Endoscopic Enucleation And Morcellation From KARL STORZ, All From A Single Source

20 Pages

File Type: PDF

File Size: 1.17 MB

File Name: KARL STORZ ENDOSKOPE - 96132038 - Endoscopic Enucleation And Morcellation From KARL STORZ, All From A Single Source - 2021-09 - 1.5.pdf

Preview

Page 1

URO 52 1.5 09/2021-E

Endoscopic Enucleation and Morcellation from KARL STORZ All from a single source

Endoscopic Enucleation of the Prostate (EEP) Instruments for endoscopic enucleation techniques – “everything from a single source” Treatment of benign prostate syndrome (BPS) is one of the most important fields of treatment in endourology. In the last 20 years, various OR techniques for transurethral endoscopic enucleation have been developed and implemented in the market. Endoscopic enucleation of the prostate (EEP) competes with the classic method of open adenoma enucleation as well as the gold standard, transurethral resection of the prostate (TURP). In a publication of the EAU Guidelines in 2016, laser enucleation (e.g., HoLEP) and bipolar enucleation are grouped under enucleation of the prostate (EEP). Similar to classical transurethral resection, EEP is thus regarded as a treatment of choice for benign prostate syndrome (BPS). To meet the requirements of this development, KARL STORZ presents variable configuration possibilities which enable you to perform both laser and HF-based applications using one basic instrument. KARL STORZ provides you with a flexible system for all techniques and energy sources and, at the same time, expands its product line for enucleation with a morcellator system for the removal of prostate tissue.

Endoscopic Enucleation of the Prostate

Morcellation

HF Surgery (e.g., BipolEP) © KARL STORZ 96132038 URO 52 1.5 09/2021/EW-E

LASER (e.g., HoLEP, ThuLEP)

Laser Enucleation and Bipolar Enucleation Formed Under the Acronym EEP KARL STORZ concept conforming to EAU guidelines The European Association of Urology (EAU) recommends various OR techniques in accordance with the size of the prostate. The “EAU Guidelines on the Management of Nonneurogenic Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO)” recommends endoscopic enucleation of the prostate (EEP) as the treatment of choice for significant enlargement of prostate adenoma (e.g., > 80 ml) as well as moderate to severe LUTS, whereby the choice of energy source is a secondary matter. In line with these guidelines, KARL STORZ offers you a broad portfolio of instruments with the prerequisites for performing the enucleation technique of your choice.

< 30 ml

Prostate Volume

> 80 ml

30-80 ml

TUIP TURP

TURP Laser Enucleation Bipolar Enucleation

Bipolar Enucleation Open Prostatectomy HoLEP ThuLEP

Source: EAU Guidelines on Management of Non-Neurogenic Male Lower Urinary Tract Symptoms (LUTS), incl. Benign Prostatic Obstruction (BPO) 2021

Customized Concept for all Requirements Compatible system for endoscopic enucleation of the prostate

Standard Instruments The standard instruments for performing endoscopic enucleation of the prostate correspond to those used for resection – telescopes, sheaths and obturators are identical for both procedures – only the working element used is different depending on the technique used. Instrumentation for EEP can therefore be conveniently adapted to your existing product portfolio. The compatibility of our sheaths makes a changeover from enucleation to morcellation possible.

Instruments for Laser Enucleation KARL STORZ offers various instruments for laser enucleation. In addition to the classic KUNTZ laser working element, a modular working element with exchangeable guide inserts for laser probes can be used. Exchangeable laser probes allow the instrument to be adapted to the diameter of the laser fiber used. The outcome makes guidance and fixation of the laser fiber possible. The laser probes of the modular working element are optionally available with retracting beaks.

Bipolar enucleation is a cost-effective entry to EEP as no acquisition or service costs are necessary for laser and the same working element is used as in bipolar resection. The passive working element in conjunction with the vapo-enucleation electrode permits mechanicalanatomical enucleation with resection, coagulation and vaporization properties combined in one instrument.

