EMDS (Endoscopic Microdiscectomy Spine System)

Transcription

RZ
Medizintechnik
GmbH
gror;:rj
Werner' s EMDS
Endoscopic M icroDiscectomy Spine System
for Minimally Invasive Surgery
E.M.D.S (Endoscopic Microdiscectomy Spine System)
PREOPERATIVE PREPARATION
All patients receive prophylactic antibiotics; one
gram of Ancef (cefazolin sodium) is administered
preoperatively. When the patient is allergic to
penicillin,vancomycin is typically utilized.
PATIENT PREPARATION
Endoscopic MicroDiscectomy is performed with the
patient in the prone position to maximize patient
comfort, minimize patient movement and rotation,
and prevent false X-ray imaging in the A-P and
lateral plane.
The patient is placed on a radiolucent frame that
allows the abdomen to hang freely and flattens the
angle of the lumbosacral junction. The bolsters of
the frame are converged distaJly to provide adequate
support under the anterior -superior iliac spine of
the patient.
Proper positioning to flatten the lumbosacral angle
is particularly important for Endoscopic
MicroDiscectomy at the LS-Sl disc space
(Figure 1).
Figure 1
A (-Arm is positioned to ensure reproducible A- P
and lateral imaging (Figure 2). A slight tilt of the ( Arm may be necessary to better visualize the L5 -SI
disc space. A marker is placed on the skin to
determine the surgical level in the A-P X-ray
projection.
The Endoscopic MicroDiscectomy procedure may be
performed under local anesthesia and conscious
sedation. Typically, a 1% Xylocaine solution is used
to infiltrate the skin and sub-cutaneous tissue. For
the paraspinal musdes, a 1% Xylocaine /
epinephrine solution is used to minimize the
incidence of postoperative psoas hematoma.
Figure 2
TIIE TRIANGULAR WORKING ZONE
To avoid entry into the spinal canal, Endoscopic
MicroDiscectomy is perfonned through a
posterolateral approach. The annular entry port for
the EMD"' instrumentation is in the "Triangular
Working Zone" (Figure 3).
The Triangular Working Zone is formed anteriorly
by the exiting root, inferiorly by
the proximal plate of the inferior vertebrae,
posteriorly by the proximal articular process, and
mdially by the tranversmg root and the dura.
Accessing the disc through the Triangular Working
Zone permits safe decompression of the nerve root.
Triangular Working Zone
Figure 3
SPINAL NEEDLE INSERTION
Correct positioning
Correct positioning of the Spinal Needle is essential
to successfully performing the
EMD'" procedure since all the instruments follow
in the path of the inserted needle.
The point of entry for the EMDN Spinal Needle is
typically 9 to 12cm from the midline on the patient·
s symptomatic side. On slim patients, a distance of
9cm may be adequate. The angle of introduction is
generally 35' to 55'Detennining the exact angle of
needle insertion may be accomplished by the CT
scan exposed through the level of the herniated disc
in a prone position (Figure 4).
Needle
Figure 4
Once the entry point and angle are determined, the
needle is inserted and rotated forward.
If the needle is placed correctly, it should penetrate
the sacrospinalis, quadratus lumborum, and psoas
major musdes (Figure 5) .
Ideally, the tip of the needle should pierce the first
cell layer of the annulus only.
When the needle is placed within the Triangular
Working Zone, the tip of the needle is visualized in
the lateral X-ray projection just posterior to the
intervertebral disc in alignment with the posterior
boundary of the adjacent vertebral bodies (figure6A). In the A-P projection, the tip of the needle is
seen to be in alignment with the mid-portion of the
pedic1es (Figure 6-B).
Figure 5
When an extraforaminal or foraninal herniation is
being evacuated, the tip of the needle may have to be
positioned over the lateral pedicular line.
Figure6-A
Figure6-B
Incon'ect Spinal Needle Positioning
c
If the neddle is introduced too lateral (Figure 7A).
there is a greater likelihood of entrance into the
abdominal cavity, which may cause serious complications. On the other hand, if the neddle is inserted
too close to the midline (Figure 7e).
adequate evacuation of disc fragments may not be
possible. As the needle is inserted correctly in the
Triangular Working Zone (Figure 7B), resistance
should be encountered when the needle reaches the
annulus.
If no resistance is encountered, it usually
indicates that a vertical insertion has been
perlormed (FigureS) , In this case, a lateral X-ray
will show that the needle has bypassed the annulus.
The A-P X-ray also shows that the annulus has not
been reached.The needle should be withdrawn and
reinserted at a more horizontal angle.
A
Figure 7
l~coRREcrVERnCALINSERn:oo
L>tmi Proj«tion
If the needle is inserted too horizontally,
resistance is usually encountered as the needle
reaches surrounding bone. An A-P and lateral X-ray
will confirm this situation (Figure 9).
Again, the needle should be withdrawn and
reinserted at a more vertical angle.
