when the retractor is introduced into the surgical site and subjected to tension. If pressed outwards, the blades can be freely positioned once again. The babies vario-retractor is usually used with one set of blades. The blades are available in two different sizes to accommodate the soft sternum and the large range of pediatric patient sizes in cardiac surgery. In addition, an extra feature was integrated in the retractor system in the form of the cranial hook. This is hooked into the pediatric patient s jugulum following sternotomy and simply fixed to the cranial arm of the retractor frame. This holds the site open in the shape of a triangle and thus improves access to the cranial area of the surgical site. Dr. J. SCHÖLLHORN, Chirurgische Universitätsklinik, Abteilung Herz- und Gefäßchirurgie, Freiburg, Germany Fig. 1: Vario-Retractor Children Fig. 2: Vario-Retractor Babies HTS 13 B 29

36 SCHÖLLHORN Vario-Retractor Children and Babies To accommodate the size of children and infants, two smaller versions of the SCHÖLLHORN multi-retractor were developed. The vario-retractors allow the use of standard retractors in an adequate size for children and infants B B SCHÖLLHORN Vario-Retractor Children 1 2 including: Retractor Frame, 19 x 15.5 cm, including Lever BS 2x Moveable Blade, freely adjustable, height 15 mm, width 30 mm 2x Moveable Blade, freely adjustable, height 22 mm, width 30 mm 7-04 Components see chapter 11, SPARE PARTS AND ACCESSORIES 30 HTS 14

37 SCHÖLLHORN Vario-Retractor Babies B B SCHÖLLHORN Vario-Retractor Babies including: 1 Retractor Frame, 17.5 x 11.5 cm, including Lever BS 2 2x Moveable Blade, small, freely adjustable, height 12 mm, width 30 mm 2x Moveable Blade, large, freely adjustable, height 15 mm, width 40 mm 3 Cranial Hook, width 15 mm, to attach to Retractor Frame BR 7-04 Components see chapter 11, SPARE PARTS AND ACCESSORIES HTS 15 31

38 Rib Spreaders A GIUDICELLI/FUENTES/OTTOMANI Rib Spreader, self-retaining, blade depth 40 mm, blade width 30 mm B GIUDICELLI/FUENTES/OTTOMANI Rib Spreader, self-retaining, blade depth 60 mm, blade width 30 mm HTS 16

39 ENDOSCOPIC VESSEL HARVESTING VEIN RETRACTOR FOR ENDOSCOPIC SAPHENOUS VEIN HARVESTING ARTERY RETRACTOR FOR ENDOSCOPIC RADIAL ARTERY HARVESTING n c SCISSORS, DISSECTING AND GRASPING FORCEPS RoBi BIPOLAR SCISSORS AND GRASPING FORCEPS CLIP APPLICATORS AND ENDO-LOOP LIGATURES n 48 ACCESSORIES FOR ENDOSCOPIC VESSEL HARVESTING 49-52

40 Vein Retractor for Endoscopic Saphenous Vein Harvesting Endoscopic Vein Retractor, FREIBURG model In heart surgery, as in other fields, the past few years have seen increased efforts to develop and apply new endoscopic surgical techniques. In co-operation with the Department of Cardiovascular Surgery at the University of Freiburg, KARL STORZ developed a new and improved instrument set for the endoscopic harvesting of the great saphenous vein. The advantages of the instrument set: Resterilizable and completely reuseable, providing significant cost benefits. The high-quality HOPKINS II telescope with 45 viewing angle allows a full view of the surgical field to be prepared. The distal tip of the retractor always remains within the telescopic field of vision. The vein can be removed with a single incision. The ergonomic handle with integrated light cable guide ensures optimal handling. Special features: The proximally angled endoscope eyepiece facilitates introduction of working instruments into the surgical field. The completely smooth underside along the entire length of the retractor allows free movement of the instrument without additional hindrances. Overall easier handling of the retractor which results in shorter removal times due to even safer handling of the instruments a shorter learning curve. Techniques for harvesting the great saphenous vein Fig. 1: Open technique Fig. 2: Open technique with skin flaps Fig. 3: Endoscopic technique via a single incision VE-VS 2 A

41 Vein Retractor, FREIBURG model, HOPKINS II Telescopes FDZ FDZ Endoscopic Vein Retractor, FREIBURG model, for harvesting the saphenous vein, enhanced telescope guiding channel, distal width 25 mm, working length 27 cm, with integrated guide in handle for fiber optic light cable, autoclavable, for use with HOPKINS II Telescope FA including: Cleaning Adaptor, for telescope channel FA FA HOPKINS II Forward-Oblique Telescope 45, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: black For use with the ClearGuide single-use spatula system from the Sorin Group BA n BA HOPKINS II Forward-Oblique Telescope 30, enlarged view, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: red Please note: Vein Retractor FDZ is only suitable for use with Fiber Optic Light Cables 495 NL and 495 NA size 3.5 mm. Accessories for endoscopic vessel harvesting see pages Components see chapter 11, SPARE PARTS AND ACCESSORIES Accessories for cleaning and sterilization see catalog ENDOPROTECT1 VE-VS 3 A 35

42 Vein Dissectors VE VE Vein Dissector, blunt, distal angled to left, autoclavable, size 3 mm, working length 41 cm VD Vein Dissector, blunt, distal angled to right, autoclavable, size 3 mm, working length 41 cm Accessories for endoscopic vessel harvesting see pages VE-VS 4

43 Artery Retractor for Endoscopic Radial Artery Harvesting n Following the recent revival of the radial artery as the second vessel of choice for arterial myocardial revascularization, its endoscopic harvesting has been the subject of great interest in order to achieve the same clinical benefits as in endoscopic vein harvesting. The endoscopic technique for harvesting the radial artery offers the following advantages compared to the open procedure: Less neurological complications Less wound complications Less wound infections Less hematomas Enhanced aesthetic results Despite the excellent performance of the endoscopic vein retractor already available on the market, the different anatomical features of the radial artery made the development of a new retractor necessary. Special features of the BISLERI Endoscopic Radial Artery Retractor: Autoclavable, stainless steel instrument HOPKINSr II lens, 45 angled telescope for optimal visualization of the operative field Ergonomic handle Enhanced front and rear design Improved smoke evacuation thanks to special channel Tunnel-like design G. BISLERI, M. D. Division of Cardiac Surgery, University of Brescia Medical School, Italy Fig. 1: Incision, 1 cm proximal to radial styloid prominence Fig. 2: Retractor positioned in the forearm Fig. 3: Assessing the potential presence of residual side branches with the artery dissector Fig. 4: Healed surgical scars VE-VS 5 A 37

44 BISLERI Artery Retractor, HOPKINS II Telescopes n FCZ n FCZ BISLERI Endoscopic Radial Artery Retractor, for harvesting the arteria radialis, distal width 20 mm, working length 27.5 cm, with U-shaped instrument guiding channel, with integrated channel for smoke evacuation, with integrated guide in the handle for fiber optic light cable, autoclavable, for use with HOPKINS II Telescope FA including: Cleaning Adaptor, for telescope channel FA FA HOPKINS II Forward-Oblique Telescope 45, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: black For use with the ClearGuide single-use spatula system from the Sorin Group BA n BA HOPKINS II Forward-Oblique Telescope 30, enlarged view, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: red Please note: Vein Retractor FCZ is only suitable for use with Fiber Optic Light Cables 495 NL and 495 NA size 3.5 mm. Accessories for endoscopic vessel harvesting see pages Components see chapter 11, SPARE PARTS AND ACCESSORIES Accessories for cleaning and sterilization see catalog ENDOPROTECT VE-VS 6 A

45 Artery Dissectors VR VL Artery Dissector, blunt, distal angled to left, autoclavable, size 3 mm, working length 41 cm VR Artery Dissector, blunt, distal angled to right, autoclavable, size 3 mm, working length 41 cm Accessories for endoscopic vessel harvesting see pages VE-VS 7 A 39

46 KARL STORZ c rotating, dismantling, instruments for endoscopic vessel harvesting c Instruments, consisting of: Handle Outer sheath Working insert Nothing could be simpler! The c series continues the development of instruments which have proven their value for years. The simplicity of handling and ease with which the instruments can be cleaned has been improved, in particular in respect of assembly and disassembly. When the rear handle is positioned horizontally, the handle can be separated from the outer sheath and the working insert at the press of a button. Reassembly is equally reliable and quick. The high frequency connection is mounted in a 45 angle on the upper side of the handle, thereby ergonomically guiding the high frequency cable away from the field of operation. Available in size 2 to 10 mm, c instruments can be completely disassembled into separate components: Handle Outer sheath/outer sheath with working insert Working insert This unique, reusable two/three-piece design offers the surgeon the following benefits: Available in size 2 mm, length 20 cm; size 3/3.5 mm, length 20 or 30 cm; size 5 to 10 mm, length 30, 36 and 43 cm Choice of handle styles Fully rotational 360 sheath facilitates easy access in all clinical situations No hidden spaces that can trap blood or tissue debris Can be dismantled at the press of a button reducing instrument cleaning time considerably Completely autoclavable design Cost-effective reusable instruments reduce O.R. costs per case and simplify inventory management, eliminating the need to store large quantities of disposable instruments Environmentally correct, i.e. if damage occurs, only the component with the defect needs to be replaced not the entire instrument Convenient and ergonomic handling Cleaning port allows the instrument to be cleaned without disassembly Due to the modular c system, the user can individually assemble the desired instrument at any time. 40 VE-VS 8

47 Plastic and Metal Handles for scissors, dissecting and grasping forceps, c rotating, dismantling, with connector pin for unipolar coagulation The anatomy of the hand varies in size from person to person. With the new c handles, KARL STORZ meets this particular challenge. Wider contact areas at the finger and thumb ring and a more ergonomic design ensures comfortable handling, preventing pressure marks even after hours of use. Due to their ergonomic shape, the new handles can be used in various holding positions and, therefore, meet a wide range of demands. Special Features: Comfortable handling Prevention of pressure marks Variable holding positions due to ergonomic shape Appropriate design unipolar n n Plastic Handle, without ratchet Plastic Handle, without ratchet Metal Y-Handle, insulated, without ratchet Metal Outer Sheaths, insulated c Metal Outer Sheath, insulated, with LUER- Lock connector for cleaning, size 5 mm, length 43 cm Plug, for LUER-Lock connection for cleaning, black, autoclavable, package of A Color Coded Plug, for LUER-Lock connection for cleaning, red, green, black, 10 each, package of 30, for easier identification of jaws on the OR table VE-VS 9 41

48 Scissors, Dissecting and Grasping Forceps c rotating, dismantling, with connector pin for unipolar coagulation Size 5 mm unipolar Outer Sheath Length 43 cm Handle n n Double action jaws: Working Insert Complete Instrument MW MW MW MW 15 c Scissors, serrated, curved, conical MA MA MA MA 20 c Scissors, spoon-shaped blades, serrated, curved, length of blades 20 mm ML ML ML ML 22 c KELLY Dissecting and Grasping Forceps, long DN DN DN DN 18 c Dissecting and Grasping Forceps, Dolphin Nose Single action jaws: EH EH EH EH _ 10 _ c Hook Scissors High Frequency Cords for unipolar coagulation see page VE-VS 10

49 RoBi Instruments Rotating Bipolar Grasping Forceps and Scissors, CLERMONT-FERRAND Model General Information Ergonomics of the Chosen Instrument A prerequisite for endoscopic surgery is the selection of ergonomic instruments. The number, location and size of trocars are the primary elements that the surgeon has to coordinate. In addition, there are essential questions associated with optimal performance of the actual endoscopic intervention, i.e., which instruments will be used and where. Although there are several solutions, they are dependent on specific rules. These rules combine the basic principles of surgery with the rules of endoscopic surgical ergonomics. The Basic Principles of Surgery Surgery comprises three fundamental phases: dissection incision hemostasis. For every individual surgical intervention, the surgeon has to recognize the organ (dissection), control the organ (hemostasis) and work on the organ (section). This surgical rule of three can only be realized if the tissue is properly exposed, which further implies that it is possible to grasp the tissue. For this reason, the surgical activities can also be subdivided as follows: dissection incision hemostasis grasping. An instrument is ideal if it can be used to implement all four functions. Dissection: The jaws can be opened by the surgeon. The force exerted on the handle is transferred to the tissue and permits dissection. Coagulation: This occurs between the jaws and is limited to the tissue situated between the jaws. This safety factor and the gripping capacity were the reasons for our decision in favor of this bipolar technique. Choice of Energy It is a well-known fact that bipolar energy is safer than monopolar energy due to the fact that the surgeon controls the power being used at all times. There is no danger from an electrical current. Nevertheless, the dispersion of heat around the coagulated area can result in a tissue burn. Active gripping restricts this effect and the dispersion is controlled. Through more or less heavy compression of the tissue, the surgeon can alter the tissue impedance and, thus, modify the dispersion of electrical energy. The power used generally depends on the size of the jaws selected. The lower the selected energy, the longer the exposure time and, as a result, the more extensive the heat dispersion. The Grasping Function Endoscopic Ergonomics Small diameters are often used in laparoscopy. Due to mechanical problems that frequently occur with these micro instruments, multifunctional instruments are very difficult to implement. The use of electrical current, which enables multifunctionality, creates an addtional difficulty. Furthermore, the operating surgeon is forced to make decisions due to the limited number of trocars, their operating site determined at the start of the intervention, and the optimization of instrument functions. After deciding on the location and number of trocars, the essential question is: Which instrument will be used where? This decision depends extensively on the functions of the instruments. Choice of Functions The instrument functions have to correspond to the surgical requirements. Because it is difficult to produce an instrument that provides all of the necessary functions, certain decisions have to be made. The following tasks can be carried out using the bipolar forceps presented here: Grasping: The instrument is capable of grasping tissue. It is designed to grasp fine tissue, such as the peritoneum, although it can also grasp stronger sections of tissue, such that the tissue can be exposed regardless of circumstances. General Information One characteristic of laparoscopy is that no retraction device is used. To compensate for this, the surgeon requires a gripping instrument. Simple distention is insufficient. As a result, he requires an instrument with which the tissue can be grasped precisely so that another instrument can be used. The surgical assistant normally has a gripping instrument. However, a single instrument is not enough and it is important that the surgeon also has a gripping instrument. The Shape of the Jaws Various jaws are available. These vary in regard to size and gauge. Generally, the jaws have a rough toothing. With these, thicker and heavier sections oftissue can be grasped. Smaller jaws have finer toothing. With these, more fragile sections of tissue can be grasped. The precision of coagulation is dependent on the gauge of the jaws. The finer the gauge of the jaws, the more precise the coagulation. Microbipolar jaws are suitable for vascular, urological, infertility procedures and tubal reanastomosis where fine precision is required. The smaller biarticulate VE-VS 11 43

50 RoBi Instruments Rotating Bipolar Grasping Forceps and Scissors, CLERMONT-FERRAND Model jaws are excellent for handling delicate tissues like the vessels, ureters and fallopian tubes. These are also suitable for tying intracorporeal knots. Kelly jaws are very popular in general laparoscopic procedures as the shape of the biarticulate jaws allows the surgeon to achieve precise dissection and coagulation. Fenestrated jaws featured here have fine atraumatic serration. Jaws are biarticulate and the broad jaws enable a strong grasping function. Monoarticulate jaws are appropriate on oncological procedures especially during lymph node dissection as one jaw remains stable to reduce trauma while the other jaw takes on the main dissecting role. The Coagulation Function The Bipolar Energy Bipolar energy is precise and safe at the same time. The path of electrons is always known. They move from the generator to the forceps, flowing through the tissue located between the jaws and return directly via the forceps cable to the generator. A neutral electrode is unnecessary. This prevents any risk of electrical burns. Coagulation, however, occurs by means of heating the tissue. If the tissue is heated too severely or the exposure times are too long, there is a risk that burns will occur around the operating site. To restrict this effect, the exposure times have to be limited and modified according to the tissue impedance. In contrast to conventional bipolar forceps, these allow the pressure applied to the tissue to be altered and, as a result, the impedance to be changed. The more the tissue is compressed, the greater the impedance. The surgeon can alter the impedance of the tissue held by the forceps via the handle, and, thereby, alter the coagulation time. In this manner, the heat dispersion can be controlled. The Energy Density The indicated power varies according to the size of the jaws. The thicker the jaws, the higher the power has to be. In principle, work proceeds with powers in the order of 30 to 50 watts. The density of energy transferred to the tissue is directly relative to the size of the jaws. The narrower the jaws, the greater the energy. Therefore, in order to coagulate a tissue zone with precision, the surgeon has to select a high power setting. With thicker jaws, he has to choose a higher power setting (50 watts), but with a shorter exposure time. With thinner jaws, he has to select a lower power setting of approximately 35 watts. Application Mode The rules for the application of bipolar energy are very precise. After selecting the power, the surgeon applies the energy with as short an exposure time as possible. After performing the coagulation, the incision is restricted to the coagulated area, i.e., the tissue that has become white. As soon as the tissue becomes pink in color again, the incision is interrupted and coagulation is continued at the spot where the incision is being made. Soiling of the jaws changes the distribution of energy. In extreme cases, coagulation is no longer possible. To avoid hemorrhaging resulting from insufficient coagulation, the electrodes (the jaws of the forceps) have to remain clean. Soiling of the jaws can be prevented by the following measures: Selection of the appropriate power, dependent on the size of the jaws Application with short exposure times Avoiding coagulation in blood. Even if the coagulation proceeds correctly, blood coagulates on the jaws causing them to become soiled. Correct, preventive coagulation is, therefore, the best preventive measure. The Dissection Function Interest The dissection of tissue found its way into the endoscopic technique relatively late. The working principle of bipolar energy initially consisted of coagulating as much tissue as possible. This surgical technique resulted from both the lack of experience among surgeons, as well as the features of bipolar instruments. Conventional forceps, for example, have no joint between the jaws. Closure of the jaws generally proceeds by sliding an external tube. Opening is usually passive. The grasping function of these instruments was very imprecise and dissection was impossible. Nevertheless, dissection is the prerequisite for precision surgery. By using dissection, tissue can be identified or secured in such a way that no other organs are involved VE-VS 12

51 RoBi Instruments Rotating Bipolar Grasping Forceps and Scissors, CLERMONT-FERRAND Model Application Mode Dissection proceeds through introduction of the instrument tip between the tissue surfaces. By opening the handle, the jaws can be moved and the tissue surfaces spread apart. The force which is transferred to the tissue can be felt in the handle and, thus, enables precise dosing for dissection. Instrument Features Characteristics This instrument is a bipolar instrument with two insulated jaws. By means of the specific joint, this insulation can be maintained. Insulation of the jaws is made possible by an intermediate ceramic layer. In this manner, current leakage is impossible. This insulation is optimum at 2,500 volts. The forceps are rotatable, detachable and autoclavable. Rotation Rotation is an essential feature of bipolar forceps. It permits the following: Through rotation, the tissue can be grasped at a correct 90 angle, coagulated and cut. This is an essential prerequisite for correct gripping, the dissection of tissue and coagulation restricted to the affected tissue. As for all instruments equipped with a single movable jaw, it is important to perform a rotation to position this jaw at the ideal location to which the force of dissection should be applied. Disassembly It has to be possible to disassemble the forceps so that inserts can be exchanged and the forceps can be cleaned easily. Thanks to the quick-change system RoBi, the inserts can be exchanged during surgery and according to surgical requirements. Cleaning In its disassembled condition, the forceps can be cleaned more easily. The collection of tissue remnants at the rear end of the jaws is limited by the recess provided at this location. In spite of the toothing, the jaws can be cleaned simply. Cleaning after surgery is facilitated if the jaws are soaked for a few minutes. By brushing the jaws with a soft brush, tissue remnants can be removed before the forceps are sterilized. Sterilization The instrument can be reused. Sterilization is performed in an autoclave at 134 C. Precautions When activating the bipolar instrument, it is important to ensure that there is no critical viscera in contact with the length of the instrument. Before stepping on the pedal, the surgeon must ensure that only the tissue concerned are grasped between the two jaws of the forceps. This is to prevent unintentional thermal injury. Conclusions The selection of functions for an instrument is made according to the surgical requirements and the technical prerequisites. If laparoscopies are being performed, the surgeon must make these decisions himself. Modern endoscopic surgery is performed using two hands. Optimization of the endoscopic intervention is dependent on the number and selection of functions that are possible for the surgeon with his two hands. We have decided on grasping, dissection and coagulation with one hand. These functions are performed by means of the bipolar forceps. If simple distention of the tissue using the instrument is also taken into account, the surgeon has four functions at his disposal, all possible with one hand. This multifunctionality optimizes endoscopic intervention, which in this way becomes simpler, faster and safer. Nomenclature RoBi stands for rotating bipolar instruments and describes an innovative and compatible range of instruments that are distinguished by the following features: bipolar rotatable detachable handle, sheath and interior specific joint mechanism VE-VS 13 45

52 RoBi Instruments rotating, dismantling, with connector pin for bipolar coagulation, CLERMONT-FERRAND Model Size 5 mm bipolar Special Features: Jaws with robust hinge for optimized bipolar grasping Fully rotating 360 sheath Top mounted 45 high frequency connector pin takes the cable away from the operative field Can be disassembled into separate parts: Handle Outer sheath Working insert Cleaning port Autoclavable n RoBi Ring Handle RoBi Metal Outer Sheath, insulated RoBi Metal Outer Sheath, insulated, with LUER-Lock irrigation connector for cleaning, size 5 mm, length 43 cm VE-VS 14

53 RoBi Bipolar Scissors and Grasping Forceps rotating, dismantling, with connector pin for bipolar coagulation, CLERMONT-FERRAND model Size 5 mm bipolar Outer Sheath Length 43 cm n Handle Double action jaws Working Insert MW FG _ 20 _ Complete Instrument MW METZENBAUM RoBi Scissors, CLERMONT-FERRAND model, curved, slender blades, for cutting and bipolar coagulation FG RoBi Grasping Forceps, width 2 mm, distally angled 45, for grasping and coagulation of vessels Single action jaws CS CS 16 RoBi Grasping Forceps, CLERMONT-FERRAND model, narrow jaws, for dissection, grasping and bipolar coagulation of fine structures Please note: For the instrument only the individual component parts are numbered. The catalog number for the complete instrument is not on the instrument. Please take this number from the numbers indicated in the red background of the table above. The color green indicates the working inserts. VE-VS 15 47

54 n Clip Applicator and Endo-Loop Ligature L n L LUTZ Clip Applicator, rotating, angled jaws, working length 43 cm, for use with Clips 8665 T 8665 T Clip, titanium LT 200, medium, sterile, 5 mm, package of 36 cartridges with 6 clips each Please note: The use of clips other than indicated can lead to damage of the jaws AE AE Endo-Loop Ligature, with ROEDER knot, for bleeding stumps, with absorbable synthetic suture, for single use, sterile, USP 0, size 3 mm, length 33 cm, package of VE-VS 16

55 Accessories for Endoscopic Vessel Harvesting Scissors, Forceps and Blades TOENNIS Dissecting Scissors, fine model, straight, blunt/blunt, length 18 cm POTTS-SMITH Dissecting Scissors, curved, blunt/blunt, length 19 cm ATRAUMA Atraumatic Tissue Forceps, length 16 cm Surgical Handle, Fig. 3, length 12.5 cm, for Blades , Blade, Fig. 10, non-sterile, package of Blade, Fig. 10, sterile, package of Same, Fig Same, Fig VE-VS 17 49

56 Accessories for Endoscopic Vessel Harvesting Retractors ANDERSON-ADSON Retractor, 4x 4 prongs, sharp, curved, length 20 cm FISCH Retractor, articulated, 3x 3 prongs, semisharp, length 17 cm Retractor, articulated, 3x 4 prongs, sharp, length 24 cm PLESTER Retractor, 2x 2 prongs, length 11 cm VE-VS 18

57 Accessories for Endoscopic Vessel Harvesting Hand Holder Special Features: Angle of the hand support adjustable Can be dismantled on one side only for easy cleaning and space-saving storage HH HH GILBERT Hand Holder, for fixation of the hand during endoscopic vessel harvesting VE-VS 19 51