Instruments for HF Enucleation

A physician’s opinion on the bipolar vapo-enucleation electrode

Conclusion Based on my own experience during the development phase, the new electrode for bipolar vapoenucleation is a convenient multi-use probe for the anatomical enucleation of the prostate. After performing 2000 AEEP procedures (anatomical endoscopic enucleation of the prostate) using both laser enucleation (HoLEP, ThuLEP) and bipolar techniques, I see no significant difference as regards the effectiveness of these techniques. Thanks to the convenient layer-by-layer dissection and effective hemostasis, the probe has proven to be a suitable and reliable tool for learning and teaching the AEEP procedure with a manageable number of participants. With BipoIEP, the bipolar current is used for dissection (cutting) and coagulation analogous to laser techniques. In my opinion, the new vapoenucleation electrode has the potential to provide a global response to the trend towards transurethral, cost-effective enucleation. Prof. Dr. med. Thomas R. W. Herrmann, Klinik für Urologie, Spital Thurgau AG, Switzerland Development partner of KARL STORZ for the bipolar VapoEnucleation Electrode (27040VE)

To view the application video, please scan the QR code

The combination of a vaporization electrode and a mechanical dissection probe with a flat cuneiform design allows detachment of the inner prostate gland (TI) from the outer gland (surgical capsule) through axial advancement of the electrode via the working element. This reduces the necessary mechanical stress on the urethra, which is particularly useful during laser enucleation. Detachment of the interior prostate gland by means of mechanical ablation allows anatomically correct dissection under visual control. The excellent coagulation and vaporization properties of the electrode ensure good hemostasis and precise dissection in areas with adhesions between the interior and exterior prostate glands. In areas that require dissection, e.g., anterior fibromuscular stroma, the excellent vaporization properties of the electrode permit convenient smoothing of the wound base. Thanks to its mechanical stability, the probe can be used on medium-sized adenomas up to five times without compromising effectiveness according to my experience.

Morcellator System for Urology Removal of the prostate tissue after enucleation With the morcellator system, KARL STORZ has expanded its product line for enucleation with instrumentation for the removal of prostate tissue after enucleation. An advantage of this system is that the S-PILOT® vacuum control unit and the UNIMAT® 30 suction pump can both be used with the existing central suction system, which presents a cost-effective solution. Tissue morcellation after enucleation of the prostate thanks to effective suctioning of tissue possible

•

Communication between the motor and the suction systems via footswitch

•

Individual installation in existing suction systems

•

Possible to adjust oscillation speed (rpm) intraoperatively

•

System Components for Enucleation Basic Instruments

27005BA, 27050SCK and 27040OC

Laser Enucleation

KUNTZ Working Element

Modular Working Elements

27056LA

27056LE and 27056EA

HF Enucleation

Working Element and Electrode

27040EB and 27040VE

Alternatives for the instruments selected in the diagram can be found on the following pages or in the UROLOGY catalog.

Morcellator System

System Components for Morcellation Sheath from basic instruments for enucleation

Angled Telescope and Adaptor

27050SCK 27293AA and 27040SC

DRILLCUT-X® II URO

UNIDRIVE® S III

Blade

27702050**

27701001-1

27056LM**

S-PILOT® Tubing Set 031457-10*

UP501S2

UNIMAT® 30

25320001

Tissue Trap Filter 030970-10*

Central Suction System

Suction Canister 030306-04*

* ** Cleaning Adaptors, see page 15

Standard Instruments for Enucleation HOPKINS® Telescopes

27005BA

HOPKINS® Forward-Oblique Telescope 30°, enlarged view, diameter 4 mm, length 30 cm, autoclavable, fiber optic light transmission incorporated, color code: red

27005FA

HOPKINS® Telescope 12°, enlarged view, diameter 4 mm, length 30 cm, autoclavable, fiber optic light transmission incorporated, color code: black

27050SCK

Resectoscope Sheath, quick-release lock, including connecting tube for in- and outflow, 26 Fr., oblique beak, rotating inner sheath with ceramic insulation, color code: yellow