Figure 8
A-P Projroion
INCORRECT HORIZONTAL INSERno~
L>tmi Projection
Figure 9
A-P Projection
E.M.D.S (Endoscopic Microdiscecfomy Spine System)
GUIDE WIRE posmONING
Once the EMD'" Spinal Needle has been properly
positioned, the Stylet is withdrawn (Figure 10). and
the EMD"' Guide Wire is inserted (Figure 11). The
Guide Wire should encounter resistance as it is
engaged into the superticiallayer of the annulus.
The spinal needle is then withdrawn, leaving only
the Guide Wire in place (Figure 12).
Figure 10
CANNULATED OBTURATOR
INTRODUCTION
Guide
Wire
A small skin incision is made to allow the
Cannulated Obturator to pass over the
EMD"' Guide Wire through the skin. The Cannulated
Obturator is rotated over the Guide Wire to partially
advance the Obturator toward the disc (Figure 13).
Once the direction of the Obturator is established,
the Guide Wire is removed.
Figure 11
With the Guide Wire removed, the Cannulated
Obturator is advanced into the Triangular Working
Zone. The blunt tip permits the Obturator to safely
bypass the exiting nerve root that forms the anterior border of the Triangular Working Zone
(Figure 14).
Figure 12
Figure 14
Figure 13
UNIVERSAL ACCESS
CANNULA PLACEMENT
While holding the Obturator firmly against the
annulus, the Universal Access Cannula
passes over the Canulated Obturator and is advanced
with a rotary motion until it reaches the annulus
Uni\'{'f'SilIAcc('SS
Cmnula
(Figure 15),
When the Cannula/Obturator assembly is
appropriately placed on the annulus, the Obturator
will have a tendency to spring back when
compressed against the annulus. Compression of the
Obturator against the annulus will typically
produce pain that mimics the patient's presenting
radicular pain. The Obturator is removed, leaving
the Universal Access Cannula in place (Figure 16).
Figure 15
ANNULAR INSPECTION
To prepare for inspection of the annulus, the fluid
Sealing Adapter must be attached to the Universal
Access Cannula. Also, the Irrigation Sheath and the
Endoscope must be assembled. Suction inflow is
attached to the Irrigation sheath and outflow to the
Fluid Sealing Adapter. Refer to page 3 for more
detailed assembly instructions.
Figure 16
The Endoscope/Irrigation Sheath assembly is
inserted through the Universal Access Cannula with
the Fluid Sealing Adapter attached. A covering of
loose, adipose tissue is observed overlying the
annulus.
For better visual inspection of the annulus, the
adipose tissue may be removed with forceps or
wiped off with a cottonoid (Figure 17).
Alternatively, a Working Channel Scope may be used
for inspection of the Triangular Working Zone and
hemo·stasis if required.
Inspection of the annulus will unequivocally
confirm the absence of neural tissue in the
Triangular Working Zone. A simple "needle test"
may be pelformed to ensure that the cannula is not
resting on the adja-cent vertebra or on marginal
osteophytes.
The needle test is perfornled by probing the internal
diameter of the Cannula with the Guide Wire or a
long needle. If bony resistance is felt, the end of the
Cannula can be repositioned by tilting it until it is
well-centered on the disc.
From this point forward in the Endoscopic
MicroDicectomy procedure, visualization of the disc
is possible at any time by inserting the Endoscope
into the Universal access Cannula.
o.'erJying AdijXlSe Tissue
Figure17
Annular Fibers
ANNULAR FENESTRATION
Once the absence of the nerve root has been visually
confirmed, fenestration of the annulus is started.
Because this part of the procedure places
additional pressure on the already sensitive
annulus, the fenestration procedure is usually
painful and requires additional anesthesia for the
patient. Infiltration of the annular fibers with local
anesthetic, using additional systemic analgesics,
and using topical anesthesia such as local delivery
of Fentanyl solution on the annular surface, should
be anempted.
The retrieval of the posterolateral herniated disc
fragments, particularly when a uniportal access is
being utilized, hinges on positioning the annular
fenestration adjacent to the intracanlicular
structures for a subliga-mentous access to the
herniation site. This positioning permits the
inserted Trephine and instruments to sweep unedr
the transversing root and the lateral dura and
provide an easy access to the herniation site.
At the time the operating surgeon tilts the inner end
of the Cannula toward the dorsum of the patient for
visualization of the epidural fat, venous system or,
at times, the transversing root or dura. When the
above structures are visualized, the inner end of the
Cannula is tilted ventrally and firmly held against
the annular surface in preparation of annular
fenestration adjacent to the content of the spinal
canal.
Fenestration of the annulus is performed first with
the 3 mm Trephine and then the 5.3 mm Trephine.
First remove the Fluid Sealing Adapter, then insert
the 3 mm Trephine through the Universal Access
Cannula and rotate with finn downward pressure
(Figure 18!.
Next, the 5.3mm Trephine is inserted and the
rotation repeated. The Trephines should completely
fenestrate the annulus. It is not necessary to
advance the Trephine completely into the cannula.
The annular fenestration may be perfonned under
direct discoscopic visualization via a Working
Channel Scope.
At this point, the operating surgeon must hold the
Universal Access Cannula firmly against the
annulus to prevent periannular migration of the
Cannula.