58 Accessories Unipolar and Bipolar High Frequency Cords Unipolar High Frequency Cords KARL STORZ Instrument High Frequency Surgery Units unipolar M Unipolar High Frequency Cord, with 4 mm plug for HF unit, models KARL STORZ, Erbe type T, older models and Ellman, length 300 cm M Unipolar High Frequency Cord, with 4 mm plug for HF unit, models Berchtold and Martin, length 300 cm M Unipolar High Frequency Cord, with 5 mm plug for HF unit, models KARL STORZ AUTOCON system (50, 200, 350), AUTOCON II 400 SCB (111, 115) and Erbe type ICC, length 300 cm M Unipolar High Frequency Cord, with 8 mm plug for HF unit, models KARL STORZ AUTOCON II 400 SCB (112, 116) and Valleylab, length 300 cm Bipolar High Frequency Cords KARL STORZ Instrument High Frequency Surgery Units bipolar LE Bipolar High Frequency Cord, to KARL STORZ Coagulator B/C/D, B/C/D, B/C/D, B/C/D, AUTOCON system (50, 200, 350), AUTOCON II 400 SCB system (111, 113, 115) and Erbe-Coagulator, T- and ICC-row, length 300 cm LM Bipolar High Frequency Cord, for Martin and Berchtold coagulators, length 300 cm L Bipolar High Frequency Cord, with 2x 4 mm banana plug for KARL STORZ Coagulator XA/XB and Ellman, length 300 cm LA Bipolar High Frequency Cord, with 2x 4 mm banana plug for KARL STORZ Coagulator XA/XB and Valleylab, length 300 cm LV Bipolar High Frequency Cord, for KARL STORZ AUTOCON II 400 SCB (112, 114, 116) and Valleylab coagulators, length 300 cm Please note: All high frequency cords on this page are delivered with a length of 300 cm. If a length of 500 cm is requested, please add the letter L to the part number, i.e ML, LVL. 52 VE-VS 20

59 MINIMALLY INVASIVE CARDIAC SURGERY HOPKINS TELESCOPES n TROCARS CardioFIT INSTRUMENTS n VASCULAR CLAMPS, PALPATION HOOK, FASCIAL CLOSURE INSTRUMENT n 74

60 Minimally Invasive Cardiac Surgery Instrument sets required for minimally invasive surgical procedures Minimally invasive surgical techniques in cardiac surgery have gained in importance compared to open surgery in recent years. Benefits such as: Fewer wound healing problems thanks to the mini-thoracotomy Retention of thoracic stability as a sternotomy not being necessary Quicker post-operative mobilization and Improved cosmetic results as well as the development of imaging systems and thoracoscopic precision instruments means that an increasing number of operations are now being performed using a minimally invasive approach. For mitral valve surgery in particular, the minimally invasive technique has become increasingly popular, whereby the mitral valve can be visualized extremely well via a right anterolateral approach. Mitral valve surgery is often the therapy of choice when medical therapy and electrocardioversion fail and can be performed entirely endoscopically. In cardiac surgery, minimally invasive interventions place unique demands on both the instrument set and the imaging systems (i. e. endoscopic unit) used. Reliability, safety, precision and ergonomics are just a few key aspects in this regard. To meet the stringent demands of minimally invasive cardiac surgery, KARL STORZ offers a newly designed product range in addition to the FULL HD camera system and various holding systems, consisting of: - KARL STORZ HOPKINS telescopes - Trocars specially adapted to anatomic conditions - New CardioFIT instruments which enable secure and thorough cleaning as the instruments can be completely dismantled - Atraumatic vascular clamps, also available with removable jaws - Palpation hooks as well as a - Fascial closure instrument Telescopes: The HOPKINS II rod lens system from KARL STORZ guarantees the best possible image quality with optimal brightness, contrast and detail features for every telescope. In combination with the FULL HD camera system from KARL STORZ even the finest structures can be identified and the surgeon is provided with the highest level of security and precision. In video-assisted mitral valve surgery, 30 telescopes with a diameter of 5 or 10 mm are employed as standard. The mitral valve and the surrounding tissue are visualized by means of an access through the right intercostal space and the right atrium. To enable accurate postioning of the ablation device in endoscopic atrial ablation, 0 telescopes with a diameter of 5 or 10 mm are mainly used. The ENDOCAMELEON, with a variable direction of view of 0 to 120, provides all round vision in both mitral valve surgery and in minimally invasive atrial ablation. This also offers an added safety bonus VA-RC 2

61 HOPKINS II Telescopes n Diameter 5 mm, length 24 cm BA AA HOPKINS II Straight Forward Telescope 0, enlarged view, diameter 5 mm, length 24 cm, autoclavable, fiber optic light transmission incorporated, color code: green BA HOPKINS II Forward-Oblique Telescope 30, enlarged view, diameter 5 mm, length 24 cm, autoclavable, fiber optic light transmission incorporated, color code: red Fiber Optic Light Cables 495 NL/NA/ND recommended Diameter 5 mm, length 29 cm AA AA HOPKINS II Straight Forward Telescope 0, enlarged view, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: green BA HOPKINS II Forward-Oblique Telescope 30, enlarged view, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: red FA HOPKINS II Telescope 45º, enlarged view, diameter 5 mm, length 29 cm, autoclavable, fiber optic light transmission incorporated, color code: black Fiber Optic Light Cables 495 NL/NA/ND recommended Fiber optic light cables for use with HOPKINS telescopes see chapter 2, page 16 VA-RC 3 A 55

62 ENDOCAMELEON n VA-RC 4 A

63 ENDOCAMELEON n Telescope with variable direction of view Until now, surgeons had to choose in advance which telescope or direction of view to use in a procedure. However, surgeons were restricted to the selected direction of view throughout surgery or had to perform an intraoperative telescope change during the procedure. To prevent this predicament in the future, we developed the ENDOCAMELEON : a telescope that allows you to adjust the desired direction of view also during surgery between 0 and 120. The ENDOCAMELEON combines the user comfort of the proven 0 HOPKINS telescope with the advantages and potential of a telescope featuring a variable direction of view offering you the quality you expect from KARL STORZ telescopes. The innovative ENDOCAMELEON technology is not difficult to use and, due to the external moving parts, does not take up extra intracorporal space. Handling remains straightforward and ergonomic. Image alignment is the same as rigid telescopes: the direction of view is selected by simply turning the adjustment knob, making the system very intuitive to use. As the ENDOCAMELEON is equipped with a standard eyepiece, the variable direction of view benefits all standard camera systems. Thanks to the HOPKINS rod lens system, ENDOCAMELEON also offers image quality that enables a useful application of three-chip cameras or HD camera systems. To have the direction of view best suited for each situation available at all times offers the surgeon a higher degree of safety. With the ENDOCAMELEON visual inspection of the entire surgical field is easily achieved. Control over instrument movement is possible throughout the entire procedure and hemorrhages can be visualized and controlled even in previously inaccessible areas. With a simple turn of the adjusting knob, the ENDOCAMELEON enables the user to easily select the direction of view between 0 and 120 to suit all OR requirements. ENDOCAMELEON with variable direction of view, lateral view ENDOCAMELEON with variable direction of view, isometric view VA-RC 5 A 57

64 ENDOCAMELEON n Diameter 10 mm, length 32 cm Special Features: Variable direction of view HOPKINS telescope with unique rod lens system Easy-to-use adjusting knob for selecting the direction of view Rigid sheath with a diameter of 10 mm AE AE ENDOCAMELEON HOPKINS Telescope, diameter 10 mm, length 32 cm, autoclavable, variable direction of view 0 120, with adjusting knob for selecting the direction of view, fiber optic light transmission incorporated, color code: gold Mitral valve reconstruction Fiber Optic Light Cables 495 NB/NCS/NE recommended 58 VA-RC 6 A

65 Trocars n Sizes 6 and 11 mm with insufflation stopcock Special Features: Specifically designed to meet the needs of minimally invasive cardiac surgery, the trocar length of 6.5 cm allows easy and safe use. Even when completely inserted, the trocar is at a safe distance to the heart. This prevents injury and ensures safe handling. The insufflation stopcock with LUER-Lock connector that is angled 45 permits placing several trocars in adjacent intercostal spaces. Cannula Silicone Leaflet Valve Trocar Size: Working length: Color code: 6 mm 6.5 cm black 11 mm 6.5 cm green-white Trocar, with blunt tip including: Cannula, with insufflation stopcock Trocar Silicone Leaflet Valve HA H A L HA H A L For KARL STORZ trocars only the individual components are numbered. The catalog number for the entire assembled trocar, as shown above in bold print, does not appear on the instrument. VA-RC 7 A 59

66 Trocars Size 6 mm with and without insufflation stopcock Special Features: Can be used for the multiple puncture approach as well as for extracorporeal and intracorporeal suturing using conventional suture material with straight needles. The elastic silicone leaflet valve seals the cannula and prevents damage to the inserted suture material. The oblique thread outside the cannula anchors the trocar safely in the abdominal wall. These trocars are made of autoclavable metal. Cannula Silicone Leaflet Valve Trocar with insufflation stopcock Size: Working length: Color code: 6 cm black-white 6 mm 10.5 cm black Trocar, with blunt tip including: Cannula, with insufflation stopcock Trocar Silicone Leaflet Valve EOX EX O L TUX TX U L1 without insufflation stopcock Size: Working length: Color code: 6 cm black-white 6 mm 10.5 cm black Trocar, with blunt tip including: Cannula, without insufflation stopcock Trocar Silicone Leaflet Valve EO E O L TU T U L For KARL STORZ trocars only the individual components are numbered. The catalog number for the entire assembled trocar, as shown above in bold print, does not appear on the instrument. 60 VA-RC 8

67 Trocars with Flexible Cannulas Sizes 6 and 11 mm for use with curved operating instruments Cannula Trocar Size: Working length: Color code: Trocar, flexible, with blunt tip, with integrated silicone leaflet valve including: Cannula, flexible Trocar 6 mm 8.5 cm black NOL NL NO 11 mm 8.5 cm green NOL NL NO Accessories Plastic Cannula, autoclavable, for flexible trocars, package of X X For KARL STORZ trocars only the individual components are numbered. The catalog number for the entire assembled trocar, as shown above in bold print, does not appear on the instrument. VA-RC 9 61

68 Trocars Size 11 mm with and without insufflation stopcock Special Features: Can be used for the multiple puncture approach as well as for extracorporeal and intracorporeal suturing using conventional suture material with straight needles. The elastic silicone leaflet valve seals the cannula and prevents damage to the inserted suture material. The oblique thread outside the cannula anchors the trocar safely in the abdominal wall. These trocars are made of autoclavable metal. Cannula Silicone Leaflet Valve Trocar with insufflation stopcock Size: Working length: Color code: 11 mm 10.5 cm green Trocar, with blunt tip including: Cannula, with insufflation stopcock Trocar Silicone Leaflet Valve TBS TS B L1 without insufflation stopcock Size: Working length: Color code: 6.5 cm green-white 11 mm 10.5 cm green Trocar, without blunt tip including: Cannula, without insufflation stopcock Trocar Silicone Leaflet Valve EV E V L TB T B L For KARL STORZ trocars only the individual components are numbered. The catalog number for the entire assembled trocar, as shown above in bold print, does not appear on the instrument. 62 VA-RC 10

69 Trocars Size 6 mm with insufflation stopcock Cannula Multifunctional Valve Trocar Size: Working length: Color code: 8.5 cm black-white 6 mm 10.5 cm black Trocar, with blunt tip including: Cannula, with insufflation stopcock Trocar Multifunctional Valve WX H X M MA H A M1 Cannula Automatic Valve Trocar Size: Working length: Color code: 8.5 cm black-white 6 mm 10.5 cm black Trocar, with blunt tip including: Cannula, with insufflation stopcock Trocar Automatic Valve FX H X A AA H A A1 For KARL STORZ trocars only the individual components are numbered. The catalog number for the entire assembled trocar, as shown above in bold print, does not appear on the instrument. VA-RC 11 63

70 Trocars Size 11 mm with insufflation stopcock Cannula Multifunctional Valve Trocar Size: Working length: Color code: 8.5 cm green-white 11 mm 10.5 cm green Trocar, with blunt tip including: Cannula, with insufflation stopcock Trocar Multifunctional Valve WX H X M MA H A M1 Cannula Automatic Valve Trocar Size: Working length: Color code: 8.5 cm green-white 11 mm 10.5 cm green Trocar, with blunt tip including: Cannula, with insufflation stopcock Trocar Automatic Valve FX H X A AA H A A For KARL STORZ trocars only the individual components are numbered. The catalog number for the entire assembled trocar, as shown above in bold print, does not appear on the instrument. 64 VA-RC 12

71 Accessories Reducers and Sealing Caps Reducers AA Reducer, 6/3 mm DB Reducer, 11/5 mm HB Reducer, 13/5 mm and 13.5/5 mm Reducers for use with trocars with silicone leaflet valve and TERNAMIAN EndoTIP cannulas with silicone leaflet valve RE Reducer, 6/3 mm RE Reducer, 11/6 mm VA-RC 13 65

72 CardioFIT Instruments fully dismantling n Minimally invasive procedures in cardiac surgery With its CardioFIT series, KARL STORZ has developed instruments that not only meet the stringent requirements presented by minimally invasive cardiac surgery but also facilitate comfortable handling and safe, precise use during minimally invasive interventions. The result is two brand-new instrument sets which comprise instruments that can be completely dismantled and which are specially designed for use in minimally invasive mitral valve surgery and endoscopic ablation of atrial fibrillation. The aim of the development process was, on the one hand, to satisfy the particular demands of cardiac surgery and, on the other hand, to offer the surgeon a range of instruments for various scenarios. The ergonomic design of the forceps handle allows surgeons to move the instruments in both a controlled and safe manner. The working length is of particular importance here as it gives the surgeon the necessary manual precision, which can prove extremely challenging during endoscopic interventions. For this reason, all instruments are available in two different working lengths. KARL STORZ offers a large range of working inserts such as scissors, grasping forceps and needle holders with a diameter of 5 mm for the restricted minimally invasive approach. The modular design of the KARL STORZ CardioFIT system and its ability to be completely dismantled enables the user to individually assemble the required instrument at any time. The fact that the instruments can be dismantled is also a major advantage in ensuring the absolute hygiene of the instruments. The handle can be separated from the outer sheath and working insert with a single hand movement. The result is three instrument parts without dirt traps or inaccessible channels, which can be cleaned efficiently to a leading-edge hygienic standard. With CardioFIT instruments, machine cleaning in particular is as simple as it is thorough. Cleaning trays, in which the individual elements of the CardioFIT instruments can be directly connected to the irrigation system, ensure particularly thorough preparation. The instruments can be reassembled just as simply and quickly as they can be taken apart VA-RC 14

73 CardioFIT Instruments fully dismantling n Video-assisted mitral valve surgery via a minithoracotomy The minimally invasive approach has been adopted in heart valve surgery since the end of the 1990s. Similar to other fields of surgery (abdominal surgery, urology or gynecology), the main goal has been to reproduce standard surgical techniques and long-term results through an alternative, smaller access, providing greater comfort, better cosmetic results and faster recovery for the patient. Less pain, blood loss and transfusions or other complications are further benefits of video-assisted valve surgery via a minithoracotomy. From the beginning, video assistance was considered a milestone in this procedure, allowing optimal illumination and screen-assisted technology. The FULL HD resolution of today s endoscopy systems enables videoassisted surgery with first-class imaging. Several approaches have been used, particularly in mitral valve surgery, to reconstruct and replace the valve. Nowadays the right mini-thoracotomy is mostly used for these patients if a minimally invasive option is selected. A microincision in the right thorax at the IV intercostal space to access the mitral valve makes the use of a complete extrathoracal extracorporeal circulation (heartlung machine) mandatory. Furthermore, the ascending aorta must be occluded in order to stop the heartbeat and enable a safe and bloodless operation. In addition, transesophageal echocardiography is mandatory during the entire operation in order to monitor intracardial cannulation and heart performance during and after surgical correction. Surgical instruments need to be adapted in order to access the valve through such a small and remote approach. Long and flattened scissors, forceps, hooks and needle-holders are required in order to reach valve structures and for intracardial work without disturbing adjacent structures. The instruments should feature special handles to make reverse-mode action easier (handle is down if the tip goes up) and to allow ergonomic movements using the fingers instead of the wrist as in standard surgery. The instrument tip needs to be robust enough during video-assisted interventions to perform certain tasks (suturing, cutting or holding tissue) but also small enough to avoid the inner curvature of the heart cavity. Special instruments are required for knot-pushing as access to the valve plane is not easy. Minimally invasive mitral valve surgery via a micro approach under video assistance is now an established procedure for reconstructing or replacing the mitral or tricuspid valves in many centers. This attractive technique requires special training and instrumentation. The latter shall probably undergo further development in the years to come, making this innovative surgical technique a standard procedure. E. GRECO, M.D. Policlinico Umberto I Sapienza Università di Roma Viale del Policlinico 155, Rome, Italy VA-RC 15 67

74 CardioFIT Instruments fully dismantling n Minimally invasive ablation of atrial fibrillation Background Atrial fibrillation (AF) is one of the most common types of cardiac arrhythmia today. The prevalence of AF among the general population ranges between 0.5 % and 2 % and increases to 8 10 % in elderly subjects aged 70 and older. Medical therapy is still considered the first step of treatment. However, side-effects from prolonged use of antiarrhymthic drugs pose a risk of sudden cardiac death and an adequate range of anticoagulation may prove difficult to maintain. Consequently, there has been an upsurge in the development of non-pharmacological treatments of AF in the last ten years (percutaneous and surgical approaches). Surgical treatment of atrial fibrillation has become increasingly popular since the introduction of various energy sources, technologies and techniques for full endoscopic ablation as an alternative to the original cut-and-suture (Maze III) technique. Technique Minimally invasive AF ablation was initially reported as a double-sided thoracoscopic or monolateral robotic procedure [1, 2]. Our group subsequently developed a monolateral thoracoscopic approach without the use of a robot, which will be briefly outlined below [3]. Following sedation, the patient is intubated with a double-lumen endotracheal tube (or with specific bronchial blockers) for selective left lung ventilation. The patient is placed in the supine position with an inflatable balloon or a folded blanket underneath the right chest area in order to achieve 30 rotation. The third, fourth and fifth intercostal spaces of the right thorax are then marked for port positioning as depicted in Fig. 1. The camera port is usually positioned at the fourth intercostal space on the anterior axillary line. The other two instrument ports are ventral to the third and fifth intercostal spaces outside the triangulation between the camera port, the jugular fossa and the xiphoid process. We routinely use 2 reusable trocars (size 11 mm) for the camera and the lower port and a reusable 6-mm trocar for the upper port. The silicone leaflet valves of the trocars and the specially adapted reduced length are particularly helpful in smaller patients. Furthermore, a 45 angled stopcock is available for CO 2 insufflation (Fig. 2). We routinely use a 10-mm telescope with variable angles (ENDOCAMELEON, Fig. 3) for endoscopic imaging. An ablation probe with a width of 1 cm is inserted in the lower port. The upper port is used for the insertion of special 5-mm instruments for minimally invasive heart surgery. Fig. 1 Fig. 2 Fig VA-RC 16

75 CardioFIT Instruments fully dismantling n Once CO 2 insufflation has started, the pericardium can be visualized (Fig. 4). It is longitudinally opened with cm thoracoscopic instruments 2 cm above the phrenic nerve (Fig. 5). A wide dissection (Fig. 6) between the superior vena cava and the right superior pulmonary vein is carried out with a blunt endopeanut dissector (US Surgical, Norwalk, CT). The pericardial reflection between the inferior vena cava and the right inferior pulmonary vein is dissected in a similar fashion (Fig. 7). In some cases, pericardial stay sutures may have to be placed to achieve better endoscopic visualization during dissection. A guiding catheter is then introduced through the lower port and advanced into the transverse sinus through the pericardial opening between the superior vena cava and the right superior pulmonary vein (Fig. 8). Generally, the pre-curved catheter is visible at the back of the pericardium through the pericardial opening between the inferior vena cava and the right inferior pulmonary vein and can be withdrawn from the thorax. Finally, the ablation probe (Cobra Adhere XL, Estech, USA) can be positioned in order to perform box ablation (Fig. 9). Minimally invasive endoscopic surgical treatment of atrial fibrillation is an established procedure nowadays. It is an effective method of surgical ablation with high rates of success, shorter OR times (approx. 1 hour) and low incidence of complications. Such a technique is possibly a fundamental step towards a common hybrid approach to be developed with electrophysiologists in order to achieve optimal treatment of atrial fibrillation through a combination of surgical and percutaneous techniques. Literature: [1] Saltman AE, Rosenthal LS, Francalancia NA, Lahey SJ: A completely endoscopic approach to microwave ablation for atrial fibrillation. Heart Surg Forum 2003;6: [2] Argenziano M, Williams MR: Robotic atrial septal defect repair and endoscopic treatment of atrial fibrillation. Semin Thorac Cardiovasc Surg 2003;15: [3] Bisleri G, Muneretto C: Innovative Monolateral Approach for Closed-Chest Atrial Fibrillation Surgery. Ann Thorac Surg 2005;80:e22-5 G. BISLERI, MD Assistant Professor of Surgery, Division of Cardiac Surgery, University of Brescia Medical School, Italy Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig VA-RC 17 69

76 CardioFIT Instruments fully dismantling n Special Features: Completely detachable in three parts Easy dismantling and reassembly Easy and efficient cleaning also by means of the LUER-Lock connection Economic advantages due to compatibility with all working inserts and outer sheaths Well-balanced handle with ergonomic design, with or without ratchet Available in size 5 mm, lengths 20 or 27 cm Great variety of working inserts Inserts can be locked into three different positions CardioFIT Instruments, consisting of: Handle Outer sheath Working insert Please note: For CardioFIT instruments only the individual component parts are numbered. The catalog numbers for the dismantling working insert and the sheath are not etched on the instrument. 70 VA-RC 18

77 n CardioFIT Instruments Dissecting and Grasping Forceps, fully dismantling Outer Sheath, with working insert C/49300 C Metal Handle Length 20 cm Length 27 cm Double action jaws CMH CMH CMH CMH 19 CardioFIT Dissecting and Grasping Forceps, atraumatic CUL CUL CUL CUL 14 CardioFIT REDDICK-OLSEN Dissecting and Grasping Forceps, robust CDY CDY CDY CDY 21 Single action jaws CMP CMP CardioFIT DeBAKEY Grasping Forceps, atraumatic CMP CMP 10 CardioFIT Dissecting and Grasping Forceps, dolphin nose, small Outer sheaths with working inserts are shown against a green background whereas the complete instrument is shown against a blue background. Accessories for cleaning and sterilization see catalog ENDOPROTECT1 VA-RC 19 71

78 CardioFIT Instruments Scissors, fully dismantling n Outer Sheath, with working insert C/49300 C Metal Handle Length 20 cm Length 27 cm Double action jaws CMW CMW CMW CMW CardioFIT GRECO Scissors, serrated, curved 90, conical CSP CSP CSP CSP 12 CardioFIT BISLERI Scissors, with tissue protection, angled CMT CMT CMT CMT 15 CardioFIT Scissors, jaws offset downwards, serrated CMG CMG CMG CMG 17 CardioFIT MAHNES Scissors, serrated Outer sheaths with working inserts are shown against a green background whereas the complete instrument is shown against a blue background. Accessories for cleaning and sterilization see catalog ENDOPROTECT1 72 VA-RC 20

79 CardioFIT Instruments Needle Holders, fully dismantling n Outer Sheath, with working insert C/49300 C Metal Handle, with ratchet Length 20 cm Length 27 cm Single action jaws CAL CAL _ 11 _ CAL CAL CardioFIT KOH Needle Holder, with tungsten carbide inserts, curved jaws, for use with suture material size 0/0 7/0 and needle sizes BV, SH or CT-1 _ 11 _ CKF CKF CKF CKF CardioFIT KOH Needle Holder, with tungsten carbide inserts, straight jaws, for use with suture material size 0/0 7/0 and needle sizes BV, SH or CT Outer sheaths with working inserts are shown against a green background whereas the complete instrument is shown against a blue background. Accessories for cleaning and sterilization see catalog ENDOPROTECT1 VA-RC 21 73

