CataRhex - Produse v2oftamedica.ro/download/aparatura/oertli_swisstech... · 2012. 3. 9. · foot...
Transcript of CataRhex - Produse v2oftamedica.ro/download/aparatura/oertli_swisstech... · 2012. 3. 9. · foot...
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CataRhex®
OS3
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Sovereignty Made in Switzerland
CataRhex®
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Maintaining Eyesightand restoring it is the sophisticated task of ophthalmic surgery. Millions of people are waiting for it. CataRhex®swisstech makes
cutting-edge cataract technique accessible everywhere and gives surgeons independence and safety in their work, even under
most challenging conditions.
4CataRhex®swisstech – Mission
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Progress is the way from the primitive via the complicated to the simple.Wernher von Braun, 1912-1977
CataRhex®swisstech has successfully trodden this path more than almost any other product. Taking up very little space, it
provides the full functionality of a large device and unsurpassed reliability. This fully developed simplicity also becomes apparent
in the clean lines of its appearance: inviting you to operate it, work with it and own it.
CataRhex®swisstech – Design 6
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In Great Shape all over the WorldThe best ophthalmic surgery for everybody – portable and affordable! This means having a small, light device that offers
the same functional complexity and performance as considerably heavier and more expensive ones – whether in high-end
medicine, in the out-patient clinic of a university or in less developed regions. This is why CataRhex®swisstech is the system of
choice for more and more surgeons. Today, thousands of surgeons in over 80 countries rely daily on CataRhex®.
CataRhex®swisstech – Concept 8
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As with every Oertli® product, CataRhex®swisstech is also a design classic, with its beautiful shape and cutting-edge tech -nology. In the background, there are the unsurpassable and uncompromising Oertli® quality development standards. CataRhex®swisstech can be combined with all Oertli® surgical instruments, including the particularly ergonomic TITANO® line.
A simple solution – simply convincingYou can use CataRhex®swisstech with minimal training thanks to its simple operation. The multifunctional pedal means it re quires less assistance. The superlative pump system makes operating faster, and the stability of the fl uidics system makes changing the height of the bottle unnecessary.
An intelligent concept – really portableWith a light weight of only 5.6 kilograms, CataRhex®swisstech is 100% portable. Being small and light means additional ease of use and provides mobility and fl exibility. For transportation, it easily fi ts into a pilot case – including pedal and instruments – and, in use, it can be adjusted to every IV pole. Moreover, it is robust and works with voltages from 85 up to 240 volts in any environment.
An intelligent technique – really comfortableNever have such intelligence, technology and performance been fi tted into so little space. No PC operating system prone to error, but direct processor control instead. No laborious sensor system, but intelligent concepts based on physics. No computer screen, but reliable control elements. No fancy emulsifi cation methods, but fi nely dosed ultrasound with easyPhaco® even for the hardest nuclei and for the sub2 mm technique. DirectAccess® reacts at the push of a button, and does not need a multi-stage operating menu. The simple cassette with its contact-free pressure sensor guarantees sterility.
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An Intelligent TechniqueCataRhex®swisstech does without a PC operating system prone to error. Instead, we use direct and reliable processor control
with embedded component parts. CataRhex®swisstech works with well-thought-out concepts based on physics and therefore
doesn’t need a laborious sensory system. No fancy emulsifi cation methods, but – thanks to easyPhaco® – fi nely dosed axial
ultrasound for each degree of hardness. Surgery is carried out by DirectAccess® without complicated menu navigation. Complex
touch-screen operation is not necessary. The simple cassette with integrated pressure sensor ensures total sterility.