TrephinE.'
Universal Access
~""
FiguyelB
After the annulus has been fenestrated, the annular
pathway is cleared. The Fluid Sealing Adapter is
reattached prior to the use of instruments. Then, the
Straight Cup Forceps are advanced down the
Universal Access Cannula to remove annular tissue
at the end of the Cannula (Figure 19).
The Angled-Up Cup Forceps can also be used to
remove interannular herniated fragments.
Figure 19
f'REf'ARATTON FOR
FRAGMENT RESECTTON
When the annular pathway is clear, the Universal
Access Cannula is advanced slightly into the
annulus. To do this, the Fluid Sealing Adapter is
removed from the Cannula and the C<UIDulated
Obturator is reinserted (Figure 20).
Figure 20
E,M,D,S (Endoscopic Microdiscectomy Spine System)
The Cannulated Obturator is advanced 1 to 2 cm into
the annulus (Figure 21).
The Universal Access Cannula is then advanced 4 to
5 mm over the Cannulated Obturator. The position of
the Cannula may be checked radiographically.
finally, the Cannula Insertion Stop is placed over
the Cannula and tightened to help maintain th new
Cannula position. (Refer to page 4 for detailed
assembly instructions.) The Cannulated O?turator
is removed (Figure 22).
Figure 21
FRAGMENT EVACUATION
Prior to resection of the herniated fragments, the
Fluid Sealing Adapter must be attached to the end of
the Universal Access Cannula. Use of the Fluid
Sealing Adapter during this portion of the procedure will prevent any of the instruments from
penetrating more than 2 cm from the end of the
Cannula.
There are a variety of instruments available for
resection of the herniated fragments. The three
manual forceps are used to reach and remove
posterior and posterolateral fragments (Figure 23).
Typically the Straight Cup Forceps are used first
followed by the Angled-UP Cup Forceps which are
used to reach more posteriorly. The flexible Shaft
Cup Forceps and the Deflecting Tube permit even
further posterior Positioning and evacuation of the
posterolateral disc fragments.
All three forceps can be rotated within a 120 arc to
permit wider access to the herniated fragments.
Figure 22
0
Figure 23
Finally, the Hexible Shaver Tip Blades, powered by
the motorized Shaver System, may be used to resect
and evacuate nuclear tissue (Figllre 24).
Refer to tbe Fluid Management Section on page 7 for
more information on suction and power sbaving.
CLOSING
When evacuation of the berniated fragments is
complets, the Endoscope is inserted into the Cannula
for a final inspection of the operative site. Visual
confirmation establishes that the annular
fenestration is clear. The fibers of the posterior
longitudinal ligament are Visualized or, at times,
the dural sac or transversing root are observed.
Figure 24
The Cannula Insertion Stop is loosened and removed,
and the Universal Access Cannula is withdrawn
(Figure 25).
A single suture is used to close the skin and a small
dressing are applied.
POSTOPERATIVE PROTOCOL
Postoperative antibioitcs are administered. The
patient may either be released on the same day or
held overnight for obeservation, if necessary.
Following discharge, the patient should be advised
against long periods of sitting, bending, or excessive
lifting for one week. Aqua therapy and swimming
are initiated at this time, followed by a
conditioning program and isokinetic exercises.
Figure 25
Werner Diskoskop
Spinal Kanülen Set und Positionierstab
Werner Discoscope
Spinal Canula Set and Positioning Probe
Spinal Kanülen
Spinal Cannulas
Spinal-Kanülen-Set, wiederverwendbar, bestehend aus:
Spinalkanüle, Innennadel scharf, stumpfer und scharfer Obturator
Spinal Canula Set, re-usable, consisting of:
Spinal Canula, inner needle sharp,blunt and sharp obturator
RZ
259-300-400
1,3 mm Ø, 300 mm Nutzlänge
259-300-400
1.3 mm Ø, 300 mm working length
259-250-400
259-250-400
259-150-400
259-150-400
Positionierstab
Positioning Probe
259-615-400
Positionierstab 5 mm Durchmesser, 400 mm Nutzlänge
259-615-400
Positioning Probe 5 mm diameter, 400 mm working length
3
RZ
Werner Diskoskop Typ I
Werner Discoscope Type I
259-063-020
Werner Diskoskop Typ I mit extra großem Arbeitskanal und 2 Saug- und
Spülkanälen mit Universaladapter zum Anschluss für sämtliche Kaltlichtkabel.
Werner Discoscope Type I with extra large working channel and 2 suctionand irrigation channels including universal adapter for use with all common
fiber optic light cables.
Die Indikation für das Werner Diskoskop Typ I liegen in der Diagnostik also auch
Therapie diskogener Schmerzen. Besonderes Augenmerk wurde auf das neu
berechnete Stablinsensystem von RZ Medizintechnik GmbH gelegt, sowie eine
optimierte Glasfaseranordnung welche für ein helles, brilliantes Bild mit hoher Auflösung und einer enormen Randschärfe sorgen. Der mit 2,8 mm Durchmesser
groß dimensionierte Arbeitskanal ermöglicht es stabil konstruierte Hilfsinstrumente zu verwenden, die durch eine lange Lebensdauer überzeugen.