80 Vascular Clamps, Palpation Hook, Fascial Closure Instrument n VC Vascular Clamp, jaws slightly curved, length of jaws 5 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm SS Vascular Clamp, straight jaws, length of jaws 7 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm DHN n DHN Palpation Hook, blunt, hook angled 90, length of hook 5.5 mm, working length 20 cm N n N Fascial Closure Instrument, with spring-loaded safety mechanism, size 2.8 mm, length 17 cm including: Handle, with spring-loaded safety mechanism Sheath Components see chapter 11, SPARE PARTS AND ACCESSORIES 74 VA-RC 22

81 LAPAROSCOPIC AORTIC SURGERY HOPKINS TELESCOPES n TROCARS 81 c SCISSORS, DISSECTING AND GRASPING FORCEPS RoBi GRASPING FORCEPS ENDOSCOPIC VASCULAR CLAMPS NEEDLE HOLDERS HANDLES, SUCTION AND IRRIGATION TUBES 109 SCALPELS, KNIFE, PALPATION PROBES, RETRACTORS 110

82 Laparoscopic Aortic Surgery Patients with abdominal aortic aneurysms are increasingly being treated using endovascular techniques. However, due to the long-term problems related to endografts and migrating prostheses, laparoscopic aortic surgery is emerging as a minimally invasive alternative, especially for younger patients. Thus a third approach has become established in addition to conventional and endoluminal surgery. Indications for laparoscopic aortic surgery: Laparoscopic techniques can be offered to patients with aorto-iliac diseases or abdominal infrarenal aortic aneurysms. A further indication, which is gradually emerging, is related to patients with failing endografts or graft migrations following stent implants. In these cases, laparoscopy is used to occlude the lumbar artery or to fix prostheses. A distinction is made between total laparoscopic procedures and laparoscopy assisted techniques: 1. A total laparoscopic approach offers the patient all the benefits of a video endoscopic procedure but requires laparoscopic suturing of the aortic anastomosis and a certain degree of patient selection. Long-term results are excellent and the side-effects of a conventional laparotomy can be avoided, i.e. incisional hernia can thus be prevented. 2. Laparoscopy assisted aortic procedures involve a mini-laparotomy between 7 and 10 cm with conventional instruments still being utilized to suture the aortic anastomosis. Postoperative pain and the incidence of incisional hernias is certainly greater than that of a total laparoscopic approach. However, the laparoscopy assisted technique has the advantage that it can be offered to most patients. 3. Hand-assisted laparoscopy is now established as a third approach. The advantage of this procedure is that the surgeon can insert one hand into the abdomen during laparoscopic surgery without losing the pneumoperitoneum. The so-called handport is inserted through a mini-incision of 7 cm and all the essential steps of the operation are performed under pneumoperitoneum. This procedure can also be offered to the majority of patients. If the working incision for the handport is made in the lower abdomen, post-operative pain and the incidence of incisional hernia is as low as in a total laparoscopic approach. The laparoscopic treatment of complications caused by endoluminal stent implants will play an increasing role in the future. In this case, total laparoscopy can be used, for example, to open the aneurysmal sac, to remove a thrombus, or to repair a lumbar artery feeding an endoleak. Graft migration can also be prevented by applying special suturing techniques. Vascular surgery now avails of the special instrumentation required to offer laparoscopic techniques to patients with aortoiliac occlusive disease or infrarenal aneurysms. It can be concluded that, with these minimally invasive techniques, postoperative recovery of patients is faster as compared to conventional surgery. Prof. R. KOLVENBACH M. D., Augusta Krankenhaus Düsseldorf, Germany AI 2

83 HOPKINS II Telescopes n Diameter 10 mm, length 31 cm AA AA HOPKINS II Straight Forward Telescope 0, enlarged view, diameter 10 mm, length 31 cm, autoclavable, fiber optic light transmission incorporated, color code: green BA HOPKINS II Forward-Oblique Telescope 30, enlarged view, diameter 10 mm, length 31 cm, autoclavable, fiber optic light transmission incorporated, color code: red FA HOPKINS II Telescope 45, enlarged view, diameter 10 mm, length 31 cm, autoclavable, fiber optic light transmission incorporated, color code: black Fiber Optic Light Cables 495 NB/NCS/NE recommended Fiber Optic Light Cables for use with HOPKINS telescopes see chapter 2, page 16 Holding Systems for use with telescopes see chapter 8, HOLDING SYSTEMS AND TRAINING MODELS Units and Accessories see chapter 10, UNITS AI 3 77

84 ENDOCAMELEON n AI 4 A

85 ENDOCAMELEON n Telescope with variable direction of view Until now, surgeons had to choose in advance which telescope or direction of view to use in a procedure. However, surgeons were restricted to the selected direction of view throughout surgery or had to perform an intraoperative telescope change during the procedure. To prevent this predicament in the future, we developed the ENDOCAMELEON : a telescope that allows you to adjust the desired direction of view also during surgery between 0 and 120. The ENDOCAMELEON combines the user comfort of the proven 0 HOPKINS telescope with the advantages and potential of a telescope featuring a variable direction of view offering you the quality you expect from KARL STORZ telescopes. The innovative ENDOCAMELEON technology is not difficult to use and, due to the external moving parts, does not take up extra intracorporal space. Handling remains straightforward and ergonomic. Image alignment is the same as rigid telescopes: the direction of view is selected by simply turning the adjustment knob, making the system very intuitive to use. As the ENDOCAMELEON is equipped with a standard eyepiece, the variable direction of view benefits all standard camera systems. Thanks to the HOPKINS rod lens system, ENDOCAMELEON also offers image quality that enables a useful application of three-chip cameras or HD camera systems. To have the direction of view best suited for each situation available at all times offers the surgeon a higher degree of safety. With the ENDOCAMELEON visual inspection of the entire surgical field is easily achieved. Control over instrument movement is possible throughout the entire procedure and hemorrhages can be visualized and controlled even in previously inaccessible areas. With a simple turn of the adjusting knob, the ENDOCAMELEON enables the user to easily select the direction of view between 0 and 120 to suit all OR requirements. ENDOCAMELEON with variable direction of view, lateral view ENDOCAMELEON with variable direction of view, isometric view AI 5 A 79

86 ENDOCAMELEON n Diameter 10 mm, length 32 cm Special Features: Variable direction of view HOPKINS telescope with unique rod lens system Easy-to-use adjusting knob for selecting the direction of view Rigid sheath with a diameter of 10 mm AE AE ENDOCAMELEON HOPKINS Telescope, diameter 10 mm, length 32 cm, autoclavable, variable direction of view 0 120, with adjusting knob for selecting the direction of view, fiber optic light transmission incorporated, color code: gold Fiber Optic Light Cables 495 NB/NCS/NE recommended 80 AI 6 A

87 Trocars and Reduction Sleeves Size 11 mm with insufflation stopcock Cannula Multifunctional Valve Trocar Size: Working length: Color code: 11 mm 10.5 cm green Accessories Trocar, with conical tip including: Cannula, without valve, with insufflation stopcock Trocar Multifunctional Valve Reduction Sleeve, reusable, instrument diameter 5 mm, cannula outer diameter 11 mm, color code: green MC H C M DB For KARL STORZ trocars only the individual components are numbered. The catalog number for the entire assembled trocar, as shown above in bold print, does not appear on the instrument. AI 7 A 81

88 KARL STORZ c rotating, dismantling, endoscopic instruments c Instruments, consisting of: Handle Outer sheath Working insert Nothing could be simpler! The c series continues the development of instruments which have proven their value for years. The simplicity of handling and ease with which the instruments can be cleaned has been improved, in particular in respect of assembly and disassembly. When the rear handle is positioned horizontally, the handle can be separated from the outer sheath and the working insert at the press of a button. Reassembly is equally reliable and quick. The high frequency connection is mounted in a 45 angle on the upper side of the handle, thereby ergonomically guiding the high frequency cable away from the field of operation. Available in size 2 to 10 mm, c instruments can be completely disassembled into separate components: Handle Outer sheath/outer sheath with working insert Working insert This unique, reusable two/three-piece design offers the surgeon the following benefits: Available in size 2 mm, length 20 cm; size 3/3.5 mm, length 20 or 30 cm; size 5 to 10 mm, length 30, 36 and 43 cm Choice of handle styles Fully rotational 360 sheath facilitates easy access in all clinical situations No hidden spaces that can trap blood or tissue debris Can be dismantled at the press of a button reducing instrument cleaning time considerably Completely autoclavable design Cost-effective reusable instruments reduce O.R. costs per case and simplify inventory management, eliminating the need to store large quantities of disposable instruments Environmentally correct, i.e. if damage occurs, only the component with the defect needs to be replaced not the entire instrument Convenient and ergonomic handling Cleaning port allows the instrument to be cleaned without disassembly Due to the modular c system, the user can individually assemble the desired instrument at any time. 82 AI 8 A

89 n Plastic Handles for Scissors, Dissecting and Grasping Forceps, c rotating, dismantling, with connector pin for unipolar coagulation The anatomy of the hand varies in size from person to person. With the new c handles, KARL STORZ meets this particular challenge. Wider contact areas at the finger and thumb ring and a more ergonomic design ensures comfortable handling, preventing pressure marks even after hours of use. Due to their ergonomic shape, the new handles can be used in various holding positions and, therefore, meet a wide range of demands. Special Features: Comfortable handling Prevention of pressure marks Variable holding positions due to ergonomic shape Appropriate design unipolar Plastic Handle, without ratchet Plastic Handle, with MANHES style ratchet Plastic Handle, with hemostat style ratchet Plastic Handle, with disengageable ratchet High Frequency Cords for unipolar coagulation see chapter 10, UNITS AI 9 A 83

90 Plastic and Metal Handles for Scissors, Dissecting and Grasping Forceps, c rotating, dismantling, with connector pin for unipolar coagulation Plastic and Metal Handles, with and without ratchet unipolar Plastic Handle, without ratchet Plastic Handle, with MANHES style ratchet Plastic Handle, with hemostat style ratchet Plastic Handle, with disengageable ratchet n Metal Handle, insulated, without ratchet Metal Y-Handle, insulated, without ratchet High Frequency Cords for unipolar coagulation see chapter 10, UNITS 84 AI 10 A

91 Metal Handles for Scissors, Dissecting and Grasping Forceps, c rotating, dismantling, without connector pin for unipolar coagulation Metal Handles, with and without ratchet n Metal Handle, without ratchet, with plastic rings with larger contact surface Metal Handle, without ratchet Metal Handle, with MANHES style ratchet Metal Handle, with hemostat style ratchet MOURET Metal Handle, with hemostat style ratchet n Metal Handle, axial, double action handle shanks, with hemostat style ratchet MOURET Metal Handle, axial, with hemostat style ratchet MOURET Metal Handle, axial, with long handle bar, with hemostat style ratchet AI 11 A 85

92 Outer Sheaths, Plugs and Accessories for Handles Metal Outer Sheaths, insulated c Metal Outer Sheath, insulated, with LUER-Lock connector, size 5 mm, length 30 cm W c Metal Outer Sheath, insulated, without LUER-Lock connector, size 5 mm, length 30 cm Same, length 36 cm W Same, length 36 cm Same, length 43 cm W Same, length 43 cm Metal Outer Sheaths M M c Metal Outer Sheath, with LUER-Lock connector for cleaning, size 5 mm, length 30 cm MW c Metal Outer Sheath, without LUER-Lock connector, size 5 mm, length 30 cm M Same, length 36 cm MW Same, length 36 cm M Same, length 43 cm MW Same, length 43 cm Please note: The metal outer sheaths may only be used with handles without a connector pin for unipolar coagulation Rotating Wheel, for c and RoBi handles, autoclavable, package of 5, makes rotation of outer sheath more comfortable F Spring, for Handle 33131, to obtain a selfretaining effect the spring has to be manually attached to the handle, autoclavable Plug, for LUER-Lock connection for cleaning, black, autoclavable, package of A Color Coded Plug, for LUER-Lock connection for cleaning, red, green, black, 10 each, package of 30, for easier identification of jaws on the OR table AI 12 A

93 User Information for easy location of the correct catalog number for the required c instrument How to find the required instrument: (a) Select the required instrument size and the required type of jaws (b) Select the required handle style - Metal handles: without connector pin for unipolar coagulation, against a blue background in the table - Handles, insulated: with connector pin for unipolar coagulation, against a red background in the table. (c) The catalog number for the fully assembled instrument can be found at the point where the horizontal line of the respective working length (see below) intersects with the vertical column of the required handle. Example: ML ML c KELLY Dissecting and Grasping Forceps, rotating, with connector pin for unipolar coagulation, long, double action jaws, size 5 mm, length 36 cm including: Plastic Handle, without ratchet Metal Outer Sheath, insulated ML Forceps Insert Dissecting and Grasping Forceps c rotating, dismantling, insulated, with connector pin for unipolar coagulation Size 5 mm unipolar Length 30 cm Handle (b) n n n n n (a) 36 cm 43 cm Double action jaws Working Insert Order number of the complete instrument ML cmml cmml cmml cmml cmml ML ML ML(c) ML ML ML ML ML ML ML ML ML ML ML ML c KELLY Dissecting and Grasping Forceps, long Length of jaws in mm (approx. measurements) Please note: For c instruments only the individual component parts are numbered. The catalog number for the complete instrument is not on the instrument. Instruments with insulated handles with connector pin for unipolar coagulation, are shown against the red background, instruments with handles without connector pin for unipolar coagulation are shown against the blue background. The color green indicates the working lengths. AI 13 A 87

94 Dissecting and Grasping Forceps c rotating, dismantling, insulated, with connector pin for unipolar coagulation Size 5 mm Length 30 cm Handle n n n n 36 cm 43 cm Double action jaws Working insert ML ML ML Catalog number for the complete instrument ML ML ML ML ML ML ML ML ML ML ML ML 22 c KELLY Dissecting and Grasping Forceps, long DF DF 30 cm DF 30 cm DF cm DF DF DF DF DF DF DF DF DF DF DF 17 c Dissecting and Grasping Forceps, atraumatic KW KW KW KW KW Single action jaws 18 c MATKOWITZ Grasping Forceps ON ON 30 cm ON 30 cm ON cm ON ON ON ON ON ON ON ON ON ON ON DY DY c Grasping Forceps, with especially fine atraumatic serration, fenestrated DY DY DY DY DY DY DY DY 24 c DeBAKEY Grasping Forceps, atraumatic AI 14 A

95 unipolar Handle n Catalog number for the complete instrument ML ML ML ML ML ML ML ML ML ML ML ML ML ML ML ML ML ML DF DF DF DF DF DF DF DF DF DF DF DF DF DF DF DF DF DF KW KW KW KW KW KW ON ON ON ON ON ON ON ON ON ON ON ON ON ON ON ON ON ON DY DY DY DY DY DY DY DY DY DY DY DY AI 15 A 89

96 Dissecting and Grasping Forceps c rotating, dismantling, insulated, without connector pin for unipolar coagulation Size 5 mm Length 30 cm 36 cm n Handle cm Double action jaws Working Insert ML ML ML Catalog number for the complete instrument ML ML ML ML ML ML ML ML ML 22 c KELLY Dissecting and Grasping Forceps, long DF DF DF DF DF DF DF DF DF DF DF DF 17 c Dissecting and Grasping Forceps, atraumatic KW KW KW KW 18 Single action jaws ON ON ON DY DY c MATKOWITZ Grasping Forceps ON ON ON ON ON ON ON ON ON c Grasping Forceps, with especially fine atraumatic serration, fenestrated DY DY DY DY DY DY 24 c DeBAKEY Grasping Forceps, atraumatic AI 16 A

97 Handle n ML ML ML Catalog number for the complete instrument ML ML ML ML ML ML ML ML ML ML ML ML DF DF DF DF DF DF DF DF DF DF DF DF DF DF DF KW KW KW KW KW ON ON ON ON ON ON ON ON ON ON ON ON ON ON ON DY DY DY DY DY DY DY DY DY DY AI 17 A 91

98 Scissors c rotating, dismantling, with connector pin for unipolar coagulation Size 5 mm unipolar Length 30 cm n Handle cm 43 cm Double action jaws Working Insert MA MA MA Catalog number for the complete instrument MA MA MA MA MA MA MA MA MA 20 c Scissors, spoon-shaped jaws, serrated, curved, length of jaws 20 mm AI 18 A

99 Handles and Outer Sheaths for Scissors, Dissecting and Grasping Forceps, c rotating, dismantling, without connector pin for unipolar coagulation n Metal Handle, without ratchet, with plastic rings with larger contact surface Metal Handle, without ratchet Metal Handle, with hemostat style ratchet Metal Outer Sheath, insulated, with LUER-Lock connector for cleaning, size 10 mm 33500, length 36 cm Metal Outer Sheath, with LUER-Lock connector for cleaning, size 10 mm M, length 36 cm Please note: The metal outer sheaths may only be used with handles without a connector pin for unipolar coagulation Rotating Wheel, for c and RoBi handles, autoclavable, package of 5, makes rotation of outer sheath more comfortable F Spring, for Handle 33131, to obtain a selfretaining effect the spring has to be manually attached to the handle, autoclavable Plug, for LUER-Lock connection for cleaning, black, autoclavable, package of A Color Coded Plug, for LUER-Lock connection for cleaning, red, green, black, 10 each, package of 30, for easier identification of jaws on the OR table AI 19 A 93

100 Grasping Forceps, Scissors, Spoon Forceps c rotating, dismantling, without connector pin for unipolar coagulation Size 10 mm Length n Handle cm Double action jaws Arbeitseinsatz Catalog number for the complete instrument BL BL BL c DeBAKEY Grasping Forceps, jaws curved to left 30 Single action jaws P P P _ 11 _ c Potts Scissors, angled 45, pointed PA PA PA 16 c Potts Scissors, angled 30, blunt WS WS WS 22 c Scissors, robust, with cylindrical grinding GS GS GS 35 c Spoon Forceps AI 20 A

101 RoBi Instruments Rotating Bipolar Grasping Forceps and Scissors, CLERMONT-FERRAND Model General Information Ergonomics of the Chosen Instrument A prerequisite for endoscopic surgery is the selection of ergonomic instruments. The number, location and size of trocars are the primary elements that the surgeon has to coordinate. In addition, there are essential questions associated with optimal performance of the actual endoscopic intervention, i.e., which instruments will be used and where. Although there are several solutions, they are dependent on specific rules. These rules combine the basic principles of surgery with the rules of endoscopic surgical ergonomics. The Basic Principles of Surgery Surgery comprises three fundamental phases: dissection incision hemostasis. For every individual surgical intervention, the surgeon has to recognize the organ (dissection), control the organ (hemostasis) and work on the organ (section). This surgical rule of three can only be realized if the tissue is properly exposed, which further implies that it is possible to grasp the tissue. For this reason, the surgical activities can also be subdivided as follows: dissection incision hemostasis grasping. An instrument is ideal if it can be used to implement all four functions. Dissection: The jaws can be opened by the surgeon. The force exerted on the handle is transferred to the tissue and permits dissection. Coagulation: This occurs between the jaws and is limited to the tissue situated between the jaws. This safety factor and the gripping capacity were the reasons for our decision in favor of this bipolar technique. Choice of Energy It is a well-known fact that bipolar energy is safer than monopolar energy due to the fact that the surgeon controls the power being used at all times. There is no danger from an electrical current. Nevertheless, the dispersion of heat around the coagulated area can result in a tissue burn. Active gripping restricts this effect and the dispersion is controlled. Through more or less heavy compression of the tissue, the surgeon can alter the tissue impedance and, thus, modify the dispersion of electrical energy. The power used generally depends on the size of the jaws selected. The lower the selected energy, the longer the exposure time and, as a result, the more extensive the heat dispersion. The Grasping Function Endoscopic Ergonomics Small diameters are often used in laparoscopy. Due to mechanical problems that frequently occur with these micro instruments, multifunctional instruments are very difficult to implement. The use of electrical current, which enables multifunctionality, creates an addtional difficulty. Furthermore, the operating surgeon is forced to make decisions due to the limited number of trocars, their operating site determined at the start of the intervention, and the optimization of instrument functions. After deciding on the location and number of trocars, the essential question is: Which instrument will be used where? This decision depends extensively on the functions of the instruments. Choice of Functions The instrument functions have to correspond to the surgical requirements. Because it is difficult to produce an instrument that provides all of the necessary functions, certain decisions have to be made. The following tasks can be carried out using the bipolar forceps presented here: Grasping: The instrument is capable of grasping tissue. It is designed to grasp fine tissue, such as the peritoneum, although it can also grasp stronger sections of tissue, such that the tissue can be exposed regardless of circumstances. General Information One characteristic of laparoscopy is that no retraction device is used. To compensate for this, the surgeon requires a gripping instrument. Simple distention is insufficient. As a result, he requires an instrument with which the tissue can be grasped precisely so that another instrument can be used. The surgical assistant normally has a gripping instrument. However, a single instrument is not enough and it is important that the surgeon also has a gripping instrument. The Shape of the Jaws Various jaws are available. These vary in regard to size and gauge. Generally, the jaws have a rough toothing. With these, thicker and heavier sections oftissue can be grasped. Smaller jaws have finer toothing. With these, more fragile sections of tissue can be grasped. The precision of coagulation is dependent on the gauge of the jaws. The finer the gauge of the jaws, the more precise the coagulation. Microbipolar jaws are suitable for vascular, urological, infertility procedures and tubal reanastomosis where fine precision is required. The smaller biarticulate AI 21 A 95

102 RoBi Instruments Rotating Bipolar Grasping Forceps and Scissors, CLERMONT-FERRAND Model jaws are excellent for handling delicate tissues like the vessels, ureters and fallopian tubes. These are also suitable for tying intracorporeal knots. Kelly jaws are very popular in general laparoscopic procedures as the shape of the biarticulate jaws allows the surgeon to achieve precise dissection and coagulation. Fenestrated jaws featured here have fine atraumatic serration. Jaws are biarticulate and the broad jaws enable a strong grasping function. Monoarticulate jaws are appropriate on oncological procedures especially during lymph node dissection as one jaw remains stable to reduce trauma while the other jaw takes on the main dissecting role. The Coagulation Function The Bipolar Energy Bipolar energy is precise and safe at the same time. The path of electrons is always known. They move from the generator to the forceps, flowing through the tissue located between the jaws and return directly via the forceps cable to the generator. A neutral electrode is unnecessary. This prevents any risk of electrical burns. Coagulation, however, occurs by means of heating the tissue. If the tissue is heated too severely or the exposure times are too long, there is a risk that burns will occur around the operating site. To restrict this effect, the exposure times have to be limited and modified according to the tissue impedance. In contrast to conventional bipolar forceps, these allow the pressure applied to the tissue to be altered and, as a result, the impedance to be changed. The more the tissue is compressed, the greater the impedance. The surgeon can alter the impedance of the tissue held by the forceps via the handle, and, thereby, alter the coagulation time. In this manner, the heat dispersion can be controlled. The Energy Density The indicated power varies according to the size of the jaws. The thicker the jaws, the higher the power has to be. In principle, work proceeds with powers in the order of 30 to 50 watts. The density of energy transferred to the tissue is directly relative to the size of the jaws. The narrower the jaws, the greater the energy. Therefore, in order to coagulate a tissue zone with precision, the surgeon has to select a high power setting. With thicker jaws, he has to choose a higher power setting (50 watts), but with a shorter exposure time. With thinner jaws, he has to select a lower power setting of approximately 35 watts. Application Mode The rules for the application of bipolar energy are very precise. After selecting the power, the surgeon applies the energy with as short an exposure time as possible. After performing the coagulation, the incision is restricted to the coagulated area, i.e., the tissue that has become white. As soon as the tissue becomes pink in color again, the incision is interrupted and coagulation is continued at the spot where the incision is being made. Soiling of the jaws changes the distribution of energy. In extreme cases, coagulation is no longer possible. To avoid hemorrhaging resulting from insufficient coagulation, the electrodes (the jaws of the forceps) have to remain clean. Soiling of the jaws can be prevented by the following measures: Selection of the appropriate power, dependent on the size of the jaws Application with short exposure times Avoiding coagulation in blood. Even if the coagulation proceeds correctly, blood coagulates on the jaws causing them to become soiled. Correct, preventive coagulation is, therefore, the best preventive measure. The Dissection Function Interest The dissection of tissue found its way into the endoscopic technique relatively late. The working principle of bipolar energy initially consisted of coagulating as much tissue as possible. This surgical technique resulted from both the lack of experience among surgeons, as well as the features of bipolar instruments. Conventional forceps, for example, have no joint between the jaws. Closure of the jaws generally proceeds by sliding an external tube. Opening is usually passive. The grasping function of these instruments was very imprecise and dissection was impossible. Nevertheless, dissection is the prerequisite for precision surgery. By using dissection, tissue can be identified or secured in such a way that no other organs are involved AI 22 A

