C2 NerveMonitor Intraoperative Neuromonitoring

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C2 NerveMonitor Intraoperative Neuromonitoring Applications Thyroid Surgery Facial Nerve Monitoring Ear, Nose and Throat Surgery Skull Base Surgery Peripheral Nerve Surgery Spine Surgery

2 inomed Hitting the Nerve inomed is a medical technology company, operating internationally, which develops nerve protection instruments and systems for precisely targeted patient treatment. Sharing Knowledge Working with doctors and users, inomed develops new tools and methods in the fields of intraoperative neuromonitoring, neurosurgery, pain therapy and neurological diagnostics. Providing Safety inomed improves treatment outcomes with high-quality products and uses innovative technologies to ensure safety for both treatment providers and patients.

3 Product Overview C2 NerveMonitor Art. no. 508 240 (4 EMG channels) Art. no. 508 280 (8 EMG channels) Safe Nerve Monitoring with Visual Feedback The C2 NerveMonitor is the result of inomed s years of experience in the field of nerve monitoring. It is available as a four or eight channel EMG monitor with high performance differential amplifiers and two independent stimulators: one for direct nerve stimulation with hand held probes and one for continuous monitoring e.g. with the V3 vagus electrode. Designed for daily use in the operating room, the C2 Nerve- Monitor can be easily used after a brief introduction. It combines simplicity with visual feedback. All components of the device have been optimised for safe neuromonitoring in order to achieve the highest quality of signal and feedback.

4 Versatile and Portable Fields of Application Selection of recordings Print preview User-friendly control concept with audio and visual feedback Audio and Visual Feedback A sound compressor ensures good acoustic reproduction of the EMG signal over a speaker. Visual feedback is given via a graphical representation of the muscle response signal. The amplitude and latency of the signal can be seen clearly. Up to eight EMG curves can be shown simultaneously on the display. 4 differential EMG channels (article no. 508 240) 8 differential EMG channels (article no. 508 280) Adaptive Auto Mute Function The auto mute function of inomed devises was further developed and improved for the C2 NerveMonitor. The loudspeaker is activated only during stimulation, while noise and coagulation artefacts are suppressed with the mute functions. In addition, the sensitivity of the auto mute function can be adapted. Monitoring Programs and Applications All relevant parameters have been set in predefined programs. Additionally, a program can be created for each surgical procedure and the user can select from these customised programs. All important stimulation and recording parameters can be saved and adjusted to the userʼs preferences for defined surgical procedures. The C2 NerveMonitor can be used in the following fields among others: Thyroid surgery Ear, nose and throat surgery Facial nerve and parotid surgery Removal of the acoustic neuroma Spine surgery, pedicle screw test and many further areas The C2 NerveMonitor should be used wherever a nerve is at risk.

Excellent Results at Every Monitoring Product Features 5 Thyroid operation using a disposable stimulation probe C2 rear panel: A multitude of connections makes the C2 highly variable Patient Management and Bar Code Scanner At the beginning of an operation, a unique patient ID is created automatically or is read by the integrated bar code scanner. All important patient information is saved continuously during an operation. Every muscle response is stored in a database for later analysis. During an operation, a response potential can be preselected by pressing a footswitch. Printing out allows a comfortable review for the selection of signals for documentation. Data can be conveniently exported to various formats. Interfaces and Accessories The front of the C2 NerveMonitor is equipped with touchproof connections for stimulation and recording. For patient data export, a USB port is integrated on the side of the device. A mute sensor can be connected to the back for suppression of coagulation artefacts. Ports for an external monitor, a network cable and a trigger for stimulation are also provided. Furthermore, an inomed recommended USB printer and inomed module can be connected for expansion of functionality. A wide range of disposable and reusable accessories is available for the C2 NerveMonitor, so that the device can work according to the maxim Switch on, measure and protect. Bar code scanner to read in patient data