The medical application of the Werner Discoscope Type I is the diagnosis as well
as the therapy of discogene pain at anatomical difficult accessible locations.
The main features are the latest designed RZ-rod lens system and the improved
structure of the fibre bundle ensuring a bright, brilliant image with high resolution and a superior marginal sharpness.
Der einzigartige Silikondichtungs-Aufsatz überzeugt durch seine 100%-ige Dichtigkeit und den universellen Einsatz für alle RZ Medizintechnik GmbH Hilfsinstrumente.
Technische Daten:
Blickrichtung:
Schaft:
Arbeitslänge:
Arbeitskanal:
The well dimensioned 2.8 mm working channel permits the use of robust auxiliary instruments with strong hinges and linkages.
The unique silicone sealing adapter is convincing by its universal application for
all RZ Medizintechnik auxiliary instruments without leakage.
Technical Details:
20°
6,30 mm
215 mm
2,80 mm
angle of view:
sheath:
working length:
working channel:
20°
6.30 mm
215 mm
2.80 mm
259-000-051
Werner Silikondichtungs-Aufsatz passend zum Werner Diskoskop Typ I
4
Werner Silicone Sealing Adapter for use with the Werner Discoscope Type I
Dilataroren und Einschlaghülsen
Dilators and Impactor
RZ
259-606-400
Dilatator 1-kanalig zur Verwendung mit Werner Diskoskop Typ I
Dilator 1-channel for use with Werner Discoscope Type I
259-616-400
Dilatator 2-kanalig zur Verwendung mit Werner Diskoskop Typ I
Dilator 2-channels for use with Werner Discoscope Type I
Einschlaghülse für Arbeitshülsen / Impactor for Working Sleeves
259-626-400
Einschlaghülse für Arbeitshülsen zum Werner Diskoskop Typ I
Impactor for Working Sleeves for Werner Discoscope Type I
5
RZ
Arbeitshülsen und Spülaufsatz
259-612-145
Arbeitshülse, gerade
Working Sleeve, straight
259-613-165
Arbeitshülse mit Doppelfenster
Working Sleeve with dual window
259-614-165
Arbeitshülse mit schrägem Fenster
Working Sleeve with oblique window
259-615-165
Arbeitshülse mit Elevationslippe
Working Sleeve with Elevator tip
259-616-165
Arbeitshülse mit seitlichem Fenster
Working Sleeve with lateral window
259-610-007
Spüladapter für alle Arbeitshülsen
Fluid Adapter for all Working Sleeves
259-610-008
Ersatz Dichtung
Spare cap
6
Working Sleeves and Fluid Adaptor
Ringinstrumente 2,7 mm Ø
Ring handle instruments 2.7 mm Ø
RZ
259-527-351
Mikro-Rongeur, einfachbewegliches Maulteil, mit Spülansatz und Überlastschutz
Micro-Rongeur, single action jaws, with cleaning port and overload protection
259-527-353
Mikro-Rongeur, doppelbewegliches Maulteil, mit Spülansatz und Überlastschutz
Micro-Rongeur, double action jaws, with cleaning port and overload protection
259-527-355
Doppellöffelzange, einfachbewegliches Maulteil, mit Spülansatz und
Überlastschutz
Double-spoon Forceps, single action jaws, with cleaning port and overload
protection
259-527-357
Faßzange, starke retrograde Zahnung, mit Spülansatz und Überlastschutz
Grasping Forceps, strong retrograde serration, with cleaning port and overload
protection
259-527-359
Stanze mit flacher Schaufel, durchschneidend, mit Spülansatz und
Überlastschutz
Punch with flat spatula Tipp, through cutting, with cleaning port and overload
protection
7
RZ
Handinstrumente
259-627-351
Raspel, Retrograd / Rasp, retrograde
259-627-353
Löffel / Spoon
259-627-355
Anulotom / Annulotome
259-627-357
Penfield Dissektor / Penfield Dissector
259-627-359
Tasthaken / Hook Probe
8
Hand Instruments
Werner Diskoskop Typ II
Werner Discoscope Type II
RZ
259-059-020
Werner Diskoskop Typ II mit großem Arbeitskanal und 2 Saug- und Spülkanälen mit Universaladapter zum Anschluss für alle gängigen Kaltlichtkabel.
Werner Discoscope Type II with large working channel and 2 suction- and
irrigation channels including universal adapter for use with all common fiber
optic light cables.
Die Indikation für das Werner Diskoskop Typ II liegen in der Diagnostik also auch
Therapie diskogener Schmerzen bei anatomisch schwierigen Gegebenheiten.
Besonderes Augenmerk wurde auf das neu berechnete Stablinsensystem von RZ
Medizintechnik GmbH gelegt, sowie eine optimierte Glasfaseranordnung welche
für ein helles, brilliantes Bild mit hoher Auflösung und einer enormen Randschärfe sorgen. Der 2,5mm Arbeitskanal ermöglicht den Einsatz eines kompletten
Hilfsinstrumentariums.