103 RoBi Instruments Rotating Bipolar Grasping Forceps and Scissors, CLERMONT-FERRAND Model Application Mode Dissection proceeds through introduction of the instrument tip between the tissue surfaces. By opening the handle, the jaws can be moved and the tissue surfaces spread apart. The force which is transferred to the tissue can be felt in the handle and, thus, enables precise dosing for dissection. Instrument Features Characteristics This instrument is a bipolar instrument with two insulated jaws. By means of the specific joint, this insulation can be maintained. Insulation of the jaws is made possible by an intermediate ceramic layer. In this manner, current leakage is impossible. This insulation is optimum at 2,500 volts. The forceps are rotatable, detachable and autoclavable. Rotation Rotation is an essential feature of bipolar forceps. It permits the following: Through rotation, the tissue can be grasped at a correct 90 angle, coagulated and cut. This is an essential prerequisite for correct gripping, the dissection of tissue and coagulation restricted to the affected tissue. As for all instruments equipped with a single movable jaw, it is important to perform a rotation to position this jaw at the ideal location to which the force of dissection should be applied. Disassembly It has to be possible to disassemble the forceps so that inserts can be exchanged and the forceps can be cleaned easily. Thanks to the quick-change system RoBi, the inserts can be exchanged during surgery and according to surgical requirements. Cleaning In its disassembled condition, the forceps can be cleaned more easily. The collection of tissue remnants at the rear end of the jaws is limited by the recess provided at this location. In spite of the toothing, the jaws can be cleaned simply. Cleaning after surgery is facilitated if the jaws are soaked for a few minutes. By brushing the jaws with a soft brush, tissue remnants can be removed before the forceps are sterilized. Sterilization The instrument can be reused. Sterilization is performed in an autoclave at 134 C. Precautions When activating the bipolar instrument, it is important to ensure that there is no critical viscera in contact with the length of the instrument. Before stepping on the pedal, the surgeon must ensure that only the tissue concerned are grasped between the two jaws of the forceps. This is to prevent unintentional thermal injury. Conclusions The selection of functions for an instrument is made according to the surgical requirements and the technical prerequisites. If laparoscopies are being performed, the surgeon must make these decisions himself. Modern endoscopic surgery is performed using two hands. Optimization of the endoscopic intervention is dependent on the number and selection of functions that are possible for the surgeon with his two hands. We have decided on grasping, dissection and coagulation with one hand. These functions are performed by means of the bipolar forceps. If simple distention of the tissue using the instrument is also taken into account, the surgeon has four functions at his disposal, all possible with one hand. This multifunctionality optimizes endoscopic intervention, which in this way becomes simpler, faster and safer. Nomenclature RoBi stands for rotating bipolar instruments and describes an innovative and compatible range of instruments that are distinguished by the following features: bipolar rotatable detachable handle, sheath and interior specific joint mechanism AI 23 A 97

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105 RoBi Instruments Rotating Bipolar Grasping Forceps, CLERMONT-FERRAND Model Size 5 mm Special Features: Jaws with robust hinge for optimized bipolar grasping Fully rotational 360 sheath Top mounted 45 high frequency connector pin leads the cable away from the operative field Available in two working lengths: 36 and 43 cm Can be completely disassembled into separate components: Handle Outer sheath Working insert Cleaning port Autoclavable RoBir Insulated Metal Outer Sheaths with LUER-Lock connector for cleaning RoBi Metal Outer Sheath, insulated, with LUER-Lock connector for cleaning, size 5 mm, length 36 cm Same, length 43 cm Length 36 cm n Handle cm Double action jaws Working Insert MD MD 19 Catalog number for the complete instrument MD MD RoBi KELLY Dissecting and Grasping Forceps, CLERMONT-FERRAND model, especially suitable for dissection Please note: For the instrument only the individual component parts are numbered. The catalog number for the complete instrument is not on the instrument. Please take this number from the numbers indicated in the red background of the table above. The color green indicates the working lengths. High Frequency Cords for bipolar coagulation see chapter 10, UNITS AI 25 A 99

106 Endoscopic Vascular Clamps Special Features: All vascular clamps are available in curved and straight versions. The conical shape of the instruments and the round sheath enable problem-free percutaneous insertion into the abdomen. A maximum incision of only 5 mm is necessary for inserting the vascular clamps. Gas loss during insertion is minimal so that the surgical workflow is hardly disturbed. The outer diameter of the sheath is 10 mm SB All the handles are equipped with a simple, but efficient securing mechanism to prevent unintentional opening of the clamps during the intervention. The irrigation port on the shaft enables perfect hygienic preparation of the instruments. Safety is the objective of every intervention. Safety is the reason for the robust design of the handle AI 26 A

107 Endoscopic Vascular Clamps Size 10 mm, length 30 cm VC Vascular Clamp, jaws slightly curved, length of jaws 5 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm SS Vascular Clamp, straight jaws, length of jaws 7 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm SB SATINSKY Laparoscopic Clamp, long version, length of jaws 10 cm, depth of jaws 2.5 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm SC SATINSKY Laparoscopic Clamp, short version, length of jaws 8 cm, depth of jaws 2 cm, straight sheath, with axial ring handle, ratchet with safety locking device, size 10 mm, length 30 cm This instrument was specially developed for clamping of calcified aortae. AI 27 A 101

108 Endoscopic Vascular Clamps Deployable Vascular Clamps Size 10 mm DA DA Vascular Clamp Applicator, size 10 mm, length 32 cm, for use with Deployable Vascular Clamps DB and DC including: Inner Rod Outer Sheath DB Deployable Vascular Clamp, single action jaws, length of jaws 5 cm, size 10 mm, total length 11 cm, for use with Vascular Clamp Applicator DA DC Deployable Vascular Clamp, parallel-action jaws, length of jaws 5 cm, size 10 mm, total length 13 cm, for use with Vascular Clamp Applicator DA 7-04 Components see chapter 11, SPARE PARTS AND ACCESSORIES 102 AI 28 A

109 Endoscopic Vascular Clamps c Grasping Forceps Size 10 mm Optional accessory for use with the deployable vascular clamp, to hold the deployable vascular clamp firmly inside the abdominal cavity while the clamp applicator is detached during introduction and deployment, or attached during clamp retrieval DD DD c Grasping Forceps, rotating, double action jaws, for grasping of deployable vascular clamps, size 10 mm, length 36 cm including: Metal Handle, without ratchet Metal Outer Sheath Forceps Insert 7-04 Components see chapter 11, SPARE PARTS AND ACCESSORIES AI 29 A 103

110 KOH Macro Needle Holder dismantling n KOH Macro Needle Holder, size 5 mm, dismantling, consisting of: Handle Outer sheath Working insert Cleaning and sterilization are gaining increasing importance for KARL STORZ as a manufacturer of surgical instruments. Similar to all our surgical instruments, the cleaning and hygiene of our needle holders also play an important role. Our KOH macro needle holders feature consistent effectiveness and precision, with significantly improved cleaning results achieved by dismantling the instrument. The handle, outer sheath and inner part can be cleaned and sterilized separately for perfect results. This unique reusable three-piece design offers the user the following benefits: Can be disassembled into three separate components Fully autoclavable Cleaning adaptor Choice of six different handles and three different working inserts With tungsten carbide inserts Environmentally correct: In the event of damage, only the component with the defect needs to be replaced User-friendly and ergonomic handling AI 30

111 Handles and Outer Sheaths KOH Macro Needle Holders, dismantling n Handles, axial and pistol grip, with disengageable ratchet AR Handle, axial, with disengageable ratchet, ratchet position right AL Handle, axial, with disengageable ratchet, ratchet position left AO Handle, axial, with disengageable ratchet, ratchet position on top PR Handle, pistol grip, with disengageable ratchet, ratchet position right PL Handle, pistol grip, with disengageable ratchet, ratchet position left PO Handle, pistol grip, with disengageable ratchet, ratchet position on top Metal Outer Sheaths Size 5 mm A A Metal Outer Sheath, with LUER-Lock connector for cleaning, size 5 mm, length 33 cm A Same, length 43 cm AI

112 KOH Macro Needle Holder dismantling n Size 5 mm Working length Handle AR AL AO 33 cm 43 cm Single action jaws Working insert R R Catalog number for the complete instrument RAR RAL RAO RAR RAL RAO KOH Macro Needle Holder, dismantling, jaws curved to right, with tungsten carbide inserts, for use with suture material size 0/0 to 7/ L L LAR LAL LAO LAR LAL LAO KOH Macro Needle Holder, dismantling, jaws curved to left, with tungsten carbide inserts, for use with suture material size 0/0 to 7/ F F FAR FAL FAO FAR FAL FAO KOH Macro Needle Holder, dismantling, straight jaws, with tungsten carbide inserts, for use with suture material size 0/0 to 7/ AI 32

113 KOH Macro Needle Holder dismantling n Size 5 mm Working length Handle PR PL PO 33 cm 43 cm Single action jaws Working insert R R Catalog number for the complete instrument RPR RPL RPO RPR RPL RPO KOH Macro Needle Holder, dismantling, jaws curved to right, with tungsten carbide inserts, for use with suture material size 0/0 to 7/ L L LPR LPL LPO LPR LPL LPO KOH Macro Needle Holder, dismantling, jaws curved to left, with tungsten carbide inserts, for use with suture material size 0/0 to 7/ F F FPR FPL FPO FPR FPL FPO KOH Macro Needle Holder, dismantling, straight jaws, with tungsten carbide inserts, for use with suture material size 0/0 to 7/ AI

114 COGGIA Needle Holders n Size 5 and 10 mm NG NC COGGIA Needle Holder, jaws with tungsten carbide inserts, conical and tapered jaws, axial ring handle with hemostat style ratchet, size 5 mm, length 33 cm, for suture material 3 0, needle size V-7 (Ethicon), KV-7 (Syneture) NG COGGIA Needle Holder, jaws with tungsten carbide inserts, conical and tapered jaws, axial ring handle with hemostat style ratchet, size 10 mm, length 33 cm, for suture material 3 0, needle size V-7 (Ethicon), KV-7 (Syneture) Please note: Using the needle holders with a needle larger than recommended may result in mechanical damage to the instrument. 108 AI 34

115 Handles, Suction and Irrigation Tubes n S S Handle, straight, with clamping valve, for suction and irrigation, autoclavable, for use with 5 and 10 mm suction and irrigation tubes with central working channel including: mtp* Promotion Pack S S Handle, pistol grip, with clamping valve, for suction and irrigation, autoclavable, for use with 5 and 10 mm suction and irrigation tubes, with central working channel including: mtp* Promotion Pack LH SC Suction and Irrigation Tube, size 5 mm, length 36 cm, for use with suction and irrigation handles LH Suction and Irrigation Tube, with lateral holes, size 10 mm, length 36 cm, for use with suction and irrigation handles * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany Note: Handles S and S can be used with sterile silicone tubing sets from the company mtp. Silicone Tubing Sets for use with Handles see chapter 11, SPARE PARTS AND ACCESSORIES Units for use with handles for suction and irrigation see chapter 10, UNITS Components see chapter 11, SPARE PARTS AND ACCESSORIES AI

116 Laparoscopic Scalpel, Knife, Palpation Hook and Retractors DE DE Laparoscopic Scalpel, round, size 5 mm, length 30 cm, including miniature blade, distendable and exchangeable DO BERCI Micro Knife, pointed, distendable, size 5 mm, length 31 cm GH GH Palpation Hook, hook angled 90, blunt, diameter 5 mm, working length 36 cm FP FP Fan Retractor, dismantling, distendable, size 10 mm, length 36 cm VR VR Retractor, dismantling, variable in curvature, blunt, size 10 mm, working length 36 cm including: Handle Outer Sheath Insert Components see chapter 11, SPARE PARTS AND ACCESSORIES 110 AI 36

117 VISUALIZATION SYSTEM FOR MICROSURGERY

118 n VITOM 25 Visualization System for Microsurgery CA-VA VIS 2

119 n VITOM 25 Visualization System for Microsurgery The VITOM 25 from KARL STORZ represents a revolutionary and innovative way of displaying surgical procedures in a high quality and ergonomic manner. The VITOM 25 is based on the renowned HOPKINS II rod lens system from KARL STORZ. With the help of a holding system, the VITOM 25 is placed at a working distance of cm above the surgical field. This gives the surgeon more room to work. The small size of the VITOM 25 reduces space requirements in the OR to a minimum. Due to its slim and compact design, the surgical field is not obstructed and even long instruments can be used with ease. The VITOM 25 provides excellent depth of field, magnification, contrast and color reproduction, which are the requisites for FULL HD display and recording. The first-class enhanced imaging can be observed via a FULL HD monitor from a convenient distance by the surgeon, the assistant as well as the entire OR team. The VITOM 25 system has proven to be an excellent alternative to OR illumination cameras, loupes or operating microscopes in various surgical disciplines. The VITOM 25 is equipped with an integrated illumination, which can be supplemented with an optional illuminator. The system allows further use of existing units. A FULL HD endoscope imaging solution from KARL STORZ can also be used with the VITOM 25 exoscope CA-VA VIS 3 113

120 VITOM 25 System Overview n Exoscope and Illumination + + VITOM 25 Exoscope and Light Cable VITOM 25 Illuminator and Y-Light Cable (optional) XENON 300 SCB Light Source Camera and Display + + IMAGE 1 HUB HD Camera Control Unit IMAGE1 H3-Z Three-Chip HD Camera Head IMAGE 1 HUB HD Monitor Holding System or or ENDOCRANE Piezoelectric Holding Arm POINT SETTER Pneumatic Holding Arm Mechanical Holding Arm Documentation System KARL STORZ AIDA compact NEO (HD/SD) Accessories and Expendable Materials Tray, for VITOM 25 Straight Forward Telescope Single-Use Cover, for FULL HD camera Single-Use Cover, for POINT SETTER holding arm STOR-E Transport Cart CA-VA VIS 4

121 n VITOM 25 Diameter 10 mm, length 11 cm AA AA VITOM 25 HOPKINS II Straight Forward Telescope 0, working distance cm, diameter 10 mm, length 11 cm, autoclavable, fiber optic light transmission incorporated, color code: green Fiber Optic Light Cables 495 NB/NCS/NE recommended VD VD VITOM 25 Distance Rod, length 25 cm optional: VI VI VITOM 25 Illuminator, for straight forward telescopes 0, 2 adjustable lenses with holding device for VITOM 25, autoclavable, for use with Y-Fiber Optic Light Cable 495 UV Y-Fiber Optic Light Cable 495 UV recommended Container for Sterilization and Storage of Telescopes see catalog ENDOPROTECT1 CA-VA VIS 5 115

122 Cold Light Fountain XENON 300 SCB Special Features: Extremely high light intensity due to 300 Watt Xenon lamp Built-in antifog pump With integrated KARL STORZ Communication Bus (KARL STORZ-SCB) Cold Light Fountain XENON 300 SCB power supply / VAC, 50/60 Hz including: Mains Cord Silicone Tubing Set, length 250 cm SCB Connecting Cable, length 100 cm Specifications: Lamp type Color temperature Light outlets Light intensity adjustment XENON 15 V, 300 Watt 6000 K 1 continuously adjustable via a membrane keyboard or KARL STORZ Communication Bus Signal Dimensions w x h x d Weight Certified to: 305 x 165 x 335 mm 7.96 kg IEC and UL 544, protection class 1/CF Spare Lamps and Spare Lamp Modules for Cold Light Fountains XENON see catalog TELEPRESENCE Components see chapter 11, SPARE PARTS AND ACCESSORIES 116 CA-VA VIS 6

123 IMAGE 1 HUB HD HD Camera Control Unit Special Features: Maximum resolution and the consistent use of the 16:9 aspect ratio guarantee FULL HD. Endoscopic and microscopic camera systems are equipped with three CCD chips that support the 16:9 input format as well as capturing images with a resolution of 1920 x 1080 pixels. The benefits of FULL HD (High Definition) for medical applications are: Up to 6 times higher input resolution of the camera delivers more detail and depth of focus. Using 16:9 format during image acquisition enlarges the field of vision and supports ergonomic viewing. The brilliance of color enables optimal diagnosis. Lateral view is enhanced by 32% when the endoscope is withdrawn slightly, providing the same image enhancement as a standard system. Any vertical information loss is restored and the lens remains clean U102 IMAGE 1 HUB HD Camera Control Unit SCB, with SDI module for use with IMAGE1 HD and standard one- and three-chip camera heads, max. resolution 1920 x 1080 Pixel, with integrated KARL STORZ-SCB and integrated digital Image Processing Module, color systems PAL/NTSC, power supply VAC, 50/60 Hz including: Mains Cord 2x BNC/BNC Video Cable, length 180 cm S-Video (Y/C) Connecting Cable, length 180 cm Connecting Cable, for controlling peripheral units, length 180 cm DVI-D Connecting Cable, length 300 cm SCB Connecting Cable, length 100 cm Keyboard, with US English character set Specifications: Signal-to-Noise Ratio AGC Video Output Input IMAGE 1 HUB HD, three-chip camera systems 60 db Microprocessor-controlled - Composite signal to BNC socket - S-video signal to 4-pin Mini-DIN socket (2x) - RGBS signal to D-Sub socket - SDI signal to BNC socket (only IMAGE 1 HUB HD with SDI module) (2x) - HD signal to DVI-D socket (2x) Keyboard for title generator, 5-pin DIN socket Control Output /Input Dimensions w x h x d Weight Power supply Certified to: - KARL STORZ-SCB at 6-pin Mini-DIN socket (2x) mm stereo jack plug (ACC 1, ACC 2) - Serial port at RJ-11 - USB port (only IMAGE 1 HUB HD with ICM) (2x) 305 x 89 x 335 mm 2.95 kg VAC, 50/60 Hz IEC 601-1, , CSA 22.2 No. 601, UL and CE acc. to MDD, protection class 1/CF Optional accessories for IMAGE 1 HUB HD see catalog TELEPRESENCE Components see chapter 11, SPARE PARTS AND ACCESSORIES CA-VA VIS 7 117

124 IMAGE1 HD Camera Heads for Endoscopy and Microscopy For use with IMAGE 1 HUB HD Camera Control Unit SCB U n Hz IMAGE1 H3-Z 60 Hz Three-Chip HD Camera Head max. resolution 1920 x 1080 pixels, progressive scan, soakable, gas- and plasma-sterilizable, with integrated Parfocal Zoom Lens, focal length f = mm (2x), 2 freely programmable camera head buttons, for use with color system PAL/NTSC Specifications: IMAGE1 HD Camera Head 50 Hz Image Sensor Pixel Output Signal H x V Dimensions Weight Min. Sensitivity Optical Interface Grip Mechanism Cable Cable Length H3-Z (PAL/NTSC) (50/60 Hz) 3x 1 /3" CCD chip 1920 x 1080 Diameter mm, length 114 mm 246 g F 1.4/1.17 Lux Integrated Parfocal Zoom Lens, f = mm Standard eyepiece adaptor non-detachable 300 cm Optional accessories for IMAGE 1 HUB HD see catalog TELEPRESENCE 118 CA-VA VIS 8

125 IMAGE 1 HUB HD HD Monitor 9524 N/NO 9526 N/NO 9524 NB/NBO 9526 NB/NBO KARL STORZ HD Flat Screens 24" 26" Desktop with pedestal 9524 N 9524 NO 9526 N 9526 NO Wall-mounted with VESA 100-adaption 9524 NB 9524 NBO 9526 NB 9526 NBO Inputs: SDI HD-SDI RGBS S-Video Composite SOG DVI-D Fiber Optic VGA Outputs: SDI HD-SDI RGBS S-Video Composite DVI-D Displayable Signal Formats: 4:3 5:4 16:9 16:10 Picture-in-Picture (PiP, HD SD) Picture-in-Picture (PiP, HD HD) PAL/NTSC compatible Picture-Perfect Technology The following accessories are included: Mains Cord, length 300 cm External 24VDC Power Supply Pedestal (only 9524 N/NO and 9526 N/NO) The systems can be operated with KARL STORZ-SCB units. Video connecting cables see catalog TELEPRESENCE CA-VA VIS 9 119

126 Data Management and Documentation KARL STORZ AIDA compact NEO (HD/SD) Continuous first-class documentation AIDA compact NEO from KARL STORZ combines all the required functions for integrated and precise documentation of endoscopic procedures and open surgeries in a single system. AIDA compact NEO: Voice control Data Acquisition Still images, video sequences and spoken comments can easily be recorded during an examination or intervention using the touch screen, voice control, footswitch, or camera head buttons. All images are displayed in the right-hand bar in thumbnail size so that still images can be previewed before archiving. Patient data are entered via an onscreen or standard keyboard. Flexible Review In the review screen, still images or video sequences can be previewed, edited or deleted before final storage. Reliable Documentation AIDA compact NEO: Review screen Digital storage of all still images, video sequences and audio files on DVD, CD-ROM, USB stick, external/internal hard drive. It is also possible to archive data in the hospital network via DICOM/HL7. Buffering ensures data backup if saving is temporarily not available Created image, video and audio material continuously available for procedure documentation and for research and teaching purposes. Efficient Data Archiving AIDA compact NEO: Automatic creation of standard reports Once a treatment is completed, KARL STORZ AIDA compact HD/SD automatically stores the data on DVD, CD-ROM, USB stick, external/internal hard drive and/or the relevant network on a FTP server. It is also possible to save the data directly on the PACS and/or HIS servers via the AIDA communication HL7/DICOM interface package. Data that cannot be stored successfully remains in a cache until final archiving is possible. If required, the user can add a two-line report header and a logo. AIDA compact NEO: Efficient archiving Multisession and Multipatient Efficient data archiving is assured as several treatments can be saved on a DVD, CD-ROM or a USB stick CA-VA VIS 10

127 Data Management and Documentation KARL STORZ AIDA compact NEO (HD/SD) Special Features: Digital storage of still images with a resolution of 1920 x 1080, video sequences in 720p and audio files with AIDA compact NEO HD Optional DICOM/HL7 interface package Sterile, ergonomic operation via touch screen, voice control, camera head buttons and/or footswitch Automatic recognition of connected camera systems at HD-SDI/SD-SDI input Efficient archiving on DVD, CD-ROM or USB stick, multisession and multipatient Network storage possible Automatic creation of standard reports Computers and monitors for use in the OR area certified according to EN Compatible with KARL STORZ Communication Bus (SCB) and KARL STORZ OR1 AV NEO KARL STORZ AIDA compact NEO HD/SD is an attractive, digital alternative to video printers, video recorders and dictating machines KARL STORZ AIDA compact NEO SD Communication documentation system for digital storage of still images, video sequences and audio files, power supply 115/230 VAC, 50/60 Hz KARL STORZ AIDA compact NEO HD Communication documentation system for digital storage of still images, video sequences and audio files, power supply 115/230 VAC, 50/60 Hz EN* KARL STORZ AIDA compact NEO SD documentation system for digital storage of still images, video sequences and audio files, power supply 115/230 VAC, 50/60 Hz * Available in following languages: DE, ES, FR, IT, NL, NO, PT, PL, RU, DK, SE, JP, CN EN* KARL STORZ AIDA compact NEO HD documentation system for digital storage of still images, video sequences and audio files, power supply 115/230 VAC, 50/60 Hz * Available in following languages: DE, ES, FR, IT, NL, NO, PT, PL, RU, DK, SE, JP, CN Specifications: Video Systems Signal Inputs PAL, NTSC - S-Video (Y/C) - Composite - RGBS - SDI - HD-SDI - DVI-D - JPG - BMP Video Formats Audio Formats Storage Media MPEG2 WAV - DVD+R - DVD+RW - DVD-R - DVD-RW - CD-R - CD-RW - USB stick Image Formats CA-VA VIS