CataRhex®swisstech is the second generation of this highly reliable and successful device. What has proven itself in millions of operations has been improved once more. With its non-contaminating pressure measurement, the I/A system is completely new. Just like the refi ned phaco control possible with CMP Cool Micropulse, and easyPhaco®, it displays a cutting-edge technique. CataRhex®swisstech can hold its own against any large device, in terms of comfort and functions, as well as safety and operation result; above all, it does so when it comes to cost-effectiveness. CataRhex®swisstech is a phaco system using cutting-edge technique with all the functions required for up-to-date anterior segment surgery:
• Irrigation/Aspiration• Continuous Irrigation• Multi-mode Phaco• Occlusion-mode Phaco• CMP Cool Phaco• easyPhaco®
• CO-MICS• Bipolar Diathermy• High-speed Vitrectomy• Bipolar Capsulotomy• Bipolar Glaucoma
CataRhex®swisstech is based on an innovative construction concept which has special advantages over more common phaco systems:
• Real portability• Unequally light and small• Can be attached directly to the I/V pole• Simple tubing system with integrated sensor• Space-saving multifunctional pedal, can be moved with the
foot
Patented pressure measurement
CataRhex®swisstech – Technology 10
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Fast programming The full performance scope of CataRhex®swisstech is at the disposal of 9 different surgeons. Each doctor has his/her own preferences memorised. Moreover, each surgeon can make his/her own pre-settings in ParaProg®. CataRhex®swisstech thus enables individuality for all users.
• Very easy DirectAccess® operating surface with immediate access to all functions
• Fast and simple preparation of the device• Short switch-over times between operations• Easy to operate, short training period• Fast programming and recall of multi-mode programmes • Ergonomic control panel with light displays and clear
pressure keys• Background programming with ParaProg® – faster and
easier than any screen
Anterior Vitrectomy, also via pars plana! The electrically-driven SUS cutter works from the precise single cut up to effi cient high-speed application of 1,200 cuts a minute, precisely controlled by the pedal setting. The 20G and 23G cutting heads have variable openings and have all been hand-fi nished during manufacture.
If necessary, trans-conjunctive anterior vitrectomies with access via pars plana can also be undertaken with the PMS incision set.
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The same function is always assigned to the relevant, clearly-laid-out command keys. The relevant function is immediately activated via a click on the key. There is no faster or clearer way to do it. This is the principle of DirectAccess®.
In the background programme, ParaProg®, the most versatile functions are individually programmed and set for each sur-geon and his/her operating technique. This is possible for up to nine surgeons. Preferred settings can be saved by the surgeon or his/her assistant at any time.
CataRhex®swisstech – DirectAccess®
Comfortable and Precise OperationBright displays shine through the dark glass of the control panel and tell you the exact operation values and settings. There
are tangible command keys with a pleasant feel to them for you to make your settings. Thanks to the DirectAccess® surface,
menu navigation is no longer necessary. A precise click, and CataRhex®swisstech is in the desired operation mode. There is
also a soft, light and precise feel to the pedal. It can be moved with the foot and carries out a large number of commands.
Fluidics and instruments react precisely and without delay to the command of your foot – an invaluable advantage, especially
in complex cases.
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swisstech control pedal To ensure fi ne linear control of all instruments, the recall of the memorised settings and the switching on and off of all functions, there are four areas of movement. The pedal is waterproof, requires very little space, can be moved with the foot and ensures fatigue-proof operation.
The CataRhex®swisstech multi-functional pedal provides a compre-hensive, precise steering and control with simple foot movements.
Example pedal setting anterior vitrectomy
Linear control*Pos. 1: irrigationPos. 2: aspirationPos. 3: cutting
Refl ux
Choice of programme• phaco 1• phaco 2• phaco 3
Refl ux
Linear controlPos. 1: irrigationPos. 2: aspirationPos. 3: phaco
Example pedal setting phaco
Phaco modulation• burst• pulse• continuous
Pos. 0:choice of programme• Vitrectomy 1• Vitrectomy 2• Vitrectomy 3
Pos. 0: instant diathermyPos. 1: single cut
*Sequence can also be I/C/A
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14CataRhex®swisstech – easyPhaco®
Discover the Magic of easyPhaco®!Fluidics on! Let the elaborate fl uidics concept of the Oertli® system work for you! Even though it sounds implausible – Oertli
easyPhaco® Technology brings to you unprecedented chamber stability, perfect emulsifi cation and effi cient fragment aspiration.