The medical application of the Werner Discoscope Type I is the diagnosis as well
as the therapy of discogene pain at anatomical difficult accessible locations.
The well dimensioned 2.5 mm working channel permits the use of robust auxiliary instruments with strong hinges and linkages.
Technische Daten:
Technical Details:
Blickrichtung:
Schaft:
Arbeitslänge:
Arbeitskanal:
20°
5,90 mm
215 mm
2,50 mm
angle of view:
sheath:
working length:
working channel:
20°
5.90 mm
215 mm
2.50 mm
259-000-050
Werner Silikondichtungs-Aufsatz passend zum Werner Diskoskop Typ II
Werner Silicone Sealing Adapter for use with the Werner Discoscope Type II
9
RZ
259-606-500
Dilatator 1-kanalig zur Verwendung mit Werner Diskoskop Typ II
Dilator 1-channel for use with Werner Discoscope Type II
259-616-500
Dilatator 2-kanalig zur Verwendung mit Werner Diskoskop Typ II
Dilator 2-channels for use with Werner Discoscope Type II
259-626-500
Einschlaghülse für Arbeitshülsen zum Werner Diskoskop Typ II
Impactor for Working Sleeves for Werner Discoscope Type II
10
RZ
259-612-245
259-613-265
259-614-265
259-615-265
259-616-265
Arbeitshülse mit seitlichem Fenster
Working Sleeve with lateral window
259-610-007
259-610-008
Ersatz Dichtung
Spare cap
11
RZ
259-523-351
259-523-353
259-523-355
Überlastschutz
protection
259-523-357
protection
259-523-359
Überlastschutz
protection
12
Handinstrumente
Hand Instruments
RZ
259-623-351
Raspel, Retrograd / Rasp, retrograde
259-623-353
Löffel / Spoon
259-623-355
Anulotom / Annulotome
259-623-357
Penfield Dissektor 7 Penfield Dissector
259-623-359
Tasthaken / Hook Probe
13
RZ
Werner Foraminoskop
Werner Foraminoscope
259-075-020
Werner Foraminoskop mit extra großem XXL Arbeitskanal und 2 Saug- und
Spülkanälen mit Universaladapter zum Anschluss für alle gängigen Kaltlichtkabel.
Werner Foraminoscope with extra large XXL working channel and 2 suctionand irrigation channels including universal adapter for use with all common
fiber optic light cables.
Die Indikation für das Werner Foraminoskopes liegen in der Diagnostik sowie in
der operativen Anwendung einer Foraminoplastik. Besonderes Augenmerk wurde
auf das neu berechnete Stablinsensystem von RZ Medizintechnik GmbH gelegt,
sowie eine optiemierte Glasfaseranordnung welche für ein helles, brilliantes Bild
mit hoher Auflösung und einer enormen Randschärfe sorgen. Der mit 3,7 mm
Durchmesser sehr groß dimensionierte Arbeitskanal ermöglicht es stabil konstruierte Hilfsinstrumente zu verwenden, die durch eine lange Lebensdauer überzeugen. Das große Fassvolumen der 3,5mm Biopsiezangen ermöglicht ein schnelles
entfernen des Foramen.
The medical indication of the Werner Foraminoscope is the diagnosis of the foramen as well as performing a Foraminoplasty.
The well dimensioned 3.7 mm XXL working channel permits the use of robust
auxiliary instruments as well as insertion of implants.
The very large cup of the biopsy and grasping forceps facilitates a fast removal
of the foramen.
Technische Daten:
Technical Details:
259-075-020
259-075-000
259-075-020
259-075-000
Blickrichtung:
Schaft:
Arbeitslänge:
Arbeitskanal:
Blickrichtung:
Schaft:
Arbeitslänge:
Arbeitskanal:
angle of view:
sheath:
working length:
working channel:
angle of view:
sheath:
working length:
working channel:
20°
7,50 mm
215 mm
3,70 mm
0°
7,50 mm
215 mm
3,70 mm
20°
7.50 mm
215 mm
3.70 mm
0°
7.50 mm
215 mm
3.70 mm
259-000-052
Werner Silikondichtungs-Aufsatz passend zu allen Werner Foraminoskopen
14
Werner Silicone Sealing Adapter for use with the Werner Foraminoscope
Werner Foraminoskop
RZ
259-606-600
Dilatator 1-kanalig zur Verwendung mit Werner Foraminoskop
Dilator 1-channel for use with Werner Foraminoscope
259-616-600
Dilatator 2-kanalig zur Verwendung mit Werner Foraminoskop