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129 HOLDING SYSTEMS AND TRAINING MODELS HOLDING SYSTEMS n ENDOCRANE HOLDING SYSTEM n POINT SETTER HOLDING SYSTEM TRAINING MODELS n

130 Holding Systems Special Features: Simple, fast and accurate positioning New, reinforced versions of various articulated stands Five joint functions enable a large number of different positions All five joint functions can be fixed by means of a mechanical central clamp Additional height adjustment by using the socket Additional angle adjustment by using the socket HR Socket for use with European and United States standard rails Ergonomical positioning at the operating table Eases the work routine of the assistant Instruments and telescopes are clamped securely Steady imaging of the operation field Modular composition using individual elements Maintenance-free solid construction Autoclavable RKB 124 VE-HT

131 Holding Systems Socket Articulated Stand HK HA HB HC C B C B C D D HR A A A D A 30 cm C 20 cm B D 17 cm A 48 cm C 20 cm B 15 cm D 17 cm A 48 cm C 27 cm B 15 cm D 24 cm Clamping Jaw UG Catalog number for the complete holding system KGA RGA KGB RGB KGC RGC Clamping Jaw, metal, with axial intake, for use with all square-headed KARL STORZ telescopes, clamping range mm UK KKA RKA KKB RKB KKC RKC Clamping Jaw, metal, with axial intake, for use with instrument, irrigation and telescope sheaths, clamping range mm UL KLA RLA KLB RLB KLC RLC Clamping Jaw, universal, clamping range 0 18 mm UF KFA RFA KFB RFB KFC RFC Clamping Jaw, for use with all KARL STORZ polymer housing fiberscopes Clamping Cylinder C Clamping Cylinder, 10 mm, for flexible mounting of 10 mm telescopes to telescope sheath, autoclavable. The clamping cylinder allows vertical movement and rotation of the telescope. VE-HT 1 A 125

132 ENDOCRANE Holding System n The ENDOCRANE holding arm is the system of choice if a particularly fast, accurate and safe positioning of instruments or endoscopes is required, i.e. in neurosurgery, laparoscopy or orthopedics. The ENDOCRANE holding arm helps surgeons and assistant surgeons save time as the positioning of instruments and telescopes is faster and easier than with a manual holding system. The system also relieves the assistant surgeon of camera guidance and delivers steady images. The ENDOCRANE holding system features a special piezoelectric locking joint mechanism. This achieves positioning without misalignment as well as rapid locking (30 ms), meeting the demands of a clinical setting. The system can be used with one hand and the large working radius of 50 cm allows variable use. A holding capacity of 20 N (2 kg) is possible in any position. The holding arm features a fail-safe function which prevents a loss of retention force in the case of malfunction, i. e. power failure. The system is very compact and can be mounted directly on standard OR table rails EC VE-HT 2 A

133 ENDOCRANE Holding System n Product Features Safety The fail-safe function of the ENDOCRANE prevents loss of retention force and ensures that the arm does not collapse in case of malfunction. Accuracy ENDOCRANE offers accurate positioning without misalignment. This is indispensable for critical applications such as neurosurgery. Speed The piezoelectric principle enables the joints of the ENDOCRANE to close in 30 ms and ensures a holding force of 20 N in all positions. Convenience The ENDOCRANE system allows single-handed use via the handle. Flexibility ENDOCRANE is equipped with the proven KARL STORZ rapid coupling, which ensures fast and secure mounting of various clamping jaws. The ENDOCRANE handle has a manual ball joint to allow convenient fine adjustment. Hygiene Der ENDOCRANE holding arm is equipped with a sterile cover during use. This guarantees 100% hygiene as well as safety and ensures that the system is in continuous use VE-HT 3 A 127

134 ENDOCRANE Holding System n EC EC ENDOCRANE, piezoregulated holding arm, set, including stand including: Socket, to clamp to the OR table Control Unit Cover*, sterile, package of 25 Spring Balance Mains Cord * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany Clamping jaws for the ENDOCRANE holding system see page 129 Components see chapter 11, SPARE PARTS AND ACCESSORIES 128 VE-HT 4

135 ENDOCRANE Holding System Accessories n UG Clamping Jaw, metal, with axial intake, for use with all square-headed KARL STORZ telescopes, clamping range mm UK Clamping Range, metal, with axial intake, for use with instrument, irrigation and telescope sheaths, clamping range 4.8 up to 12.5 mm UL Clamping Jaw, universal, clamping range 0 18 mm UF Clamping Jaw, for use with all KARL STORZ polymer fiberscopes UU Clamping Jaw, for use with instrument, irrigation and telescope sheaths C Clamping Cylinder, 10 mm, for flexible mounting of 10 mm telescopes to telescope sheath, autoclavable. The clamping cylinder allows vertical movement and rotation of the telescope. For use with Clamping Jaw UG and UG as well as Universal Adaptor mm * * Cover, sterile * Cover, sterile, package of 25 Specifications: Arm: Maximum holding capacity 2 kg/20 N Working radius 500 mm/19.7" Swivel range 360 Maximum locking time 30 ms (fail-safe) Weight of holding arm and stand 7 kg/15.4 lbs Protection against electric shock Type CF Type of protection IP 50 Control Unit Power supply Mains frequency Weight Dimensions (w x h x d) VAC 50/60 Hz 5 kg/11.0 lbs 305 x 80 x 305 mm * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany Specifications subject to change without notice. VE-HT 5 129

136 POINT SETTER Holding System n The POINT SETTER holding system is the perfect solution for positioning endoscopes as well as cameras, retractors or other instruments. The POINT SETTER holding arm is mounted directly to the operating table and features safe, simple and reliable use. The patented self-locking pneumatic system ensures perfect safety, eliminating the need for additional errorprone electronics. Furthermore, the POINT SETTER holding arm allows convenient single-handed use. Pressing and holding the control button on the handle releases the arm for quick and accurate positioning. The POINT SETTER arm locks as soon as the button is released. The flexible OR table adaptor and the arm length of 650 mm provides more work space. Combined with a holding capacity of 2 kg this makes the POINT SETTER an ideal tool for surgical interventions. Special Features: The self-locking pneumatic system ensures that low, fluctuating or deficient gas pressure does not affect the stability of the arm. A press of a control button releases the arm immediately for quick positioning. Side guards prevent accidental activation of the POINT SETTER arm. A locking mechanism offers additional safety. A manual ball joint at the tip of the handle enables convenient fine-tuning. Special surface structure for uniform and smooth movement as well as accurate positioning Precise positioning without forward or backward motion The POINT SETTER arm is very robust and has high torsional stiffness to ensure low oscillation and high reliability VE-HT 6

137 POINT SETTER Holding System n M M POINT SETTER, pneumatic holding arm, with OR table adaptor including: Universal Adaptor, for use with telescopes diameter mm and diameter 5 10 mm Universal Adaptor, mm, pediatric Adaptor, for KARL STORZ fiberscopes Connecting Tube Schrader, length 6 m, for USA and Asia* Case, for POINT SETTER arm Drape, for single use, sterile, package of C Clamping Cylinder, 10 mm, for flexible mounting of 10 mm telescopes to telescope sheath, autoclavable. The clamping cylinder allows vertical movement and rotation of the telescope. For use with Clamping Jaw UG and UG as well as Universal Adaptor mm * Note: For the POINT SETTER holding system, compressed-air tubes and various adaptors are available for connection to the central gas supply in the OR. For further information please contact your KARL STORZ customer service department. Components see chapter 11, SPARE PARTS AND ACCESSORIES VE-HT 7 131

138 STOR-E Transport Cart for POINT SETTER holding arm n With the aid of the transport cart, the POINT SETTER holding system can be easily transported into the OR. The components of the POINT SETTER holding system are safely suspended from the cart at a convenient height. This enables easy and quick mounting to standard OR table rails. Special Features: Mobile and safe storage of the POINT SETTER holding arm Faster installation and readiness of the POINT SETTER for immediate use in the OR Offers space for the POINT SETTER with standard OR table adaptor, connecting tube, sterile covers and small parts STOR-E Transport Cart, for the POINT SETTER holding arm including: Attachment, POINT SETTER set Tray Components see chapter 11, SPARE PARTS AND ACCESSORIES 132 VE-HT 8

139 n Training Model for endoscopic vein harvesting The training model for endoscopic vein harvesting comprises a reusable housing and a replaceable insert. To closely represent the flexed position of the leg during endoscopic vein harvesting, both the housing and insert are curved. The silicone-coated insert features simulated subcutaneous tissue with an embedded vessel TV TV Training Model, for endoscopic vein harvesting including: Working Insert Housing Cover Pins VE-HT 9 133

140 n Training Model for endoscopic artery harvesting The training model offers a realistic method for endoscopic artery harvesting that is quick and easy to learn. Consequently, it provides a cost-effective alternative to human samples. The replaceable working insert features muscle, fascia and an imitation blood vessel TA TA Training Model, for endoscopic artery harvesting including: Forearm Housing with Hand Working Insert Quick Lock-Release Mechanism Protective Cover Lubricant VE-HT 10

141 HEADLIGHTS AND HEADBANDS n HEADLIGHT KS60 WITH COLD LIGHT ILLUMINATION 136 HEADLIGHTS WITH COLD LIGHT ILLUMINATION 137

142 Headlight KS60 with Cold Light Illumination n Special Features: Luminous field can be focused adjustable from 20 to 80 mm at a working distance of 40 cm resulting in brightness of over 175,000 lux Double lens system provides outstanding illumination in the depths of the operating field Precise delineation and no luminous field color margins Homogeneous illumination of the luminous field without shadows Newly designed, lightweight headband provides improved comfort, also suitable for a small head size, can be adjusted both horizontally and vertically Sterilizable handle allows adjustment under sterile conditions, moveable and height adjustable Light cable is divided in the head area, ensuring even distribution of weight Extremely robust and flexible light cable due to special protective casing Convenient light cable length of 290 cm provides greater freedom of movement / Headlight KS60, with double lens system and Y-fiber optic light cable, >175,000 lux, illuminated area adjustable from mm in diameter with 40 cm working distance, with removable and sterilizable Focus Handle including: Headband, fully adjustable, with Forehead Cushion , with cross band, including holder for Headlight Y-Fiber Optic Light Cable, with special protective casing for Headlight , length 290 cm Clip with Band, for attaching the fiber optic light cable to OR clothing Same, including: Y-Fiber Optic Light Cable, with 90 deflection to the light source Components see chapter 11, SPARE PARTS AND ACCESSORIES 136 VE-J 2 A

143 Headlights with Cold Light Illumination Special features: Excellent illumination in the depth of the operating field Ideally suited for all areas of medicine 150 percent more brightness in comparison to standard headlights Diameter of light field can be adjusted from 10 to 60 mm Sterilizable handle , removeable Headlight can be adjusted with the sterile hand Comfortable, adjustable headband, including forehead cushion with push-button lock Clip for attaching the fiber optic light cable to OR clothing / Headlight, with ball joint and vertical height adjustment, front section movable in all directions, with U-shaped suspension and ball joint including: Headband Fiber Optic Light Cable Clip with Band Same, including: Fiber Optic Light Cable, with 90 deflection to the light source Components see chapter 11, SPARE PARTS AND ACCESSORIES VE-J 3 A 137

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145 UNITS AND ACCESSORIES VIDEOCARTS INSUFFLATORS SUCTION AND IRRIGATION SYSTEMS HIGH FREQUENCY SURGERY UNITS

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147 Units and Accessories for Cardiovascular Surgery INSUFFLATORS VIDEOCARTS VIDEOCARTS INSUFFLATORS SUCTION AND IRRIGATION SYSTEMS HIGH FREQUENCY SURGERY UNITS The units manufactured by KARL STORZ combine longlasting precision mechanics with state-of-the-art microelectronic programmable controls. At KARL STORZ, the greatest emphasis is placed on user and patient safety. The quality assurance system of KARL STORZ is certified in accordance with the requirements of ISO 9001/EN It guarantees constant quality testing in the selection of materials and components. At the end of each manufacturing process, tests are carried out with automatic measuring and testing systems developed specially for this purpose. The results are recorded and logged. That gives each device a distinct fingerprint that can be checked at any time before and after it is delivered to the customer. The standardized, modular design of KARL STORZ units was developed based on extensive ergonomic studies and is conceived for ease of care and cleaning and user-friendly practice, as well as to meet the demands of the special hygienic standards required in surgery. Clearly laid out adjacent function keys and displays guarantee efficient operation and make it easier to constantly monitor actual and set parameters. Acoustic and visual warning signals also assist the user. The settings can be changed manually at any time. Automatic microelectronic control systems guarantee optimum operating conditions and therefore relieve the surgeon in his work who can then fully concentrate on medical procedures. SUCTION AND IRRIGATION SYSTEMS The overall KARL STORZ product line includes the following categories of units with Insufflators Suction and Irrigation Systems Motor Systems Lithotripsy Systems Units for High Frequency Surgery HIGH FREQUENCY SURGERY UNITS CARDIO-UNITS-INTRO U 3

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149 Videocarts Basic Set VIDEOCARTS 9526 NB 26" KARL STORZ HD Flat Screen Cold Light Fountain XENON 300 SCB 495 NCS Fiber Optic Light Cable, extremely heat-resistant, diameter 4.8 mm, length 250 cm U102 IMAGE 1 HUB HD Camera Control Unit SCB, with SDI module IMAGE 1 H3-Z Three-Chip HD Camera Head KARL STORZ AIDA compact NEO HD Communication HAMOU ENDOMAT SCB Electronic CO 2 ENDOFLATOR SCB, accessories optional AUTOCON II 400 SCB, High-End, accessories optional Neutral Electrode Neutral Electrode Connecting Cable M Unipolar High Frequency Cord LE Bipolar High Frequency Cord Two-Pedal Footswitch LAP Mobile Videocart HFH Pedal Holder, suspended, for mounting to normal rails, suitable for two-pedal footswitch of high frequency surgery units AUTOCON II 400 SCB and Erbe Vio HFS Double Pedal Holder, for mounting to videocart side boom, model xx and xx, suitable for two-pedal footswitch, for use with AUTOCON 50/200/350, AIDA, TELE PACK, GASTRO PACK and all KARL STORZ motor systems CARDIO-UNITS 3 C U 5

150 Electronic CO 2 ENDOFLATOR SCB Recommended System Configuration Special Features: High degree of patient safety Easy to use Clear, adjacent displays for set value and actual value facilitate monitoring of the insufflation process Touch keys for precise preselection of set values Optical and acoustic alarm signals in the event of patient overpressure Fully automatic, electronically controlled gas refill (e. g. in case of gas loss when changing instruments) Secuvent Safety System: Constant monitoring of intraabdominal pressure; any overpressure is reduced immediately SCB model with connections to the KARL STORZ Communication Bus (KARL STORZ-SCB) INSUFFLATORS Electronic CO 2 ENDOFLATOR SCB, power supply VAC, 50/60 Hz including: Mains Cord Silicone Tubing Set, sterilizable Universal Wrench SCB Connecting Cable, length 100 cm CO 2 /N 2 O Gas Filter*, sterile, for single use, package of 10 Specifications: Operating Mode Gas Flow Pressure Gas Measuring/Control System Parameter Display Operating mode 0-20 l/min 0-30 mmhg (3990 Pa) CO 2 Electronic - Insufflation pressure - Intraabdominal pressure: 0-50 mmhg (6650 Pa) - Gas flow: 0-20 l/min - Gas consumption: l Secuvent Safety System Power Supply Dimensions w x h x d Weight Certified to VAC, 50/60 Hz 305 x 164 x 233 mm 6 kg IEC 601-1, CE acc. to MDD * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany Optional Accessories for the Electronic CO 2 ENDOFLATOR SCB see pages U Components see chapter 11, SPARE PARTS AND ACCESSORIES U 6 CARDIO-UNITS 4 B

151 Electronic CO 2 ENDOFLATOR SCB System Components CO 2 Bottle, Pin-Index connector CO 2 Bottle, German connector empty filled empty filled High Pressure Tube, Pin-Index connector High Pressure Tube, German connector High Pressure Tube, ISO connector Low Pressure Tube, for central CO 2 gas supply length 55 cm length 102 cm length 55 cm length 102 cm length 102 cm length 300 cm INSUFFLATORS U N I T S I D E PATIENT SIDE CO 2 /N 2 O Gas Filter, sterile, for single use * Silicone Tube, for insufflation VERESS Pneumoperitoneum Cannula Trocar J MC LC * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany CARDIO-UNITS 5 B U 7

152 Thermoflator SCB with Speed-Flow Insufflation (30 l/min), Recommended System Configuration Special Features: High degree of patient safety Easy to use Simultaneous display of set values and actual values facilitate monitoring of the insufflation process Touch keys for precise preselection of set values Optical and acoustic alarm signals in the event of patient overpressure Fully automatic, electronically controlled gas refill (e.g. in case of gas loss when changing instruments) Secuvent Safety System: Constant monitoring of intraabdominal pressure Very high gas flow capacity of up to 30 l/min Especially suitable for providing a high gas flow when using smoke generating techniques Special initialization mode for establishing pneumoperitoneum at a preset insufflation pressure of 15 mmhg and a gas flow rate of 1 l/min with warning function A High-Capability Trocar (HiCap ) is a recommended option Optitherm Heating Element: For preheating gas to body temperature to prevent peritoneum from cooling down SCB model with connections to the KARL STORZ Communication Bus (KARL STORZ-SCB) INSUFFLATORS Thermoflator SCB, power supply VAC, 50/60 Hz including: Mains Cord Optitherm Heating Element, autoclavable Silicone Tubing Set, sterilizable Universal Wrench SCB Connecting Cable, length 100 cm CO 2 /N 2 O Gas Filter*, sterile, for single use, package of 10 Specifications: Operating Mode - Initialization mode - Operating mode - Initialization mode: 1 l/min - Operating mode: 0-30 l/min - Initialization mode: 15 mmhg (1995 Pa) - Operating mode: 0-30 mmhg ( Pa) CO 2 Electronic Secuvent Safety System Optitherm Gas Preheating Power Supply Dimensions w x h x d Weight Certified to Gas Flow Pressure Gas Measuring/Control System Parameter Display VAC, 50/60 Hz 305 x 164 x 233 mm 7 kg IEC 601-1, CE acc. to MDD - Insufflation pressure - Intraabdominal pressure: 0-50 mmhg (6650Pa) - Gas flow: 0-30 l/min - Gas consumption: l * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany Optional Accessories for the Thermoflator SCB see pages U Components see chapter 11, SPARE PARTS AND ACCESSORIES U 8 CARDIO-UNITS 6 B

153 Thermoflator SCB System Components CO 2 Bottle, Pin-Index connector CO 2 Bottle, German connector empty filled empty filled High Pressure Tube, Pin-Index connector High Pressure Tube, German connector High Pressure Tube, ISO connector Low Pressure Tube, for central CO 2 gas supply length 55 cm length 102 cm length 55 cm length 102 cm length 102 cm length 300 cm INSUFFLATORS U N I T S I D E PATIENT SIDE CO 2 /N 2 O Gas Filter, sterile, for single use Optitherm Heating Element * Silicone Tubing Set, for insufflation part 1 of Trocar Silicone Tubing Set, for insufflation part 2 of VERESS Pneumoperitoneum Cannula MC J * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany CARDIO-UNITS 7 A U 9

154 Optional Accessories for Insufflators for use with Electronic CO 2 ENDOFLATOR SCB Thermoflator SCB INSUFFLATORS J VERESS Pneumoperitoneum Needle, with spring-loaded blunt stylet, LUER-Lock, autoclavable, diameter 2.1 mm, length 10 cm JK Same, length 7 cm JL Same, length 13 cm JLL Same, for setting up pneumoperitoneum for adipose patients employing DOUGLAS puncture, length 15 cm MC Trocar, size 11 mm High Pressure Inline Gas Filter Silicone Tubing Set, sterilizable Silicone Tubing Set, for insufflation, sterilizable CO 2 Bottle, empty, with German connection Same, filled CO 2 Bottle, empty, with Pin-Index connection Same, filled * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany U 10 CARDIO-UNITS 8 B

155 Optional Accessories for Insufflators for use with Electronic CO 2 ENDOFLATOR SCB Thermoflator SCB CO 2 High Pressure Tube, American connection/german connection, length 55 cm Same, length 102 cm CO 2 High Pressure Tube, American connection/pin-index connection, length 55 cm Same, length 102 cm INSUFFLATORS CO 2 High Pressure Tube, American connection/iso connection, length 102 cm Low Pressure Tube, for the central CO 2 gas supply, length 150 cm Same, length 100 cm Same, length 300 cm Same, length 600 cm SCB Connecting Cable, length 60 cm Same, length 30 cm * * Gas Filter, with 3 m insufflation tube, for single use, sterile, package of * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany CARDIO-UNITS 9 B U 11

156 HAMOU ENDOMAT SCB Suction and Irrigation System, Recommended System Configuration Special Features: Suction and irrigation system for use in laparoscopy and gynecology Irrigation function is performed by a roller pump Maximum parameters for LAP and HYST mode are automatically fixed by the choice of the tubing set Precise presetting of suction and irrigation parameters via touch keys Adjacent display scales for set values and actual value ensure safe monitoring of suction and irrigation levels SCB model with connections to the KARL STORZ Communication Bus (KARL STORZ-SCB) SUCTION AND IRRIGATION SYSTEMS HAMOU ENDOMAT SCB power supply VAC, 50/60 Hz including: Mains Cord 3x HYST Tubing Set*, for single use 3x LAP Tubing Set*, for single use SCB Connecting Cable, length 100 cm VACUsafe Promotion Pack Suction*, 2l Specifications: Pressure Regulated Flow Regulated Suction Pressure Regulated - HYST mmhg (26.6 kpa) - LAP mmhg (53.2 kpa) - HYST ml/min - LAP ml/min - HYST 0-(-)0.5 bar (-50 kpa) - LAP 0-(-)0.8 bar (-80 kpa) Power Supply Dimensions w x h x d Weight Certified to VAC, 50/60 Hz 305 x 164 x 233 mm 6 kg IEC 601-1, CE acc. to MDD * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany Optional Accessories for the HAMOU ENDOMAT SCB see page U 14 Components see chapter 11, SPARE PARTS AND ACCESSORIES U 12 CARDIO-UNITS 12 B

157 HAMOU ENDOMAT SCB System Components One-Pedal Footswitch Tubing Set, LAP Tubing Set, LAP * U N I T S I D E PATIENT SIDE Silicone Tubing Set, for suction, part 1 of 2 Filter Bottle Caps Suction Bottles, 5 l Bottle Stands Holder for Bottle Stand * Pistol Grip Handle A Suction and Irrigation Tube SUCTION AND IRRIGATION SYSTEMS SC Silicone Tubing Set, part 2 of * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany CARDIO-UNITS 13 A U 13

158 Optional Accessories for HAMOU ENDOMAT SCB SC Suction and Irrigation Tube, size 5 mm, length 36 cm, for use with suction and irrigation handles Suction Bottle, 1.5 l, sterilizable Bottle Cap, for suction bottles 1.5 l and 5 l, sterilizable Bottle Stand, for suction bottle 1.5 l or irrigation bottle 1 l Suction Bottle, 5 l, sterilizable Bottle Cap, for suction bottles 1.5 l and 5 l, sterilizable Bottle Stand, for suction bottle 5 l Bottle Stand Holder, for Bottle Stand One-Pedal Footswitch, one-stage Two-Pedal Footswitch, one-stage SUCTION AND IRRIGATION SYSTEMS * Silicone Tubing Set, for suction, sterilizable Silicone Tubing Set, for suction, sterilizable, short * Filter, to block fluid during suction, for single use, unsterile, package of * HYST Tubing Set, for irrigation, for single use, sterile, package of * LAP Tubing Set, for irrigation, for single use, sterile, package of 10 mtp* Receptacle, reusable, 2 l suction bag, with filter, for single use mtp* Tubing Set, for suction, sterile, for single use * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany U 14 CARDIO-UNITS 14 C