6 Sophisticated and Compatible Accessories Art. no. 540 415 (2 channel) Art. no. 540 425 (4 channel) EMG electrodes mini box with ground, 4 x 1.5 mm or 8 x 1.5 mm touchproof connectors DIN 42802, cable 4 m Art. no. 530 667 Connecting cable S, shielded for inomed laryngeal electrodes cable 4 m, channel 1 and 2 with ground, bend protection: blue delivered non-sterile can be disinfected Recording Art. no. 530 626 (10 pieces) 2 Subdermal needle electrodes cable 1.2 m, needle 20 mm with 1.5 mm touchproof connectors red/black (universal applications) Art. no. 530 627 (10 pieces) Subdermal needle electrode cable 1.2 m, needle 20 mm with 1.5 mm touchproof connector green (ground electrode) Art. no. 530 655 (10 pieces) inomed adhesive laryngeal electrode for tube of 6 7 mm inner diameter adhesive surface width 29 mm Art. no. 530 656 (10 pieces) for tube of 7.5 9 mm inner diameter adhesive surface width 37 mm length 32 mm, with neutral adhesive electrode Art. no. 530 666 (10 pieces) Disposable electrode for vocal muscle bipolar, with neutral electrode, needle length 15 mm, 30 angled, 1.5 mm touchproof connectors red/black/green, round cable 1.5 m, individually packaged Stimulation Probes Art. no. 522 603 (10 pieces) Bipolar concentric stimulation probe, length 4.5 cm angled, for direct nerve stimulation, cable 3 m, instrument total length with handle 15.5 cm Art. no. 522 610 (10 pieces) Microfork probe, length 4.5 cm straight, bipolar, for direct nerve stimulation, cable 3 m, instrument total length with handle 15.5 cm Vagus Stimulation Minimally Invasive Procedure Art. no. 522 200 V3 Tripolar stimulation electrode for the vagus nerve Work piece: outer diameter 5 mm, length 21 mm, contact ring: width 3 mm, with 4 pole male connector, cable length 40 cm delivered non-sterile autoclavable Art. no. 522 128 Bipolar concentric stimulation probe, length 31 cm, straight for direct nerve stimulation, total length with handle 41.5 cm, work length 310 mm, diameter 1.3 mm delivered non-sterile autoclavable

Sophisticated and Compatible Technical Data 7 Recording Frequency range Measuring range Resolution Stimulator Stimulation frequency Pulse Stimulation current Stimulation voltage Current sensor 4 8 differential EMG inputs Selectable in range 0.5 5000Hz 80μV-800mV 16 Bit with 20 khz sampling rate 2 independent stimulation channels Freely selectable in range of 1 30 Hz Negative, 200 μs pulse width Constant current, 0.01 ma to max. 25 ma Max. 100 V For display of current flow Connectors Three USB ports: one on the side and two on the rear Optional connection of two inomed USB modules possible Mute sensor for suppression of coagulation artefacts VGA outlet for connection of a second monitor Network connection with 100 MBit LAN/Ethernet 4 x Trigger In / 4 x Trigger Out (programmable) Certified in accordance with DIN EN ISO 13485:2003 0297 Our Product Portfolio Our broad range of products is divided into four core areas: Intraoperative Neuromonitoring, Neurosurgery, Pain therapy and Neurological Diagnostics. In close collaboration with customers, we continually translate new ideas into tools and develop new methods for the patientsʼ benefit. Our website reflects the variety of our competences. Worldwide Support via Licensing Partners We are an internationally operating company. In many countries, our clients can count on specialised staff closely associated with inomed. We also invest heavily in training and workshops for our partners and distributors. You will find inomed s support and benefit from all advantages anywhere you are! For further information, please visit our website: www.inomed.com

inomed Medizintechnik GmbH Im Hausgruen 29 79312 Emmendingen (germany) Tel.: +49 7641 94 14-0 Fax: +49 7641 94 14-94 info@inomed.com www.inomed.com 1000508 E/2.0 Content subject to alterations copyright by inomed 09.2010