Dilator 2-channels for use with Werner Foraminoscope
259-626-600
Einschlaghülse für Arbeitshülsen zum Werner Foraminoskop
Impactor for Working Sleeves for Werner Foraminoscope
15
RZ
Werner Foraminoskop
259-612-345
259-613-365
259-614-365
259-615-365
259-610-007
259-610-008
Ersatz Dichtung
Spare cap
16
Werner Foraminoskop
RZ
259-535-351
259-535-353
259-535-355
Überlastschutz
protection
259-535-357
protection
259-535-359
Überlastschutz
protection
17
RZ
Werner Foraminoskop
Zur Verwendung durch Arbeitshülsen
For use with working sleeves
Trephine mit Schneidefenster
Trephine with cutting window
259-603-195
Trephine, 5,9 mm Außendurchmesser, 220 mm Arbeitslänge,
3,0 mm Schneidedurchmesser
Trephine, 5.9 mm outer diameter, 220 mm working length,
3.0 mm cutting diameter
259-653-195
Trephine, 5,9 mm Außendurchmesser, 220 mm Arbeitslänge,
5,3 mm Schneidedurchmesser
Trephine, 5.9 mm outer diameter, 220 mm working length,
5.3 mm cutting diameter
259-599-012
Werner Lumbal- und Zervikal Rongeure mit 90° öffnenden Maulteilen
Werner Lumber and Cervical Rongeurs with 90° opening jaws
259-599-012
mit 12 mm langem Maulteil, 90° öffnend
with 12 mm long jaws, 90° opening
259-599-006
mit 6 mm langem Maulteil, 90° öffnend
with 6 mm long jaws, 90° opening
18
Geräte
XENON Lichtquelle
Equipment
XENON Light Source
300-001-180 ALEXiS 180M
Die ALEXIS 180M XENON Kaltlichtquelle liefert Ihnen
hervorragendes weißes Untersuchungslicht
(Tageslichtspektrum) bei allen Einsätzen in der
Endoskopie, wie z.B.:
• in der Video-Endoskopie
• in der Fiberendoskopie
• beim Einsatz von starren Optiken
• beim Einsatz von Stirnbeleuchtungen
The ALEXIS 180M XENON light source offers outstanding white examination light (sunlight spectrum) for
all endoscopic applications, for example:
• during video endoscopy
• during fiber endoscopy
• during endoscopy using rigid optics
• during usage of forehead illumination
Technische Daten
Tecnical Data
Xenon Speziallampe Typ XBO 180
180 W Nennleistung
Integrierter Ellipsoidreflektor
bis 5800 K (Tageslichtspektrum)
IR 3 (Option KG / UV – Sperrfilter)
500 Stunden.
30 Min. AN und 15 Min. AUS
Auf Leuchtmittel keine Garantie!
Betriebsdauer Anzeige
Digital
Netzanschluss
115 & 230 VAC, 50/60 Hz,
3,15 (1,6) Amp. +10% / -5%
Leistungsaufnahme
350 VA
Sicherungen
2 x 3,15 AT, (2 x 1,6) IEC127–2/III
5 x 20 mm
Abmessungen (B x T x H) 32,5 x 26,5 x 14,5 cm
Gewicht
9,5 kg
Gehäuse –Schutzart
Schutzgrad IPX 1 / IEC 529
Ganzmetallgehäuse, beschichtet
Temperatur – Betrieb
+10°C - +40°C
Temperatur – Lagerung
-20°C - +45°C
Zulässige Luftfeuchte
85%
Funkenstörung
Nein
Netzkabel
EURO / USA – Ausführung
Schutzgrad, Gerätegruppe MedGV Gruppe 1
Klassifikation
Typ CF (cardiac floating)
Elektrische Schutzklasse
1 / TÜV getestet
CE Zeichen
Council Directive 93/42/EEC Klasse I
Bauart
entspricht
IEC 601-2-18 : 1992
EN 60601-1 : 1993
EN 55011, IEC 801
TÜV Bauart geprüft
ESD (EMV) Richtlinien
DIN VDE 0751 Teil 1
Lamp type
Output / Performence
Lamp geometry
Color temperature
Heat protection filter
Lifetime of XENON lamps
Average value at
Lampentyp
Leistung
Lampengeometrie
Farbtemperatur
Wärmeschutzfilter
Lebensdauer der Lampe
Durchschnittswert bei
4
Operating hours indicator
Power requirements
Power consumption
Fuses
Dimensions (WxHxD)
Weight
Housing safety standard
Temperature - operation
Temperature - storage
Max. relative air humidity
Radioscreening
Power supply cord
Protection grade
Classification
Electr. protection class
CE standard
Compliance
ESD 8EMV) in accordance to
XEON speciallamp type: XBO 180
180 Watts
integrated ellipsoidreflector
5800° K (daylight spectrum)
IR 3 (Option KG/UV-Rejection filter)
500 hours
30 minutes ON and 15 minutes OFF
No warranty on lamp!