159 The New AUTOCON II 400 SCB HF Unit Special Features: For interdisciplinary use Cutting-edge next-generation unit with a convenient, easy-to-disinfect touch screen Equipped with 2 bipolar or 2 unipolar HF outputs CF outputs for maximum patient and user safety Permanent monitoring of the neutral electrode during unipolar use 2 footpedals can be connected Automatic activation or via handswitch or footswitch Self-test for maximum patient and user safety Connection sockets individually selectable according to user requirements Logical arrangement and color coding of the control elements make the unit extremely simple to operate unipolar bipolar bipolar NaCl HIGH FREQUENCY SURGERY UNITS CARDIO-UNITS 15 C U 15

160 AUTOCON II 400 SCB Safety and Special Features Integrated voltage stability control or arc control The two state-of-the-art generators both guarantee optimal surgical cutting and coagulation power that adapts continuously to the particular indication, especially when there are wide variations in the tissue structures and tissue impedances. At the press of a button, the operator can switch between arc control (TOP Cut mode) and voltage stability control (POWER Cut mode). TOP Cut mode In this mode, the HF energy required for a cutting effect is automatically reduced to the necessary physical minimum in each individual case. The electric arc always remains at a constant level, thus ensuring a uniform surgical effect. Given precise operation, this offers a clear safety advantage and produces a cut that conserves tissue and reduces stress for the patient. This increased safety with the AUTOCON II 400 SCB unit is achieved by using the latest and fastest microprocessor and sensor technology, which enables the unit to capture all the important parameters, such as variable incision speed, geometry of the active electrode, different impedance behavior of biological tissue types and fluids, and transition and contact resistances. This data is then used to adjust the HF power output and HF voltage. This means that the operator is not restricted in his work or obliged to adapt to the HF unit. On the contrary, the HF unit adapts optimally to all the user's application and operating techniques. POWER Cut mode with constant HF voltage and power This mode ensures a uniform surgical effect and consistent cutting efficiency over a wide impedance range and many different tissue types. RAM system return electrode application monitoring This safety system continuously monitors the contact quality between the neutral electrode and the patient s skin, and additionally indicates it with symbols. If the contact surface area decreases, the safety system gives an early visual and acoustic alarm, thus preventing a burn under the application site of the patient electrode. To increase the contact reliability of the neutral electrode, the user can prevent the application of single-faced electrodes. LF/HF leakage currents Stray currents and the associated risk of burns are minimized by design measures. SCB- and OR1 -compatible The units are designed for integration in the KARL STORZ Communication Bus (SCB). Full integratability of the HF unit in the networked, and even speech-controlled, operating room of the future is already a standard feature (system requirement: RUI software release or later). C-Cut mode and LAP-C-CUT mode the intermittent coagulation-cutting mode with AUTOCON II 400 SCB Designed for blood-free cutting during laparoscopy and when using irrigation liquids, the electric current is specially modulated and offers a reproducible coagulation current with high cutting efficiency. This makes time-consuming subsequent coagulation a thing of the past. Using the C-Cut mode thus reduces the need for blood transfusions and saves surgery time. The result is an overall reduction in operating costs, and for the patient it means additional protection. Bipolar generator with 370 W HF power This outstanding performance range allows the unit to be used in conjunction with the newly developed bipolar special and standard accessories. This highend unit is even suitable for indications using irrigation liquids, which in the past could only be performed with special-purpose HF systems. The safety of the bipolar technology from KARL STORZ eliminates the need for applying a neutral electrode, including for interventions which used to be standard unipolar procedures. Unipolar generator with 300 W HF power With a peak power of 300 watts, the AUTOCON II 400 SCB is ideally equipped for interventions in all areas of use. Precise power setting and power limitation Exact fine tuning in 1 W steps is provided for interventions requiring maximum precision with very low power. Up to 8 hemostatic effects Individual selection of up to 8 hemostatic effects for unipolar and bipolar cutting, each with up to 370 W output, permits optimal control of coagulation and the surgical effect in every situation. HIGH FREQUENCY SURGERY UNITS Gastro Cut and Papillo Cut These two new resection modes, which were specially developed by KARL STORZ for use in flexible endoscopy, permit a fractionated, and controlled cut with no bleeding. The special HF generator technology allows controlled output of cutting and coagulation pulse current. Both the pulse sequence and the pulse speed can be set separately and specifically for each mode. Forceps auto-start function When the forceps tips contact the tissue, bipolar coagulation is activated automatically after a freely adjustable delay of up to 9.9 seconds. 6.5" touch screen The color touch screen makes the AUTOCON II 400 SCB the world s first HF unit with this new, user-friendly U 16 CARDIO-UNITS 16 B

161 AUTOCON II 400 SCB Safety and Special Features operating technology. It also offers the important advantage of very easy cleaning and wipe-down disinfection. 100 program memories Simple programming of the indication-related unit parameters makes the AUTOCON II 400 SCB easy and intuitive to operate because all the programs can be stored in numeric order or text-based with user name and indication. The stored programs can be called up in the indication list at the touch of a button. Bipolar coagulation auto-stop function Automatic power shutdown when the coagulation procedure has been ended. Self-test program A comprehensive software safety concept ensures smooth, safe use after switching on. Detected component faults are indicated by an error code display, enabling rapid troubleshooting. The self-test also includes the connected accessories for the specific purpose of minimizing waiting times in preoperative work-up. Software upgrade The service port on the back of the unit allows the HF functions of the AUTOCON II 400 SCB to be expanded economically for future forms of HF treatment. This means that the AUTOCON II 400 SCB is always up-todate HIGH FREQUENCY SURGERY UNITS CARDIO-UNITS 17 B U 17

162 AUTOCON II 400 SCB, AUTOCON 200 Special Features Special Features: AUTOCON II 400 SCB AUTOCON 200 Degree of coagulation can be preselected in several steps: The degree of coagulation measures extent of coagulation depth Soft and/or standard coagulation: coagulation with unmodulated HF voltage (Up < 200 V); the coagulation electrode can be positioned in direct contact with the tissue without damaging deeper layers of tissue through carbonisation Forced coagulation: coagulation with modulated HF voltage (Up > 500 V); to reach deeper coagulation zones, electric arcs are generated between the active coagulation electrode and the tissue. Damage to deeper layers of tissue has to be accepted. Autostart function: manual adjustment of operating time limit for bipolar coagulation Voltage-regulated cutting Service port for software updates and HF functionality upgrades Separate papillo-cut and gastro-cut functions enable fractionated cutting with regulated HF current at different cutting speeds for flexible endoscopy Autostart function for bipolar coagulation: Automatic activation of coagulation current as soon as coagulation electrode touches tissue with both branches Activation of HF functions possible via footswitch or manual control switch Bipolar resection with KARL STORZ bipolar electrotomes Bipolar application with NaCl irrigation solution Modular connecting sockets for unipolar and bipolar applications can be selected according to individual requirements 100 user programs can be stored Convenient use via 6.5" Touch Screen Switchover function enables switching between two modes within a user program via a footswitch from the sterile area HIGH FREQUENCY SURGERY UNITS Compatible with KARL STORZ Communication Bus (KARL STORZ-SCB) Interdisciplinary use Spray Coagulation: Coagulation with modulated HF voltage (Up > 500 V); very long arc enables coagulation of large and bleeding areas of tissue without contact to tissue Arc-controlled cutting, unipolar U 18 CARDIO-UNITS 18 B

163 AUTOCON II 400 SCB Specifications HF Modes Effects P max. at 500 Ohm V P max. at 500 Ohm Crest Factor Arc Control Voltage Control Unipolar TOP-Cut POWER-Cut C-Cut LAP-C-Cut Gastro-Cut Papillo-Cut Standard Coag (at 50 Ohm) Forced Coag Spray Coag Bipolar Bipolar-Cut Saline-C-Cut Saline-Time-C-Cut Saline Coag 8 time sec (at 50 Ohm) Saline-Time-Coag time sec. (at 50 Ohm) Bipolar Soft Coag (at 75 Ohm) Bipolar Soft with Auto-Stop (at 75 Ohm) Bi-Vascular-Safe (at 75 Ohm) Specifications: Safety Systems - Automatic self-test - Maldosage - Neutral electrode safety system (dynamic, two-part, one- and two-part NE) - LF/HF leakage current monitor - Activation time - Deactivable HF Power Supply Dimensions w x h x d Weight Certified to x: 230 VAC, 50/60 Hz U11x: 115 VAC, 50/60 Hz 448 x 164 x 345 mm 10 kg IEC 601-1, CE acc. to MDD HIGH FREQUENCY SURGERY UNITS CARDIO-UNITS 19 B U 19

164 AUTOCON II 400 SCB High Frequency Surgery Unit, Recommended System Configuration x AUTOCON II 400 SCB, power supply 230 VAC, 50/60 Hz including: Mains Cord SCB Connecting Cable, length 100 cm AUTOCON II 400 SCB Set AUTOCON II 400 SCB Socket Position Standard Bipolar Bipolar Unipolar 3-pin and Erbe Neutralelectr. 6.3 mm jack Bipolar US-2-pin Bipolar US-2-pin Unipolar 3-pin and Bovie Neutralelectr. 2-pin High-End Bipolar Bipolar Multifunction Unipolar 3-pin and Erbe Neutralelectr. 6.3 mm jack HIGH FREQUENCY SURGERY UNITS Bipolar US-2-pin Bipolar Multifunction Optional Accessories for AUTOCON II 400 SCB see pages U Components see chapter 11, SPARE PARTS AND ACCESSORIES Unipolar 3-pin and Bovie Neutralelectr. 2-pin U 20 CARDIO-UNITS 20

165 AUTOCON II 400 SCB System Components Three-Pedal Footswitch Two-Pedal Footswitch One-Pedal Footswitch U N I T S I D E PATIENT SIDE Bipolar High Frequency Cord Unipolar High Frequency Cord Unipolar High Frequency Cord Connecting Cable LE M Handle RoBi KELLY Dissecting and Grasping Forceps MD Knife Electrode RoBi KELLY Dissecting and Grasping Forceps Neutral Electrode ML HIGH FREQUENCY SURGERY UNITS CARDIO-UNITS 21 U 21

166 AUTOCON 200 High Frequency Surgery Unit, Recommended System Configuration AUTOCON 200, power supply VAC, 50/60 Hz including: Mains Cord Adaptor, for unipolar HF output, diameter 4/5 mm AUTOCON 200, with ENDOCUT function, power supply VAC, 50/60 Hz including: Mains Cord Adaptor, for unipolar HF output, diameter 4/5 mm C AUTOCON 200, power supply VAC, 50/60 Hz including: Mains Cord Adaptor, for unipolar HF output, diameter 4/5 mm C010 AUTOCON 200, with ENDOCUT function, power supply VAC, 50/60 Hz including: Mains Cord Adaptor, for unipolar HF output, diameter 4/5 mm Specifications: HIGH FREQUENCY SURGERY UNITS HF Rated Power Max. Voltage Output Control - Cutting unipolar: 200 Watt/500 Ohm - Coagulation unipolar soft: 120 Watt/125 Ohm unipolar standard: 120 Watt/350 Ohm bipolar: 120 Watt/125 Ohm - Cutting unipolar: Vp=600 Volt - Coagulation unipolar soft: Vp=190 Volt unipolar standard: Vp=1300 Volt bipolar: Vp=190 Volt - Cutting unipolar: automatic voltage control - Coagulation unipolar soft: automatic voltage control unipolar standard: pulse modulation bipolar: automatic voltage control Optional Accessories for AUTOCON 200 see pages U Coagulation Degrees Autostart Autostop Safety Systems Power Supply Dimensions w x h x d Weight Certified to Cutting 4 steps Coagulation bipolar Coagulation unipolar soft - permanent power control - maldosage - neutral electrode, safety system - automatic self-test VAC or VAC, 50/60 Hz 305 x 164 x 345 mm 7.7 kg IEC 601-1, CE acc. to MDD 9-05 Components see chapter 11, SPARE PARTS AND ACCESSORIES U 22 CARDIO-UNITS 22 B

167 AUTOCON 200 System Components Two-Pedal Footswitch U N I T S I D E PATIENT SIDE Connecting Cable Neutral Electrode E Bipolar Connecting Cable Unipolar High Frequency Cord Handle with Cable, unipolar Unipolar High Frequency Cord LE M Handle RoBi KELLY Dissecting and Grasping Forceps MD Knife Electrode Knife Electrode RoBi KELLY Dissecting and Grasping Forceps ML HIGH FREQUENCY SURGERY UNITS CARDIO-UNITS 23 A U 23

168 Optional Accessories for AUTOCON II 400 SCB and AUTOCON 200 for use with Three-Pedal Footswitch, with switch function for switching between mode levels A and B, for use with x AUTOCON II 400 SCB AUTOCON Two-Pedal Footswitch, for use with x One-Pedal Footswitch, for activating coagulation, for use with x Two-Pedal Footswitch, for controlling the coagulation and cutting function One-Pedal Footswitch, for controlling the coagulation function Neutral Electrode, of conductive silicone with 2 rubber ties for attachment, contact surface A = 500 cm 2, for use with Connecting Cable E Neutral Electrode, made of conductive silicone, with 1 rubber strap for fastening contact face A = 187 cm² surface area, for use with Connecting Cable Neutral Electrode Connecting Cable, for Neutral Electrodes and E, length 400 cm UR Neutral Electrode Connecting Cable, for Neutral Electrode US Neutral Electrode Connecting Cable, for Neutral Electrode Neutral Electrode, for single use, contact face divided into two, A = 169 cm 2, package of 50, Connecting Cable is required Connecting Cable, for connecting Neutral Electrode 27802, length 500 cm HIGH FREQUENCY SURGERY UNITS Electrode Handle, with 2 buttons for activating the unipolar generator, yellow button: unipolar cutting, blue button: unipolar coagulation (Cable required) High Frequency Cable, for Electrode Handle , length 400 cm Electrode Handle, without buttons, with integrated connecting cable, length 300 cm U 24 CARDIO-UNITS 24 B

169 Optional Accessories Surgery Set, for AUTOCON II 400 SCB and AUTOCON 200 unipolar Surgery Electrodes Set including: Container with Lid and Sterilizing Insert, for 16 electrodes with diameter 4 mm Wire Snare, 5mm Same, 10 mm Ribbon Snare, 10 mm KIRSCHNER Spatula Electrode, straight MAGENAU Knife Electrode, angled Same, lancet-shaped Ball Electrode, 2mm Same, 4mm Same, 6mm Needle Electrode Flat Electrode, 8 x10mm Same, 10 x 15 mm HIGH FREQUENCY SURGERY UNITS For use with Electrode Handle Components see chapter 11, SPARE PARTS AND ACCESSORIES CARDIO-UNITS 25 B U 25

170 Optional Accessories Unipolar and Bipolar High Frequency Cords for AUTOCON II 400 SCB and AUTOCON 200 Unipolar High Frequency Cords KARL STORZ Instrument High Frequency Surgery Units unipolar M Unipolar High Frequency Cord, with 4 mm plug for HF unit, models KARL STORZ, Erbe type T, older models and Ellman, length 300 cm M Unipolar High Frequency Cord, with 4 mm plug for HF unit, models Berchtold and Martin, length 300 cm M Unipolar High Frequency Cord, with 5 mm plug for HF unit, models KARL STORZ AUTOCON system (50, 200, 350), AUTOCON II 400 SCB (111, 115) and Erbe type ICC, length 300 cm M Unipolar High Frequency Cord, with 8 mm plug for HF unit, models KARL STORZ AUTOCON II 400 SCB (112, 116) and Valleylab, length 300 cm Bipolar High Frequency Cords KARL STORZ Instrument High Frequency Surgery Units bipolar LE Bipolar High Frequency Cord, to KARL STORZ Coagulator B/C/D, B/C/D, B/C/D, B/C/D, AUTOCON system (50, 200, 350), AUTOCON II 400 SCB system (111, 113, 115) and Erbe-Coagulator, T- and ICC-row, length 300 cm LM Bipolar High Frequency Cord, for Martin and Berchtold coagulators, length 300 cm L Bipolar High Frequency Cord, with 2x 4 mm banana plug for KARL STORZ Coagulator XA/XB and Ellman, length 300 cm LA Bipolar High Frequency Cord, with 2x 4 mm banana plug for KARL STORZ Coagulator XA/XB and Valleylab, length 300 cm HIGH FREQUENCY SURGERY UNITS LV Bipolar High Frequency Cord, for KARL STORZ AUTOCON II 400 SCB (112, 114, 116) and Valleylab coagulators, length 300 cm Please note: All high frequency cords of this page are delivered with a length of 300 cm. If a length of 500 cm is requested please add letter L to the part number, e. g ML, LVL. U 26 CARDIO-UNITS 26 B

171 n Accessories Unipolar and Bipolar High Frequency Cords Bipolar High Frequency Cords KARL STORZ Instrument High Frequency Surgery Units bipolar E Bipolar High Frequency Cord, for KARL STORZ Coagulator B/C/D, B/C/D, B/C/D, B/C/D, AUTOCON system (50, 200, 350), AUTOCON II 400 SCB system (111, 113, 115) and Erbe coagulator, T and ICC series, with two 2 mm cable sockets for KARL STORZ Bipolar Suction Forceps , and Bipolar Forceps 8615 A/AS, length 450 cm M Bipolar High Frequency Cord, for Martin and Berchtold coagulator, with two 2 mm cable sockets for KARL STORZ Bipolar Suction Forceps , and Bipolar Forceps 8615 A/AS, length 450 cm A Bipolar High Frequency Cord, with 2x 4 mm banana plug for KARL STORZ coagulator XA/XB, with two 2 mm cable sockets for KARL STORZ Bipolar Suction Forceps , and Bipolar Forceps 8615 A/AS, length 450 cm V Bipolar High Frequency Cord, for KARL STORZ AUTOCON II 400 SCB system (112, 114, 116), Valleylab coagulator, with two 2 mm cable sockets for KARL STORZ Bipolar Suction Forceps , and Bipolar Forceps 8615 A/AS, length 450 cm KARL STORZ Instrument Standard Forceps Bipolar Cords U Bipolar Universal High Frequency Cord, one side with two 2 mm cable sockets for KARL STORZ Bipolar Suction Forceps , and Bipolar Forceps 8615 A/AS, other side with standard pin for connection to all current forceps bipolar cords, length 40 cm for use with Bipolar High Frequency Cords or A/E/M/V see page U 29 HIGH FREQUENCY SURGERY UNITS High Frequency Surgery Units see pages U CARDIO-UNITS 27 B U 27

172 n Accessories Unipolar and Bipolar High Frequency Cords Unipolar High Frequency Cords for use with Working Elements C/D/E, D/E, E, E and ER KARL STORZ Instrument High Frequency Surgery Units unipolar 277 Unipolar High Frequency Cord, with 4 mm plug for HF unit, models KARL STORZ and Erbe type T, older models, length 300 cm 277 A Unipolar High Frequency Cord, with 4 mm plug for HF unit, models Berchtold and Martin, length 300 cm 277 KE Unipolar High Frequency Cord, with 5 mm plug for HF unit, models KARL STORZ AUTOCON system (50/200/350), AUTOCON II 400 SCB system (111, 115) and Erbe type ICC, length 300 cm 277 KB Unipolar High Frequency Cord, with 8 mm plug for HF unit, models KARL STORZ AUTOCON II 400 SCB system (112, 116) and Valleylab, length 300 cm Unipolar High Frequency Cords for use with Working Element E 278 Unipolar High Frequency Cord, with 4 mm plug for HF unit, models KARL STORZ and Erbe type T, older models, length 300 cm 278 KE Unipolar High Frequency Cord, with 5 mm plug for HF unit, models KARL STORZ AUTOCON system (50/200/350), AUTOCON II 400 SCB (111, 115) and Erbe type ICC, length 300 cm Unipolar High Frequency Cords M Unipolar High Frequency Cord, with 4 mm plug for HF unit, models KARL STORZ, Erbe type T, older models and Ellman, length 300 cm M Unipolar High Frequency Cord, with 4 mm plug for HF unit, models Berchtold and Martin, length 300 cm M Unipolar High Frequency Cord, with 5 mm plug for HF unit, models KARL STORZ AUTOCON system (50, 200, 350), AUTOCON II 400 SCB (111, 115) and Erbe type ICC, length 300 cm M Unipolar High Frequency Cord, with 8 mm plug for HF unit, models KARL STORZ AUTOCON II 400 SCB (112, 116) and Valleylab, length 300 cm Bipolar High Frequency Cords HIGH FREQUENCY SURGERY UNITS LEB Bipolar High Frequency Cord, for KARL STORZ AUTOCON II 400 SCB system ( ), for use with KARL STORZ bipolar resectoscopes, length 300 cm LEBL Same, length 500 cm bipolar NaCl Please note: All high frequency cords of this page are delivered with a length of 300 cm. If a length of 500 cm is requested please add letter L to the part number, e. g ML, LVL. U 28 CARDIO-UNITS 28 B

173 n Accessories High Frequency Cords, for use with Bipolar Coagulating Instruments Bipolar High Frequency Cords KARL STORZ Instrument High Frequency Surgery Units bipolar E Bipolar High Frequency Cord, to KARL STORZ Coagulator B/C/D, B/C/D, B/C/D, B/C/D, AUTOCON system (50, 200, 350), AUTOCON II 400 SCB system (111, 113, 115) and Erbe-Coagulator, T- and ICC-row, length 300 cm Bipolar High Frequency Cord, with 2x 4 mm banana plug to KARL STORZ Coagulator XA/XB for KARL STORZ bipolar coagulation forceps, length 300 cm A Bipolar High Frequency Cord, with 2x 4 mm banana plug for KARL STORZ Coagulator XA/XB and Valleylab, length 300 cm M Bipolar High Frequency Cord, for Martin and Berchtold coagulators, length 300 cm V Bipolar High Frequency Cord, for KARL STORZ AUTOCON II 400 SCB system (112, 114, 116), Valleylab coagulator, length 300 cm HIGH FREQUENCY SURGERY UNITS Please note: The standard length of the high frequency cords is 300 cm. CARDIO-UNITS 29 B U 29

174 HIGH FREQUENCY SURGERY UNITS

175 SPARE PARTS AND ACCESSORIES

176 Introduction The chapter spare parts and accessories lists all KARL STORZ spare parts available for a specific instrument. Spare parts are available for instruments which are subject to a considerable amount of wear and tear resulting from repeated use in everyday practice. For easy location and reference, an index is available where spare parts are assigned to the order number of the entire instrument or unit. Exchange Instructions for use are provided with each spare part to ensure smooth exchange. These instructions can also be accessed via our internet portal karlstorz.com Hotline Queries concerning products, exchange, maintenance and cleaning can be addressed to the KARL STORZ EP1 Hotline: 07461/ , daily between 8 and 18 h. Spare parts and accessories for: DA Vascular Clamp Applicator DE Inner Rod DF Outer Sheath Catalog page DF DE Spare part Plug, for LUER-Lock adaptor Spare parts and accessories for: DD c Grasping Forceps Catalog page DD M Metal Handle, without ratchet M Metal Outer Sheath DD Forceps Insert Spare part Plug, for LUER-Lock connection for cleaning, black, autoclavable, package of Spare parts assigned to instrument with catalog page reference and order numbers for individual spare parts SP 2