27050SLK

Resectoscope Sheath, including connecting tube for inand outflow, 26 Fr., oblique beak, rotating inner sheath with ceramic insulation, color code: yellow

27040OC

Standard Obturator, for 24/26 Fr. sheaths

27050BK

SCHMIEDT Visual Obturator, for 24/26 Fr. sheaths, 27040BK/BO/SD/SL, 27240BO, 27241BK/BO, 27042B, 27242BZ, 27050SL

Resectoscope Sheaths

Obturator

Laser Enucleation KUNTZ Working Elements

27056LA

KUNTZ Working Element, for use with 24/26 Fr. resectoscope sheaths 27040SL, 27050SL and laser probes up to 0.8 mm

27056LB

Same, laser probes up to 1.5 mm

27056LE

Laser Working Element, for use with exchangeable laser probes with 24/26 Fr. resectoscope sheaths

27056EA

Laser Guide Probe, inner diameter 0.8 mm, exchangeable, for use with Laser Working Element 27056LE

27056EB

Same, inner diameter 1.5 mm

27056EC

Laser Guide Probe, with retracting beaks, inner diameter 0.8 mm, exchangeable, for use with Laser Working Element 27056LE

27056ED

Same, inner diameter 1.5 mm

Modular Working Elements

HF Enucleation Working Element (bipolar)

27040EBH

Electrotome, bipolar, passive (cutting by means of a spring), movable thumb ring. In rest position the electrode tip is inside the sheath including: Working Element 2x Cutting Loops, bipolar 2x Coagulation Electrodes, bipolar High Frequency Cord Protection Tube

For bipolar enucleation, only the passive Working Element (27040EB) is suitable.

27040VE

VapoEnucleation Electrode, bipolar, hemispherical, 24/26 Fr., package of 6, color code: yellow

011169-10*

VapoEnucleation Electrode, bipolar, hemispherical, 24/26 Fr., sterile, for single use, package of 10, color code: yellow

VapoEnucleation Electrodes

High Frequency Surgery Units

UH400

AUTOCON® III 400 High-End, with KARL STORZ-SCB control NEO, power supply 220-240 VAC, 50/60 Hz, including mains cord

UH400U

AUTOCON® III 400 High-End, with KARL STORZ-SCB control NEO, power supply 100-127 VAC, 50/60 Hz, including mains cord

UH400E

AUTOCON® III 400 High-End, mit CE-Zertifizierung, Betriebsspannung 220 – 240 VAC, 50/60 Hz, einschließlich Netzkabel

UH400UE

AUTOCON® III 400 High-End, mit CE-Zertifizierung, Betriebsspannung 100 – 127 VAC, 50/60 Hz, einschließlich Netzkabel

UH801

Bipolar High Frequency Cord, length 400 cm, for KARL STORZ AUTOCON® III 400 SCB, for use with KARL STORZ bipolar resectoscopes

UF902

Two-Pedal Footswitch, with button for switchover function, for use with HF generators

Morcellation Standard Instruments

HOPKINS® Wide-Angle Straight Forward Telescope 6°, with angled eyepiece, autoclavable, fiber optic light transmission incorporated with working channel, with LUER-Lock connection for inflow, color code: green-red

27292AMA

HOPKINS® Wide-Angle Straight Forward Telescope 6°, with parallel eyepiece, autoclavable, fiber optic light transmission incorporated with working channel, with LUER-Lock connection for inflow, color code: green-red

27040SC

Adaptor, for use with Telescopes 27293AA and 27292AMA with resectoscope outer sheaths of 27050SC/SD

27040LB

Adaptor, for use with Telescopes 27293AA and 27292AMA with resectoscope outer sheaths of 27040SL/SD and 27050SL

27293AA

Motor Control Unit

27701001-1 UNIDRIVE® S III, Urology Set, UNIDRIVE® S III motor system, with integrated SCB module, power supply 100-120/230-240 VAC, 50/60 Hz, for use with DRILLCUT-X® II Morcellator Handpiece URO 27702050 and Morcellator Blade 27056LM including: Mains Cord One-Pedal Footswitch, two-stage SCB Connecting Cable, length 100 cm