Digital
115 & 230 VAC,50/60 Hz,
3.15 / 1.6 Amp. +10% / -5%
350 VA
2 x 3.15 AT, (2 x 1.6)
IEC 127-2/III 5 x 20 mm
32.5 x 26.5 x 14.5 cm
9.5 kg
protection class IPX 1 / IEC 529
full metal casing, powder coated
+10° C - +40° C
-20° C - +45° C
85%
No
Euro / USA - Edition
MedGV Apparatus Group 1
Typ CF (cardiac floating)
1 / TÜV certified
Council Directive 93/42/EEC Class I
with Corresponds to
IEC 601-2-18 : 1992
EN 60601-1 : 1993
EN 55011, IEC 801,
TÜV Type tested
DIN VDE 0751 Part 1
Geräte
Zubehör für Lichtquellen
Equipment
Accessories for light sources
250-035-180
Lichtleitkabel, 3.5 x 1800 mm
Fibreoptic light guide, 3.5 x 1800 mm
250-035-230
250-048-180
250-048-230
250-048-300
Fibreoptic light guide,4.8 x 3000 mm
Adapter für Lichtleitkabel / Adaptor pieces for Fibre light guide
Endoskop / Endoscope
Projektor / Lightsource
Bestellbeispiel / Ordering Example:
Wolf
250-040-000
250-037-000
ACMI/British St.
250-038-000
250-041-000
Lichtleitkabel, 4.8mm x 2300 mm für RZ Laparoskop
und ALEXiS 180M
= 250-048-230 + 250-039-000 + 250-042-000
Light guide, 4.8 mm x 2300 mm for RZ
Laparoscope and ALEXiS 180M
= 250-048-230 + 250-039-000 + 250-042-000
RZ / Storz
250-039-000
250-042-000
Olympus
250-042-000
250-044-000
5
Geräte
Kamera
Equipment
Camera
300-001-410
300-001-411
RZ-410 230V / PAL
RZ-410 110V / NTSC
Die RZ-410 ist eine wasserdichte 1-Chip-MikroFarbkamera mit den Leistungsmerkmalen einer
3-Chip Kamera für die Endoskopie.
The RZ-410 is a waterproofed 1-Chip-Micro-colour
camera with the technical features of a 3-ChipCamera or endoscopy
Spezielles Zubehör/Special accessories
250-015-025
Zoom-Adapter von 15-25 mm
Zoom Adaptor from 15-25 mm
250-025-040
Zoom-Adapter von 25-40 mm
Zoom Adaptor from 25-40 mm
Leistungsmerkmale:
Features:
• durch die eingesetzte neueste 1-Chip-Technik
bietet die Kamera eine exzellente
Bildwiedergabe, die annähernd die gleiche
Qualität einer 3-Chip-Technik erreicht.
• die Bedienung ist sehr einfach ohne komplizierte
Einstellungen und daher bedienerfreundlich.
• alle vom Anwender eingestellten Parameter
werden auf dem Display des Steuergerätes
angezeigt.
• beim Ausschalten werden die Einstellungen
automatisch gespeichert
• die Kamera benötigt keine Hilfefunktion
• der Kamerakopf kann durch Einlegen in Lösung
desinfiziert werden.
• die RZ-410 ist geeignet sowohl für Halogen als
auch für Xenon Lichtquellen
• The Camera offers an excellent image quality by
using a new 1-Chip-video technology offering
almost the same quality of a 3-Chip technology.
• Handling is simple and user-friendly without any
complicated adjustments.
• User adjustments displayed on grafic display of
the control unit.
• Automatic memorizing of the configuration when
switched off.
• No help function on screen needed anymore.
• Decontamination by immersion (camera head)
• RZ-410 can be used for Halogene as well as
for Xenon light sources
RZ 410 bestehend aus:
RZ 410 consisting of:
1 Steuergerät
1 Kamerakopf mit 3,0 m Kabel
1 BNC-BNC Kabel
1 Y/C Kabel
1 Netzkabel
1 Bedienungsanleitung
1 Fokussier Optik 28 mm
1 Control Unit
1 Camera head with 3.0 m cable
1 BNC-BNC cable
1 Y/C cable
1 Main cable
1 Operating manual
1 Focusing lens 28 mm
6
Geräte
Kamera
Equipment
Camera
Technical data
Technische Daten
Videosystem:
Bildsensor:
Bildpunkte:
Horizontale Auflösung:
Vertikale Auflösung:
Mindestbeleuchtung:
Weißabgleich:
AGC:
Blendensteuerung:
Mode- Umschaltung:
Videoausgänge (PAL):
Stromaufnahme:
Netzspannung:
Netzfrequenz:
Netzsicherungen:
Betriebstemperatur:
Betriebsluftfeuchte:
Lagertemperatur:
Lagerluftfeuchte:
Abmessungen:
Gewicht:
Abmessungen/
Anwendungsteil:
Gew.a Anwendungsteil:
Fassung am
Anwendungsteil:
Objektivbrennweite:
Lichtquellenabhängigkeit:
PAL / NTSC
1/2" Interline Transfer CCD - Chip
752(H) x 582(V) Pixel
> 450 TV Linien bei Y/C
> 420 TV Linien bei Y/C
2 Lux bei F 1/1.3
Automatisch / 3200° Kelvin
6000 Kelvin Manuell
Automatisch / Aus
Automatisch / Aus
Mittelwertlichtmessung
Spitzenwertlichtmessung
Ausschnitt-Mittelwertlichtmessung