177 Table of Contents SPARE PARTS AND ACCESSORIES TELESCOPES HOPKINS II Telescopes, ENDOCAMELEON HOPKINS Telescope SP 3 MISCELLANEOUS Multi-Retractor SP 4-SP 7 Cannulas SP 8-SP 9 Silicone Leaflet Valve, Reduction Sleeve SP 10 Multifunctional Valve, Automatic Valve SP 11 Fascial Closure Instrument SP 12 Vascular Clamp Applicator, c Grasping Forceps, Needle Holders SP 13 Retractors, Laparoscopic Scalpel, Micro Knife SP 14 Handles SP 15-SP 16 Outer Sheaths SP 17-SP 19 Vascular Clamps, Suction and Irrigation Tubes SP 20 Cold Light Fountains, IMAGE 1 HUB HD Camera Control Unit SCB SP 21 Clamping Jaw, ENDOCRANE SP 22 STOR-E Transport Cart, Training Models SP 23 Headlights SP 24-SP 27 Headbands SP 28 UNITS AND ACCESSORIES Insufflators Electronic CO 2 ENDOFLATOR SCB SP 29 Thermoflator SCB SP 30 Suction and Irrigation Systems HAMOU ENDOMAT SCB SP 31-SP 35 High Frequency Surgery Units AUTOCON II 400 SCB, AUTOCON 200 SP 36 AUTOCON 200 SP 37 Surgery Electrodes Set SP 38 Product Page Product Page Product Page SP 29, SP SP 29, SP SP SP 15, SP SP 15, SP SP SP 26, SP 27, SP SP 26, SP 27, SP SP 24, SP 25, SP 26, SP 27, SP SP 24, SP 25, SP 26, SP SP 26, SP 27, SP SP 26, SP SP 26, SP SP SP 26, SP SP SP SP SP SP SP SP 21, SP 29, SP 30, SP 31, SP SP SP U SP SP SP 29, SP SP 36, SP SP SP SP SP SP SP 29, SP SP 33, SP SP SP 33, SP SP 32, SP SP 32, SP SP 32, SP SP 34, SP SP 29, SP SP 29, SP SP 29, SP SP 29, SP SP 29, SP SP SP 29, SP SP SP SP C SP SP C010 SP SP C SP SP C010 SP SP SP SP SP SP SP SP SP SP SP SP U102 SP SP AA SP BA SP FA SP AA SP BA SP DE SP DO SP KO SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP SP 32, SP SP 32, SP SP 32, SP SP SP SP 32, SP SP SP SP 33, SP SP 33, SP SP 31, SP 33, SP 35 I

178 Numerical Index SPARE PARTS AND ACCESSORIES Product Page Product Page Product Page SP 36, SP HG SP EC SP ECS SP ECW SP UF SP AK SP SP 29, SP SP 29, SP SP 2, SP 13, SP 17, SP 18, SP SP XA SP XB SP A1 SP H1 SP H2 SP M1 SP EX1 SP L1 SP NL SP TX1 SP X SP L1 SP NL SP TS1 SP X SP DB SP H1 SP H2 SP A SP A SP SP 14, SP FP SP R SP V SP VR SP SP SP SP 24, SP SP 24, SP SP 24, SP 25, SP SP SP 2, SP SP M SP MW SP W SP SP M SP MW SP W SP SP M SP MW SP W SP SP M SP 2, SP A SP D SP S SP A SP D SP S SP SC SP LH SP SP SP A SP 21, SP 22, SP 29, SP 30, SP 31, SP 36, SP AA SP AE SP BA SP FA SP AA SP BA SP AA SP BA SP FA SP B SP BR SP BS SP D SP DA SP DE SP DG SP DH SP K SP KD SP KE SP KT SP L SP LB SP LS SP M SP MG SP ML SP MM SP MP SP MR SP VK SP VL SP VM SP H1 SP B SP BR SP VK SP VM SP B SP BR SP CH SP VG SP VK SP H1 SP FA SP FC SP FCZ SP FD SP FDZ SP FZ SP TA SP TB SP TC SP TD SP TE SP TF SP TG SP TH SP TI SP TJ SP TK SP TV SP DA SP 2, SP DE SP 2, SP DF SP 2, SP NC SP NG SP SS SP VC SP N SP NA SP NI SP F SP 3, SP G SP 3, SP NAS SP NWMS SP NY SP NYW SP DD SP 2, SP DD SP 2, SP SP MK SP S SP SP SP SP SP SP 26, SP SP SP SP 2, SP 13, SP AFT SP SP 9, SP SP SP SP SP SP SP SP SP SP 15, SP SP 9, SP SP SP 9, SP SP 17, SP SP 17, SP SP SP SP SP 15, SP SP 15, SP SP SP SP 14 VO4210 SP II

179 Telescopes HOPKINS II Telescopes, ENDOCAMELEON HOPKINS Telescope Spare parts and accessories for: Catalog page AA HOPKINS II Straight Forward Telescope 0, enlarged view BA HOPKINS II Forward-Oblique Telescope 30, enlarged view FA HOPKINS II Telescope 45, enlarged view AA HOPKINS II Straight Forward Telescope BA HOPKINS II Forward-Oblique Telescope AA HOPKINS II Straight Forward Telescope 0, enlarged view 12, BA HOPKINS II Forward-Oblique Telescope 30, enlarged view 12, FA HOPKINS II Telescope 45, enlarged view 12, AA HOPKINS II Straight Forward Telescope 0, enlarged view 11, BA HOPKINS II Forward-Oblique Telescope 30, enlarged view 11, FA HOPKINS II Telescope 45, enlarged view 11, AA HOPKINS II Straight Forward Telescope 0, enlarged view 11, BA HOPKINS II Forward-Oblique Telescope 30, enlarged view 11, F 495 G Spare parts 495 F Receptacle, diameter 9 mm, for Wolf fiber optic light cable 495 G Screw Base, for KARL STORZ fiber optic light cable and Olympus/Winter & Ibe Spare parts and accessories for: AE ENDOCAMELEON HOPKINS Telescope 495 F 495 G Catalog page 15, 58, 80 Spare parts 495 F Receptacle, diameter 9 mm, for Wolf fiber optic light cable 495 G Screw Base, for KARL STORZ fiber optic light cable and Olympus/Winter & Ibe Spare parts and accessories for: FA HOPKINS II Forward-Oblique Telescope 45 Catalog page 35, F 495 G Spare parts 495 F Receptacle, diameter 9 mm, for Wolf fiber optic light cable 495 G Screw Base, for KARL STORZ fiber optic light cable and Olympus/Winter & Ibe CARDIO-VAS-SP 1 SP 3

180 Multi-Retractor Spare parts and accessories for: B SCHÖLLHORN Standard Retractor BR Retractor Frame, 25 x 22 cm, including Lever BS BS Lever, spare part VK Moveable Blade, freely adjustable, height 30 mm VM Moveable Blade, freely adjustable, height 40 mm VL Moveable Blade, freely adjustable, height 50 mm BS BR Catalog page VK/VM/VL 20 Spare parts and accessories for: D IMA Extension DE IMA Elevating Plate DH IMA Holding Device, for Elevating Plate DE DG Rack, for Holding Device DH DA IMA Counter Pressure Plate DG DH Catalog page DE DA SP 4 CARDIO-VAS-SP 2

181 Multi-Retractor Spare parts and accessories for: K Mitral Valve Extension KT Holding Device, for mitral valve retractors KD Mitral Valve Retractor, hook length 40 mm KE Mitral Valve Retractor, hook length 50 mm Catalog page KD/KE KT Spare parts and accessories for: M MIDCAB Extension MG MIDCAB Elevating Frame Holder MR MIDCAB Elevating Frame, Elevating Plate MP MP MIDCAB Elevating Plate MM MIDCAB Counter Blade, height 30 mm ML MIDCAB Counter Blade, height 40 mm MR Catalog page MG MM/ML Spare part MP Adjusting Screw CARDIO-VAS-SP 3 SP 5

182 Multi-Retractor Spare parts and accessories for: LS Fiber Optic Light Carrier Extension L Fiber Optic Light Carrier, malleable, for illumination of the OR field LB Universal Fixation Device, for securing Fiber Optic Light Carrier L, for use with rectangular retractor frames with profile min. 5 x 15 mm to max. 8 x 34 mm and round components with profile min.10 to max.16 mm Catalog page LB L Spare parts 495 F Receptacle, diameter 9 mm, for Wolf fiber optic light cable 495 G Screw Base, for KARL STORZ fiber optic light cable and Olympus/Winter & Ibe Spare parts and accessories for: B SCHÖLLHORN Vario-Retractor Children Catalog page BR Retractor Frame, 19 x 15.5 cm, including Lever BS VK Moveable Blade, freely adjustable, height 15 mm, width 30 mm VM Moveable Blade, freely adjustable, height 22 mm, width 30 mm BS BR VK/VM Spare parts and accessories for: B SCHÖLLHORN Vario-Retractor Babies BR Retractor Frame, 17.5 x 11.5 cm, including Lever BS VK Moveable Blade, small, freely adjustable, height 12 mm, width 30 mm VG Moveable Blade, large, freely adjustable, height 15 mm, width 40 mm CH Cranial Hook, width 15 mm, to attach to Retractor Frame BR CH Catalog page VK/VG BR BS SP 6 CARDIO-VAS-SP 4

183 Multi-Retractor Spare parts and accessories for: FDZ Endoscopic Vein Retractor, FREIBURG model Catalog page FD Vein Retractor, FREIBURG model FZ Cleaning Adaptor, for telescope channel FD FZ Spare parts and accessories for: FCZ BISLERI Endoscopic Radial Artery Retractor Catalog page FC BISLERI Artery Retractor FZ Cleaning Adaptor, for telescope channel FC FZ CARDIO-VAS-SP 5 SP 7

184 Cannulas Spare parts and accessories for: H1 Cannula H2 Cannula EX1 Cannula TX1 Cannula TS1 Cannula H1 Cannula H2 Cannula Catalog page 64 64, Spare parts Spring Cap Stopcock Spare parts and accessories for: Catalog page H1 Cannula H1 Cannula Spare parts Spring Cap Stopcock Spare part for H1 Spare part for H XA Sealing Cap, size 5 mm, autoclavable, package of 5, color code: black XB Sealing Cap, size 10 mm, autoclavable, package of 5, color code: green SP 8 CARDIO-VAS-SP 6

185 Cannulas Spare parts and accessories for: Catalog page NL Cannula Spare parts Sealing Cap, (50/4) Silicone Leaflet Washer Accessories X Plastic Cannula, autoclavable, package of 5 Spare parts and accessories for: Catalog page NL Cannula Spare parts Sealing Cap, (60/10) Silicone Leaflet Washer Accessories X Plastic Cannula, autoclavable, package of CARDIO-VAS-SP 7 SP 9

186 Silicone Leaflet Valve, Reduction Sleeve Spare parts and accessories for: Catalog page L1 Silicone Leaflet Valve 59, Spare parts Sealing Cap, (50/4) Silicone Leaflet Washer Spare parts and accessories for: Catalog page L1 Silicone Leaflet Valve Spare parts Sealing Cap, (60/11) Silicone Leaflet Washer Spare parts and accessories for: Catalog page DB Reduction Sleeve 81 Spare part Sealing Cap, (50/4) SP 10 CARDIO-VAS-SP 8

187 Multifunctional Valve, Automatic Valve Spare parts and accessories for: Catalog page M1 Multifunctional Valve 64, Spare parts Sealing Screw Tappet Sealing Cap, small Sealing Cap, (60/10) Seal Spare parts and accessories for: Catalog page A1 Automatic Valve Spare parts Sealing Screw Sealing Cap, (60/10) Seal CARDIO-VAS-SP 9 SP 11

188 Fascial Closure Instrument Spare parts and accessories for: N Fascial Closure Instrument Catalog page NI Handle, with spring-loaded safety mechanism NA Sheath NA NI SP 12 CARDIO-VAS-SP 10

189 Vascular Clamp Applicator, c Grasping Forceps, Needle Holders Spare parts and accessories for: DA Vascular Clamp Applicator DE Inner Rod DF Outer Sheath Catalog page DF DE Spare part Plug, for LUER-Lock adaptor Spare parts and accessories for: DD c Grasping Forceps Catalog page DD M Metal Handle, without ratchet M Metal Outer Sheath DD Forceps Insert Spare part Plug, for LUER-Lock connection for cleaning, black, autoclavable, package of 10 Spare parts and accessories for: Catalog page NC COGGIA Needle Holder NG COGGIA Needle Holder Spare part Plug, for LUER-Lock adaptor CARDIO-VAS-SP 11 SP 13

190 Retractors, Laparoscopic Scalpel, Micro Knife Spare parts and accessories for: DE Laparoscopic Scalpel Catalog page Spare parts Miniature Blade, round, sterile, package of Cap Plastic Ring Spare parts and accessories for: DO BERCI Micro Knife Catalog page KO Spare parts KO BERCI Spare Blade Cap Spare parts and accessories for: FP Fan Retractor Catalog page 110 Spare part Outer Sheath Spare parts and accessories for: VR Retractor Catalog page Handle V Outer Sheath R Insert R V SP 14 CARDIO-VAS-SP 12

191 Handles Spare parts and accessories for: Catalog page Handle Spare part Knurled Screw Spare parts and accessories for: S Handle, straight, with clamping valve Catalog page A Handle, straight mtp* Promotion Pack A Spare parts D Seal Set Adaptor Adaptor, complete Cap Nut Accessories * Tubing Set, for single use, sterile, package of 10, for use with Suction and Irrigation Handles A and A * Tubing Set, for single use, sterile, package of 10, for use with Suction and Irrigation Handles A and A in combination with silicone tube inner diameter 5 mm at the patient end Please note: The sterile tubing sets for KARL STORZ Handles A and A can be ordered directly from mtp: * mtp medical technical promotion gmbh Take-Off GewerbePark 46 D Neuhausen ob Eck Germany Telephone: +49/74 67/ Fax: +49/74 67/ CARDIO-VAS-SP 13 SP 15

192 Handles Spare parts and accessories for: S Handle, pistol grip, with clamping valve Catalog page A Handle, pistol grip mtp* Promotion Pack A Spare parts D Seal Set Cap Nut Adaptor, complete Blind Plug Adaptor Accessories * Tubing Set, for single use, sterile, package of 10, for use with Suction and Irrigation Handles A and A * Tubing Set, for single use, sterile, package of 10, for use with Suction and Irrigation Handles A and A in combination with silicone tube inner diameter 5 mm at the patient end Please note: The sterile tubing sets for KARL STORZ Handles A and A can be ordered directly from mtp: * mtp medical technical promotion gmbh Take-Off GewerbePark 46 D Neuhausen ob Eck Germany Telephone: +49/74 67/ Fax: +49/74 67/ SP 16 CARDIO-VAS-SP 14

193 Outer Sheaths Spare parts and accessories for: Catalog page c Metal Outer Sheath, insulated c Metal Outer Sheath, insulated c Metal Outer Sheath, insulated 41, 86 Spare parts Plug, for LUER-Lock connection for cleaning, black, autoclavable, package of Silicone Ring Halfround Plate Spare parts and accessories for: A Metal Outer Sheath A Metal Outer Sheath M c Metal Outer Sheath M c Metal Outer Sheath M c Metal Outer Sheath Catalog page Spare parts Plug, for LUER-Lock connection for cleaning, black, autoclavable, package of Silicone Ring Halfround Plate CARDIO-VAS-SP 15 SP 17

194 Outer Sheaths Spare parts and accessories for: Catalog page c Metal Outer Sheath, insulated Spare parts Plug, for LUER-Lock connection for cleaning, black, autoclavable, package of Silicone Ring Halfround Plate Spare parts and accessories for: Catalog page MW c Metal Outer Sheath MW c Metal Outer Sheath MW c Metal Outer Sheath Spare parts Halfround Plate Silicone Ring Spare parts and accessories for: Catalog page W c Metal Outer Sheath, insulated W c Metal Outer Sheath, insulated W c Metal Outer Sheath, insulated Spare parts Halfround Plate Silicone Ring SP 18 CARDIO-VAS-SP 16

195 Outer Sheaths Spare parts and accessories for: Catalog page RoBi Metal Outer Sheath, insulated RoBi Metal Outer Sheath, insulated 46, 99 Spare part Plug, for LUER-Lock connection for cleaning, black, autoclavable, package of CARDIO-VAS-SP 17 SP 19

196 Vascular Clamps, Suction and Irrigation Tubes Spare parts and accessories for: SS Vascular Clamp Catalog page 74, Spare part Plug, for LUER-Lock adaptor Spare parts and accessories for: VC Vascular Clamp Catalog page 74, 101 Spare part Plug, for LUER-Lock adaptor Spare parts and accessories for: SC Suction and Irrigation Tube Catalog page 109, U 14 Spare part O-Ring, small Spare parts and accessories for: LH Suction and Irrigation Tube Catalog page 109 Spare parts O-Ring, large Adaptor O-Ring, small SP 20 CARDIO-VAS-SP 18

197 Cold Light Fountain, IMAGE 1 HUB HD Camera Control Unit SCB Spare parts and accessories for: Cold Light Fountain XENON 300 SCB Catalog page Cold Light Fountain XENON 300 SCB, with KARL STORZ-SCB, power supply / VAC, 50/60 Hz 400 A Mains Cord, length 300 cm 610 AFT Silicone Tubing Set, length 250 cm SCB Connecting Cable, length 100 cm Spare parts and accessories for: U102 IMAGE 1 HUB HD Control Unit SCB, with SDI module Catalog page IMAGE 1 HUB HD Control Unit SCB, with SDI module 400 A Mains Cord, length 300 cm 536 MK BNC/BNC Video Cable, length 180 cm 547 S S-Video (Y/C) Connecting Cable, length 180 cm Connecting Cable, for controlling peripheral units, length 180 cm DVI-D Connecting Cable, length 300 cm SCB Connecting Cable, length 100 cm U Keyboard, with US English character set CARDIO-VAS-SP 19 SP 21

198 Clamping Jaw, ENDOCRANE Spare parts and accessories for: Catalog page UF Clamping Jaw 125, Spare parts Spring Star Grip, large Spare parts and accessories for: EC ENDOCRANE, piezoregulated holding arm Catalog page ECS ENDOCRANE Arm, including stand HG Socket, to clamp to the OR table Control Unit * Cover, sterile, package of ECW Spring Balance 400 A Mains Cord, length 300 cm ECS * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany SP 22 CARDIO-VAS-SP 20

199 STOR-E Transport Cart, Training Models Spare parts and accessories for: STOR-E Transport Cart, for POINT SETTER Catalog page Mobile Stand, for POINT SETTER Attachment, POINT SETTER set AK Tray AK Spare parts and accessories for: TV Training Model TH Working Insert TI Housing TJ Cover TK Pins Catalog page TH TI TK TJ Spare parts and accessories for: TA Training Model Catalog page TB Forearm TC Housing with Hand TD Working Insert TE Quick Lock-Release Mechanism TF Protective Cover TG Lubricant TB TE TC CARDIO-VAS-SP 21 SP 23

200 Headlights Spare parts and accessories for: Headlight KS Headlight KS60, with removeable and sterilizable Focus Handle Headband, fully adjustable, with Forehead Cushion , with cross band, including holder for Headlight NY Y-Fiber Optic Light Cable, with special protective casing for Headlight , length 290 cm Clip with Band, for attaching the fiber optic light cable to OR clothing Catalog page NY Spare parts Forehead Cushion, with push-button lock Headlight KS60, with double lens system and Y-fiber optic light cable, >175,000 lux, illuminated area adjustable from mm with 40 cm working distance, with removeable and sterilizable Focus Handle Headband, fully adjustable, with Forehead Cushion , with cross band, including holder for Headlights , and NY Y-Fiber Optic Light Cable, with special protective casing for Headlight , diameter 2 x 2.5 mm, length 290 cm Handle, with focusing screw, sterilizable Accessories Clip with Band, for attaching fiber optic light cable to OR clothing SP 24 CARDIO-VAS-SP 22

201 Headlights Spare parts and accessories for: Headlight KS Headlight KS60, with removeable and sterilizable Focus Handle Headband, fully adjustable, with Forehead Cushion , with cross band, including holder for Headlight NYW Y-Fiber Optic Light Cable, with special protective casing for Headlight , with 90 deflection to the light source, length 290 cm Clip with Band, for attaching the fiber optic light cable to OR clothing Catalog page NYW Spare parts Forehead Cushion, with push-button lock Headlight KS60, with double lens system and Y-fiber optic light cable, >175,000 lux, illuminated area adjustable from mm with 40 cm working distance, with removeable and sterilizable Focus Handle Headband, fully adjustable, with Forehead Cushion , with cross band, including holder for Headlights , and NYW Y-Fiber Optic Light Cable, with special protective casing for Headlight , with 90 deflection to the cold light fountain, diameter 2 x 2.5 mm, length 290 cm Handle, with focusing screw, sterilizable Accessories Clip with Band, for attaching fiber optic light cable to OR clothing CARDIO-VAS-SP 23 SP 25

202 Headlights Spare parts and accessories for: Catalog page Headlight Headlight, with U-shaped suspension and ball joint Headband, fully adjustable, with Forehead Cushion , with cross band, including ball joint holder for Headlights , , and NAS Fiber Optic Light Cable, straight plug, diameter 3.5 mm, length 230 cm Clip with Band, for attaching the fiber optic light cable to OR clothing NAS Spare parts Screw Cap Handle, sterilizable, with sleeve Brake Cylinder, 3-part, for ball joint Forehead Cushion, with push-button lock Headband, fully adjustable, with Forehead Cushion , with cross band, including ball joint holder for Headlight , , and Headlight, with U-shaped suspension and ball joint 495 NAS Fiber Optic Light Cable, straight plug, diameter 3.5 mm, length 230 cm Thread Pin, for lamp head Suspension, with cross connection, for Accessories Clip with Band, for attaching fiber optic light cable to OR clothing SP 26 CARDIO-VAS-SP 24

203 Headlights Spare parts and accessories for: Catalog page Headlight Headlight, with U-shaped suspension and ball joint Headband, fully adjustable, with Forehead Cushion , with cross band, including ball joint holder for Headlights , , and NWMS Fiber Optic Light Cable, with 90 deflection to the light source, diameter 3.5 mm, length 230 cm Clip with Band, or attaching the fiber optic light cable to OR clothing NWMS Spare parts Screw Cap Handle, sterilizable, with sleeve Brake Cylinder, 3-part, for ball joint Forehead Cushion, with push-button lock Headband, fully adjustable, with Forehead Cushion , with cross band, including ball joint holder for Headlight , , and Headlight, with U-shaped suspension and ball joint 495 NWMS Fiber Optic Light Cable, with 90 deflection to the cold light fountain, diameter 3.5 mm, length 230 cm Thread Pin, for lamp head Suspension, with cross connection, for Accessories Clip with Band, for attaching fiber optic light cable to OR clothing CARDIO-VAS-SP 25 SP 27

204 Headbands Spare parts and accessories for: Catalog page Headband Spare parts Forehead Cushion, with push-button lock Protection Clip, for cold light cable, for fixing the light cable to the headband, 2 pcs Spare parts and accessories for: Catalog page Headband Spare parts Screw Cap Forehead Cushion, with push-button lock Brake Cylinder, 3-part, for ball joint Protection Clip, for cold light cable, for fixing the light cable to the headband, 2 pcs SP 28 CARDIO-VAS-SP 26

205 Insufflators Electronic CO 2 ENDOFLATOR SCB Spare parts and accessories for: Electronic CO 2 ENDOFLATOR SCB Catalog page U Electronic CO 2 ENDOFLATOR with KARL STORZ-SCB, power supply VAC, 50/60 Hz 400 A Mains Cord, length 300 cm Silicone Tubing Set, sterilizable Universal Wrench SCB Connecting Cable, length 100 cm * CO 2 /N 2 O Gas Filter, sterile, for single use, package of Spare part Mains Fuse, VAC, T 2.0 AL (SB), package of 10 Accessories Spare parts for Silicone Tubing Set, for insufflation, sterilizable Plastic Connector, male LUER-Lock Tube Connector, male, tube diameter 10 mm CO 2 High Pressure Tube, American connection/pin- Index connection, length 55 cm CO 2 High Pressure Tube, American connection/pin- Index connection, length 102 cm CO 2 High Pressure Tube, American/German connection, length 55 cm CO 2 High Pressure Tube, American/German connection, length 102 cm Spare parts for and Seal, for use with CO 2 bottle, German connection * Gas Filter, for single use, sterile, package of 25 Spare part for and Seal, for use with CO 2 bottle, Pin-Index connector * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany CARDIO-VAS-SP 27 SP 29