27702050

DRILLCUT-X® II Morcellator Handpiece URO, for use with the following accessories: Handle 40712090 and Cleaning Adaptor 41250RA

40712090

Handle, adjustable, for use with DRILLCUT-X® II N shaver handpiece

41250RA

Cleaning Adaptor, LUER-Lock, for cleaning DRILLCUT-X®/DRILLCUT-X® II handpieces

27056LM

Morcellator Blade, straight, sterilizable, drop-shaped cutting window, outer window serrated, inner window double fenestrated and serrated, diameter 4 mm, length 40 cm, for use with DRILLCUT-X® II Shaver Handpiece 27702050

41200RA

Cleaning Adaptor, LUER-Lock, for cleaning the inner and outer blades of DRILLCUT-X® accessories

Suction S-PILOT® Set, incl. control cable including: Connecting Cable Tubing Set Suction, sterile, for single use, package of 10

UP501S2

UNIMAT® 30, suction pump set, power supply 230 VAC, 50/60 Hz including: Bacterial Filter Secretion Bottle Bottle Cap Connecting Tube, short Patient Tube Overflow Case Mains Cord, length 300 cm

Tubing Set, for suction, sterile, for single use, package of 10, for use with KARL STORZ S-PILOT®

031457-10*

030306-04*

Guardian Suction Canister, 12 l, for single use, package of 4

030970-10*

Tissue Trap Filter, unsterile, for single use, package of 10, for use with Suction Canister 030306-04 and other suction bottle systems

030381-01

Guardian LVC Roll Stand, for 1 canister, 12 l

* 1 2

UNIMAT® 30 is not required when using the central suction system. Availability subject to country-specific approval.

25320001

Optional Accessories General Fiber Optic Light Cable, with straight connector, extremely heat-resistant, with safety lock, enhanced light transmission, can be used for ICG applications, diameter 3.5 mm, length 230 cm

27218LO

REINER-ALEXANDER Syringe, 150 ml

27224LO

ELLIK Evacuator, with locking device “LO”

27050LC

Adaptor, for use with bladder syringes in outer sheaths of Resectoscopes 27050SC/SD and 27054SC

495NAC

Steri-Trays…

…for Instruments 39301H

Plastic Container, for sterilization and storage, perforated, with transparent lid, with silicone mat, external dimensions (w x d x h): 515 x 237 x 64 mm including: Base Lid Silicone Mat

39502Z

Metal Wire Tray, for cleaning, sterilization and storage of instruments, stackable, including hole plate walls and foldaway handles, external dimensions (w x d x h): 480 x 250 x 66 mm

39301BS

Plastic Container, for sterilization, especially suited for hydrogen peroxide (Sterrad®) sterilization and storage, perforated, with lid, for use with two rigid endoscopes up to max. 32 cm working length, external dimensions (w x d x h): 446 x 90 x 45 mm

39501B1

Metal Wire Tray, for cleaning, sterilization and storage of instruments, of one rigid endoscope, including holder for light post adaptors, silicone telescope holders and lid, external dimensions (w x d x h): 430 x 65 x 52 mm, for rigid endoscopes up to diameter 10 mm and working length 34 cm

39314G

Plastic Container, for sterilization and storage, perforated, with transparent lid, external dimensions (w x d x h): 515 x 240 x 84 mm, for two angled telescopes of up to 10 mm

39501U

Metal Wire Tray, for sterilization and storage of telescopes, with lid, tray for small parts and silicone telescope holder, external dimensions (w x d x h): 510 mm x 185 mm x 82 mm, for angled telescopes and uretero-renoscopes up to working length 34 cm

…for Standard Telescopes

…for Angled Telescopes

Notes

It is recommended to check the suitability of the product for the intended procedure prior to use. Please note that the described products in this medium may not be available yet in all countries due to different regulatory requirements.

Previous Page Next Page