Ausschnitt-Spitzenwertlichtmessung
2 x FBAS- Signal an BNC- Buchse:
1Vss an 75 W, Sync. negativ 2 x Y/C
Signal an S- VHS- Buchse:
Y / 1,0Vss an 75 WC / 0,3 Vss an 75 W
0,065 Ampere
230V / 110V
50Hz
2x T 80mA
0°C bis +40°C
Bis 80 % (keine Kondensation erlaubt)
-20°C bis +60°C
Bis 90 % (keine Kondensation erlaubt)
(B x H x T) 330 x 75 x 280 mm
3400g
Ø 28.5 x 50 mm (Ø x L)
240g bei 3 m Kabellänge
C- Mount- Gewinde
Variabel durch TV-Adapter
Geeignet für Halogen und Xenon
250-025-028
Fokussier Optik 28 mm
Focusing lens 28 mm
250-025-035
Fokussier Optik 35 mm
Focusing lens 35 mm
Videosystem:
Image sensor:
Resolution:
Horizontal resolution:
Vertical resolution:
Sensitivity:
White balance:
AGC:
Iris control:
Exposure mode:
Video outputs (PAL):
Current consumption:
Power requirement:
Power frequency:
Fuses:
Operating temperature:
Operating humidity:
Storage temperature:
Storage humidity:
Dimensions:
Weight:
Dimension
Applied part:
Weight Applied part:
Applied part
fitting:
Objective focal length:
Light source dependency:
250-020-360
PAL / NTSC
1/2" Interline Transfer CCD - Chip
752(H) x 582(V) Pixel
> 450 TV Linien at Y/C
> 420 TV Linien at Y/C
2 Lux at F 1/1.3
Automatic / 3200° Kelvin
6000 Kelvin Manual
Automatic / Off
Automatic / Off
Average light measuring
Spot light measuring
"Cut out"- Average light measuring
"Cut out"- Spot light measuring
2 x FBAS signal to BNC connector:
1Vpp / 75 W, Sync. negativ 2 x Y/C
signal to S-VHS connector:
Y/1,0Vpp 75 WC / 0,3 Vpp / 75 W
0,065 Ampere
230V / 110V
50Hz
2x T 80mA
0°C to +40°C
Up to 80 % (no condensation permitted)
-20°C to +60°C
Up to 90 % ( no condensation permitted)
(W x H x D) 330 x 75 x 280 mm
3400g
(Ø x L) Ø28.5 x 50 mm
240g including 3 m cable
C- mount- thread
Variabel with TV- Adapter
Suitable for Halogen and Xenon
Bildteiler, 35 mm, zum gleichzeitigen
Betrachten durch die Optik und auf dem Monitor.
Beam splitter, 35 mm, for simultaneously
viewing by endoscope and monitor screen
7
HIGH COLOUR MEDICAL TFT DISPLAY
“Our advantages - Your
benefits“
Features
•
•
•
•
•
•
•
•
•
Support up to SXGA (1280x1025) resolution
Automatic Mode detection from VGA to SXGA
Accept H-/V- Separate Sync, Csyn (LVDS 2 Port), Sync On Green, and Interlace
mode
PIP (Picture in Picture) supports at RGB and Video dual sources
Provides up to 1600k Colors
Flicker- free, sharp image/text data
Refresh rates up to 85Hz without external video memory
Full screen image expansion or centered-mode display for lower resolutions
User friendly On Screen Display Menu to control image
•
•
•
•
•
•
•
•
•
•
•
•
Auto-Adjust
Brightness
Contrast
RGB Control
Clock Phase
Geometry
Scrren Zooming
Input Type Select
OSD Control
Default- Settings
Power management support (DPMS – VESA complaint)
VESA-DDC 1/2B display ID for Plug and Play Operation (Option)
www.RZ-Medizintechnik.com
Page 2 of 2
Newsletter Date
Volume 1, Issue 1
HIGH COLOUR MEDICAL TFT DISPLAY
Electrical Specifications
-Video input timing
-Supported vertical refresh rates for each modes are as follows:
• 640x350
70HZ
• 640x400
70Hz
• 720x400
70Hz
• 640x480
56~85Hz
• 800x600
56~85Hz
• 1024x768
56~85Hz
• 1280x1024
56~85 Hz
Technical data
Power Supply
12V DC INPUT in Display Max. 4A
Power consumption
Frequency
Active display area
Pixel pitch
Pixel format
Response time (rise)
Contrast Ration
Luminance, white
Color depth
Viewing angle
Display operating mode
Backlight lamp lifetime
Video Input
Weight
Dimensions
Housing
Surface
Protection class
Classification
Test standard
Max. 45W
60 /50 Hz
19 inches diagonal
0.294 mm x 0.294 mm
1280 horiz. by 1024 vert. pixels
12 ms
500:1
250cd/ m²
8-bit, 16.777.216 colors
176° right/ left, 176° up/down
Transmissive mode, normally black
40.000 Hrs
1 x Y/C (S-VHS), 1 x FBAS, 1 x VGA
9,5 kg
445x370x50mm
Aluminium frame
Coated glass anti – glare
I
BF without function group with 1 Patient circuit
IEC 601-1, IEC 601-1-2, MPG
www.RZ-Medizintechnik.com

EMDS (Endoscopic Microdiscectomy Spine System)

Transcription

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