206 Insufflators Thermoflator SCB Spare parts and accessories for: Thermoflator SCB Catalog page U Thermoflator with KARL STORZ-SCB, power supply VAC, 50/60 Hz 400 A Mains Cord, length 300 cm Optitherm Heating Element, autoclavable Silicone Tubing Set, sterilizable Universal Wrench SCB Connecting Cable, length 100 cm * CO 2 /N 2 O Gas Filter, sterile, for single use, package of Spare part Mains Fuse, VAC, T 2.5 AL (SB), package of 10 Accessories Spare parts for Spare part for and Silicone Tubing Set, for insufflation, sterilizable Plastic Connector, male LUER-Lock Tube Connector, male, tube diameter 10 mm CO 2 High Pressure Tube, American connection/pin- Index connection, length 55 cm CO 2 High Pressure Tube, American connection/pin- Index connection, length 102 cm Spare part for and CO 2 High Pressure Tube, American/German connection, length 55 cm CO 2 High Pressure Tube, American/German connection, length 102 cm Seal, for use with CO 2 bottle, German connection Optitherm Heating Element, autoclavable Spare parts for VO4210 Spring Cap, for stopcock Stopcock, with lever Seal, for use with CO 2 bottle, Pin-Index connector * Gas Filter, for single use, sterile, package of * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany SP 30 CARDIO-VAS-SP 28

207 Suction and Irrigation Systems HAMOU ENDOMAT SCB Spare parts and accessories for: HAMOU ENDOMAT SCB Catalog page U HAMOU ENDOMAT SCB with KARL STORZ-SCB, power supply VAC, 50/60 Hz 400 A Mains Cord, length 300 cm mtp* HYST Tubing Set, for single use mtp* LAP Tubing Set, for single use SCB Connecting Cable, length 100 cm mtp* VACUsafe Promotion Pack Suction, 2 l Spare part Mains Fuse, VAC, T 2.0 AL (SB), package of 10 Accessories Silicone Tubing Set, for suction, sterilizable Bottle Cap, for suction bottles 1.5 and 5 l, sterilizable Spare parts for LUER-Lock Tube Connector, male, tube diameter 9 mm Spare parts for Overflow Case, gray, for Bottle Cap LUER-Lock Tube Connector, female, tube diameter 8 mm Plunger Ball, green, to overflow case, 2 pcs required Tubing Connector Set, for Bottle Cap * Filter, to block fluid during suction, for single use, unsterile, package of * mtp medical technical promotion gmbh, Take-Off GewerbePark 46, D Neuhausen ob Eck, Germany CARDIO-VAS-SP 29 SP 31

208 Suction and Irrigation Systems HAMOU ENDOMAT SCB Accessories HYST Pressure Dome, without silicone tubing set Spare parts for Lock Ring HYST HYST Tubing Set, reusable, sterilizable Dome Included in delivery of HYST Pressure Dome, without silicone tubing set Dome Ring Sealing Disk, for pressure relief valve HYST Silicone Tubing Set, without pressure dome Compression Spring ARTHRO/HYST Plastic Disk Pump Tubing HYST, without connectors, package of Diaphragm for Pressure Dome, package of O-Ring, package of 10 Inflow Tube, with Y-adaptor SP 32 CARDIO-VAS-SP 30

209 Suction and Irrigation Systems HAMOU ENDOMAT SCB Accessories Spare part for Pump Tubing HYST, without connectors, package of 25 Inflow Tube, with Y-adaptor Connector Set HYST, blue Spare parts for inflow tube Silicone Tubing HYST Puncture Needle, for irrigation bottle Spare parts for pump tubing HYST Tube Connector Y-Adaptor, package of LUER-Lock Tube Connector, male, tube diameter 9 mm Tube Clip, white, package of CARDIO-VAS-SP 31 SP 33

210 Suction and Irrigation Systems HAMOU ENDOMAT SCB Accessories LAP Pressure Dome, without silicone tubing set Spare parts for Lock Ring LAP LAP Tubing Set, reusable, sterilizable Dome Included in delivery of LAP Pressure Dome, without silicone tubing set Dome Ring Sealing Disk, for pressure relief valve LAP Silicone Tubing Set, without pressure dome Compression Spring LAP Plastic Disk Pump Tubing LAP, without connectors, package of Diaphragm for Pressure Dome, package of O-Ring, package of 10 Inflow Tube, with Y-adaptor SP 34 CARDIO-VAS-SP 32

211 Suction and Irrigation Systems HAMOU ENDOMAT SCB Accessories Spare part for Pump Tubing LAP, without connectors, package of 25 Inflow Tube, with Y-adaptor Connector Set LAP Spare parts for inflow tube Silicone Tubing LAP Puncture Needle, for irrigation bottle Spare parts for silicone tubing LAP Tube Connector Y-Adaptor, package of LUER-Lock Tube Connector, male, tube diameter 9 mm Tube Clip, white, package of CARDIO-VAS-SP 33 SP 35

212 High Frequency Surgery Units AUTOCON II 400 SCB, AUTOCON 200 Spare parts and accessories for: Catalog page U / / AUTOCON II 400 SCB, Set AUTOCON II 400 SCB, power supply 230 VAC, 50/60 Hz Mains Cord, length 300 cm SCB Connecting Cable, length 100 cm A A A A Spare part Mains Fuse, VAC, T 4.0 AL (SB), package of 10 Spare parts and accessories for: AUTOCON 200 Catalog page U AUTOCON 200, power supply VAC, 50/60 Hz 400 A Mains Cord, length 300 cm Adaptor, for unipolar HF output, diameter 4/5 mm Spare part Mains Fuse, VAC, T 4.0 AL (SB), package of SP 36 CARDIO-VAS-SP 34

213 High Frequency Surgery Units AUTOCON 200 Spare parts and accessories for: C AUTOCON 200 Catalog page U C AUTOCON 200, power supply VAC, 50/60 Hz 400 A Mains Cord, length 300 cm Adaptor, for unipolar HF output, diameter 4/5 mm Spare part C Mains Fuse, VAC, T 8.0 AL (SB), package of 10 Spare parts and accessories for: AUTOCON 200 Catalog page U AUTOCON 200, with ENDOCUT function, power supply VAC, 50/60 Hz 400 A Mains Cord, length 300 cm Adaptor, for unipolar HF output, diameter 4/5 mm Spare part Mains Fuse, VAC, T 4.0 AL (SB), package of 10 Spare parts and accessories for: C010 AUTOCON 200 Catalog page U C010 AUTOCON 200, with ENDOCUT function, power supply VAC, 50/60 Hz 400 A Mains Cord, length 300 cm Adaptor, for unipolar HF output, diameter 4/5 mm Spare part C Mains Fuse, VAC, T 8.0 AL (SB), package of 10 CARDIO-VAS-SP 35 SP 37

214 Surgery Electrodes Set Spare parts and accessories for: Surgery Electrodes Set Catalog page U Container with Lid and Sterilizing Insert, for 16 electrodes with diameter 4 mm Wire Snare, 5 mm Wire Snare, 10 mm Ribbon Snare, 10 mm KIRSCHNER Spatula Electrode, straight MAGENAU Knife Electrode, angled MAGENAU Knife Electrode, lancet-shaped Ball Electrode, 2 mm Ball Electrode, 4 mm Ball Electrode, 6 mm Needle Electrode Flat Electrode, 8 x 10 mm Flat Electrode, 10 x 15 mm SP 38 CARDIO-VAS-SP 36

215 KARL STORZ OR1 Ergonomics, Safety and Efficiency in the OR

216

217 DATA MANAGEMENT KARL STORZ OR1 Recommended Configurations TELEMEDICINE SYSTEM INTEGRATION AND DOCUMENTATION KARL STORZ OR1 offers virtually unlimited possibilities for OR device configurations. In order to provide a custom-made solution, tailored to the user s personal requirements, there are four recommended levels of configuration from the sound basic version OR1 Basic to the sophisticated solution OR1 Advanced through to the high-end configuration OR1 Advanced PLUS and the HD configuration OR1 Advanced PLUS HD ready. All four concepts incorporate system integration, data management and documentation as well as telemedicine. With OR1 Foundation the customer configures his entire OR1 system according to his requirements OR1-ERG 3 OR1 3

218 KARL STORZ OR1 Integrated Design of OR Workstations KARL STORZ OR1 Optimization of OR Processes The KARL STORZ OR1 objective is to provide an optimal operating room design for performing minimally invasive and conventional surgeries. Customized to meet disciplinary and interdisciplinary needs, the OR1 operating room concept offers the optimal solution to each requirement for an integrated OR workstation design: Simplified work processes by means of intuitive device control directly in the sterile area Reduced setup and changeover times through user-defined and accessible system settings Integration of existing systems Optimal image reproduction by various camera systems and other signal sources 4 Integration of KARL STORZ endoscopic equipment Control of equipment and peripheral systems of other third-party manufacturers, such as the OR table or room lighting, with full functional range 2 Simple and secure documentation of intraoperative recordings and OR environment in a central area State-of-the art multimedia applications for audio and video communication (telemedicine) Reduced costs through optimized OR workflow Guaranteed future compatibility due to open system architecture The system s modular design allows all components and functionalities to be integrated in the OR1 operating room solution and, therefore, become part of the workstation system. Once again, KARL STORZ sets new standards in ergonomics, safety and efficiency in the OR. OR1 intuitive control of all functions via touch screen and/or voice control fast, simple and secure control directly from the sterile area 1 OR Lighting with Integrated Lighting Camera Centralized control of OR lighting, OR lighting camera and room lighting via touch screen 2 OR Equipment Centralized control via touch screen; pre-programmed system configurations for short setup and changeover times 3 OR Table OR table adjustable via touch screen control 8-05 OR1 4 OR1-ERG 4

219 Documentation 8 Flat Screens Records the most important intraoperative Less space required, optimal image quality sequences 9 Touch Screen 5 Video Routing Convenient use, monitoring and control directly Flexible access to image data from the sterile area Video Conferencing Professional communication from the sterile area 7 Boom Arms Clear and secure positioning of equipment 10 Nurse Workstation Flexible system control at the nurse workstation with full functional range OR1-ERG 5 OR1 5

220 OR1 Basic Launching the Integrated OR Concept System Integration Devices always within virtual reach Operation in the sterile area Individual combination of device units Option of system expansion Data Management and Documentation Recording of images, video and audio sequences Sterile, ergonomic operation Compact and reliable documentation solution CD-ROM or DVD archiving Data exchange possible with HIS, PACS and RIS Telemedicine Flexible routing functions First steps to telemedicine Modular expandable System Integration (SCBcom) As a mobile trolley solution, OR1 Basic enables you to control, with SCBcom remote control, up to six endoscopic devices, such as the endoscopic camera, light source, insufflator, pump, HF-electrosurgery unit and motor system. Four predefined start configurations simplify preparation in the OR prior to surgery OR1 6 OR1-ERG 6

221 Level I 6-08 Data Management and Documentation (AIDA compact II or AIDA DVD-M) For managing data, level I with AIDA compact II or AIDA DVD-M offers the possibility of producing integrated documentation of endoscopic interventions with accompanying images, video and audio sequences. Data is stored on DVD or CD-ROM. The option of linking AIDA compact II to the hospital network provides a simple network solution. Telemedicine (OR1 connect S2+) OR1 connect S2+ facilitates the transfer of data. An OR1 Room Camera, an OR1 Large Screen, OR1 AUX Video Input, OR1 StreamConnect or OR1 TELESTRATION can be optionally integrated. Level I TELESTRATION makes it possible for a surgeon to mark the live image directly using a drawing tablet. OR1-ERG 7 OR1 7

222 OR1 Advanced The Solution for all OR Requirements System Integration Devices always within virtual reach Improved coordination due to central operation/voice control Realistic user interfaces of the integrated devices Fast access to preset configurations Individual combination of device units Modular expandable Data Management and Documentation Recording of images, video and audio sequences Intuitive control via central touch screen Sterile, ergonomic operation Compact and reliable documentation solution CD-ROM or DVD archiving Data exchange possible with HIS, PACS and RIS Telemedicine Flexible routing functions incl. telephone function Intuitive control via central touch screen Modular expandable System Integration (SCB control System und SCB ACC Control ) Level II, OR1 Advanced, enables you to control different endoscopic devices, the AIDA documentation system and the operating table. Furthermore, in conjunction with the SCB ACC Control, telephone, video routing and diverse room functions, like room lighting or blinds, can be easily operated at the tip of a finger on the touch screen even from the sterile area. Optionally, the devices can be operated by voice control using VOICE1 including microphone and headset. A central user interface encompasses the individual device user interfaces, which are realistic and in a format familiar to the operating personnel, so there is no need for the users to get reacclimatized. In addition, several configurations can be programmed which enable the devices to automatically adopt preset values depending on the user or discipline each time the system is used. Data Management and Documentation (AIDA compact II incl. AIDA/SCB-Interface or AIDA DVD-M) Data is managed, as in OR1 Basic, with AIDA compact II. The documentation system in level II 6-08 OR1 8 OR1-ERG 8

223 Level II 6-08 is controlled using the same touch screen with which the devices are controlled. A connection to the hospital s PACS/RIS and HIS is also possible as an option. AIDA DVD-M is available as an alternative. Telemedicine (OR1 connect S2+) In level II, the specific transfer of data is also facilitated by the OR1 connect S2+ system. In conjunction with the SCB ACC Control, OR1 Advanced is controlled using the same touch screen with which the devices are controlled. Thus all functions are available to the user on one and the same user interface. An OR1 Wireless Microphone Headset, an OR1 Room Camera, an OR1 Active Loudspeaker System, an OR1 Large Screen, OR1 AUX Video Input, OR1 StreamConnect and also OR1 TELESTRATION are optionally available. At level II, the AIDA system can be integrated directly into the media technology. Direct connection to an analog telephone system is also available to the user. OR1-ERG 9 OR1 9

224 OR1 Advanced PLUS Maximum Support in the OR System Integration Devices always within virtual reach Improved coordination due to central operation/voice control Realistic user interfaces of the integrated devices Multiple possibilities of integrating telemedicine applications Fast access to preset configurations Individual combination of device units Modular expandable Data Management and Documentation Database supported OR archiving system Intuitive control via central touch screen Rights and roles Sterile, ergonomic operation CD-ROM or DVD archiving Individual OR reports Data exchange possible with HIS, PACS and RIS FDA approved Telemedicine Flexible routing functions: Routing of S-video signals, digital SDI signals, RGBHV signals Intuitive control via central touch screen incl. telestration Video conference option Modular expandable System Integration (SCB control System) Level III OR1 Advanced PLUS offers extended options for connecting external devices. For example, video conferences with physicians from other hospitals can be held from within the sterile area. The room camera as well as audio and video routing can be operated by touch screen or voice control. As in level II, several configurations can be programmed in level III so that depending on the discipline or user the devices automatically adopt preset values each time the system is used. Data Management and Documentation (AIDA 2.3 or AIDA compact II, both incl. AIDA/SCB-Interface) OR1 Advanced PLUS is equipped with the database supported information and documentation solution AIDA 2.3. Using this system you can not only manage an efficient electronic archive, but also facillitate simple picture editing, create standardised reports as well as assisting scientific efforts and creating various forms of analysis. An optionally available connection to the hospital s HIS and PACS/RIS optimizes fast access to all kind of patient and image data. Alternatively, AIDA compact II is available OR1 10 OR1-ERG 10

225 Level III 6-08 Telemedicine (OR1 connect S4 or S6) The basis for telemedicine applications in OR1 Advanced PLUS is OR1 connect S4 or, alternatively, OR1 connect S6. A new icon interface facilitates easy and ergonomic handling of the system. Additionally OR1 Advanced PLUS is controlled using the same touch screen with which the devices are controlled. A modular structure facilitates both connection to existing systems and the accommodation of changes in requirements. Furthermore, OR1 Advanced PLUS offers numerous optional add-ons: OR1 Room Camera OR1 Active Loudspeaker System OR1 Large Screen OR1 AUX Video Input OR1 StreamConnect OR1 PC-Display OR1 Touch Screen PC-Preview OR1 CD Player OR1 TELESTRATION OR1 Audio Conference OR1 Video Conference OR1 Room Control OR1 KVM Switch OR1 QuadVideo (only S6) OR1 Computer Quad (only S6) OR1-ERG 11 OR1 11

226 OR1 Advanced PLUS HD ready Brilliant Vision Inside the OR System Integration Devices always within virtual reach Improved coordination due to central operation/voice control Realistic user interfaces of the integrated devices Integration of HD Videorouting Multiple possibilities of integrating telemedicine applications Fast access to preset configurations Individual combination of device units Modular expandable Data Management and Documentation Database supported OR archiving system Intuitive control via central touch screen Rights and roles Sterile, ergonomic operation CD-ROM or DVD archiving Individual OR reports Data exchange possible with HIS, PACS and RIS FDA approved Telemedicine Flexible routing functions: Routing of S-Video signals, digital SDI signals, RGBHV signals and HD signals Intuitive control via central touch screen incl. TELESTRATION Video conference option Modular expandable System Integration (SCB control System) OR1 Advanced PLUS HD ready offers in addition to the enhanced possibilities of connecting external devices and various telemedicine options the specific feature of HD routing integration. So the high resolution signal of the KARL STORZ IMAGE 1 HD camera can be shown on up to 4 monitors; therefore the OR staff can benefit from the excellent quality and the expanded 16:10 format of the HD signal from any position in the room. The individual composition of various presets allows shorter set-up times, because all devices will be prepared according to the setting required by the surgeon and/or the procedure. Data Management and Documentation (AIDA 2.3 or AIDA compact HD, both incl. AIDA/SCB-Interface) Also OR1 Advanced PLUS HD ready is equipped with the database supported information and documentation solution AIDA 2.3. An optionally available connection to the hospital s HIS and PACS/RIS optimizes fast access to all kinds of patient and image data. Alternatively, AIDA compact HD is available OR1 12 OR1-ERG 12

227 Level IV 6-08 Telemedicine (OR1 connect S4 HD or S6 HD) To establish substantial telemedicine appliances, OR1 Advanced PLUS HD ready devotes the resources of the solutions OR1 connect S4 HD or S6 HD. Also the Telemedicine system is controlled via the same Touch Screen which allows a central monitoring of all devices. The modularity of the system guarantees a high degree of flexibility and allows the connection to existing systems as well as a future expansion considering prospering requirements. There are numerous telemedicine options available: OR1 Room Camera OR1 Active Loudspeaker System OR1 Large Screen OR1 AUX Video Input OR1 StreamConnect OR1 PC-Display OR1 Touch Screen PC-Preview OR1 CD Player OR1 TELESTRATION OR1 Audio Conference OR1 Video Conference OR1 Room Control OR1 KVM Switch OR1 QuadVideo (only S6) OR1 Computer Quad (only S6) OR1-ERG 13 OR1 13

228 OR1 The OR with Unlimited Potential OR1 Basic Advanced Advanced PLUS Advanced PLUS HD ready SCB System Integration Control of up to 6 endoscopic devices, e.g.: Camera Light source Insufflator Pump OR1 Basic and Control of e.g.: Room lights OR light Telephone Video routing OR table OR1 Advanced and Control of e.g.: QuadVideo CD player Audio/video streaming Telestration Video conference OR1 Advanced PLUS and Control of e.g.: HD video routing various telemedicine applications via SCBcom remote control via Touch screen optional Voice control via Touch screen optional Voice control via Touch screen optional Voice control SCB Data Management and Documentation AIDA compact II or AIDA DVD-M AIDA compact II or AIDA DVD-M AIDA 2.3 or AIDA compact II AIDA 2.3 or AIDA compact HD optional access to: HIS, PACS and RIS (with AIDA compact II) optional access to: KIS, PACS and RIS (with AIDA compact II) optional access to: KIS, PACS and RIS (with AIDA 2.3 and AIDA compact II) optional access to: KIS, PACS and RIS (with AIDA 2.3 and AIDA compact HD) OR1 connect Telemedicine OR1 connect S2+ incl. 6" OR1 Touch screen OR1 connect S2+ incl. SCB ACC Control OR1 connect S4 or alternatively OR1 connect S6 OR1 connect S4 HD or alternatively OR1 connect S6 HD Control from the sterile area Control from the sterile area Control from the sterile area Level I Level II Level III Level IV 6-08 OR1 14 OR1-ERG 14

229 TELEPRESENCE IMAGING SYSTEMS DOCUMENTATION ILLUMINATION VIDEOCARTS

230 TELEPRESENCE Imaging Systems Documentation Illumination Videocarts FULL HD New Vision in Medicine Camera Systems - IMAGE 1 HUB - IMAGE 1 HUB HD - TELECAM DX II - HEADCAM Video Head Lamps - TELE PACK Data Management and Documentation Monitors and Video Printers - WideView Monitors - Touch Screen Monitors - Flat Screen Monitors Light Sources - Cold Light Fountains HALOGEN - Cold Light Fountains XENON Videocarts 7-09 TP 2

231 FULL HD New Vision in Medicine DOK-HD 1 TP 3

232 KARL STORZ FULL HD Highest Standards for Image Input and Image Display Maximum resolution and the consistent use of the 16:9 aspect ratio guarantee FULL HD. Endoscopic camera systems have to be equipped with three CCD chips that support the 16:9 input format as well as capturing images with a resolution of 1920 x 1080 pixels. These factors provide users with significantly better image definition and a correspondingly larger display window. The benefits of High Definition Technology (HD) for medical applications are: Up to 6 times* higher input resolution of the camera delivers more detail and depth of focus. Using 16:9 format during image acquisition enlarges the field of vision and supports ergonomic viewing. The brilliance of color enables optimal diagnosis. Lateral view is enhanced by 32% when the endoscope is withdrawn slightly, providing the same image enhancement as a standard system. Any vertical information loss is restored and the lens remains clean. All reasons for KARL STORZ to further develop its proven IMAGE1 camera system for use with this new technology to the highest possible standard! Image acquisition is a determining factor for resolution and a larger display window. Standard resolution 720 X 576 Up to 6x higher resolution than standard format Image rendering in other systems Interlaced scan (half-frame) displays 25/30* half-frames per second. HD resolution 1920 X 1080 The KARL STORZ HD standard has the following resolution: 1080p (progressive); 1920 x 1080 pixels, 16:9 format 16:9 format for input and output! Further formats available on the market with low resolution or half-frames: 720p (progressive); 1280 x 720 pixels, 16:9 format 1080i (interlaced); 1920 x 1080 pixels, 16:9 format A new standard for endoscopic imaging In contrast to the frequently used interlaced method, the KARL STORZ 1080p HD progressive scan system delivers an extremely stable image, with no flickering or interference. For medical users this improved image quality virtually eliminates the eye fatigue which can result from working with a monitor. KARL STORZ image rendering Progressive scan (full frame) displays 50/60* full frames per second * depending on the color system (PAL/NTSC) used TP 4 DOK-HD 2

233 IMAGE 1 HUB HD HD Camera Head, HD Camera Control Unit, HD Monitor Ready for the future Continuous improvement in standardization is a cornerstone of KARL STORZ camera systems. All future IMAGE1 products will be compatible with previous products, ensuring upward and downward compatibility and securing your investment in the future. Image acquisition with KARL STORZ IMAGE1 HD The High Definition three-ccd chip in the IMAGE1 HD camera head captures images in 16:9 format that can be displayed on WIDEVIEW monitors in the same format without being converted. IMAGE1 HD acquires images with an input resolution of more than 2 million pixels 5/6* times higher than with SD. Digital input guarantees the best possible image quality and eliminates the need to convert analog input signals to digital output formats which can result in a loss of image quality. IMAGE 1 HUB HD Camera Control Unit The update for the IMAGE1 CCU, combined with a new front panel and an extension of the plug-in slots on the back of the unit, enable all IMAGE1 users to experience the advantages of FULL HD. The full range of IMAGE1 functions are also available in the FULL HD system. IMAGE 1 HUB HD with backward compatibility All existing systems can continue to be used after upgrading the IMAGE1 system to FULL HD. Equipment modules and adaptations to existing infrastructures remain completely compatible. IMAGE1 HD Camera Head with 16:9 three-ccd chip IMAGE 1 HUB HD Camera Control Unit Update of IMAGE1 CCU HD WIDEVIEW Monitor Image format and image rendering determine quality Using 16:9 aspect ratio in place of the conventional 4:3 format provides a larger display window and demonstrably improves the viewing ergonomics. KARL STORZ FULL HD produces the highest possible resolution of 1920 x 1200 pixels, providing medical users with improved depth of focus and color contrast for enhanced surgical performance :9 WIDEVIEW Monitor * depending on the color system (PAL/NTSC) used DOK-HD 3-US TP 5

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235 CLEANING, STERILIZATION AND MAINTENANCE, CARRYING CASE