And all of this without the undesired side effects hitherto caused by high vacuum. Intelligent and drastically improved fl uidics
properties – Oertli easyPhaco® Technology brings visible and perceptible advantages:
• no turbulence and effi cient aspiration without repulsion of fragments
• concentrated axial ultrasound energy delivery for perfect emulsifi cation
• no vacuum surge thanks to a capillary aspiration path
• emulsify the hardest nuclei without clogging
• reduced risk of burns, thanks to large coaxial infl ow
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easyTip® CO-MICSIdeal for 1.6-1.8 mm incisions.
For astigmatism-free sub2 mm surgery without compromise on effi ciency and chamber stability. Set vacuum to 350 mmHg and fl ow to 30 ml.
easyTip® 2.2 mmIdeal for 2.2-2.4 mm incisions.
Turn vacuum on to 600 mmHg, set fl ow to 50 ml and experi-ence absolute chamber stability and effi cient emulsifi cation.
easyTip® 2.8 mmIdeal for 2.8-3.2 mm incisions.
Work with full vacuum and full fl ow without worrying about bottle height. Emulsify the hardest nuclei and forget about clogging. Ideal for the conversion from SICS to Phaco.
easyPhaco® is a development of Oertli® R&D in scientifi c cooperation with Prof. Rupert Menapace, Vienna.
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16CataRhex®swisstech – easyPhaco®
easyPhaco® Technology
1 No TurbulenceThe high vacuum setting of easyPhaco® and a wide infusion path create a strong, axially directed fl ow. The result: no tur -bu lence, no fl oating fragments, magnetic attraction of ma te-rial and perfect followability.
2 No RepulsionThe high vacuum setting of easyPhaco® and the optimised bevel of the easyPhaco® tip lock fragments fi rmly to the tip mouth with magnetic holdability, strong enough to prevent repulsion.
3 No Laterally Radiating EnergyUS energy is applied axially and totally absorbed within the high vacuum locked core material.
4 Perfect Emulsifi cationHigh vacuum locking and optimised tip design provide superb coupling of US energy to the core material. Energy transfer to core material is increased by a factor of 6. Hard and mature nuclei create no problems.
5 Effi cient Fragment AspirationFinely emulsifi ed nuclear particles are smoothly aspirated by high vacuum through the capillary aspiration channel. No risk of clogging.
6 No SurgeUpon occlusion break, the capillary aspiration channel resists a sudden liquid fl ow while the wide infusion path provides constant IOP. Infusion capacity is 7 times larger than aspiration volume. The AC remains almost unconditionally stable.
2 Full vacuum
Magnetic holding force
No repulsion
All US energy absorbed in core material
No sideward radiation of energy
3 Full vacuum
4 Full vacuum
Perfect power coupling, emulsifi es soft and hard material
1 Full aspiration
Strongest infl ow
Strongest axial fl ow Magnetic attraction of particles
Limited outfl ow
6 Full vacuum
Stable anterior chamber
Strongest infl ow
5 Full vacuum
Effi cient fragment aspiration
Fine emusifi cation, no clogging
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Phaco ModulationCataRhex®swisstech offers four kinds of power modulation that can be app lied with easyPhaco® or any other phaco technique. The ideal fl uidics support with easyPhaco® anyhow reduces ultrasound application to a minimum. Also with traditional linear control, shortest phaco times are therefore achieved.
Continuous LinearThe standard method. Very effi cient. The surgeon needs to set the output level him/herself. The phaco intensity corresponds to the degree of pedal defl ection.
PULSE Modulation*Reduces the emitted ultrasound energy. The pulse frequency (up to 40 Hz) and cooling factor are freely selectable and not linked to the pedal position. The pulse intensity corresponds to the pedal position.
BURST ModulationReduces the emitted ultrasound energy. The duration and intensity of the bursts (packets of energy pulses) are freely selectable and not linked to the pedal position. The pause between bursts is controlled by the pedal. The more the pedal is depressed, the shorter the pauses become.
CMP Cool Micropulse PhacoGenuinely cool phaco under all conditions – even at 100% phaco output! The pulse frequency (up to 40 Hz) and cooling factor are freely selectable within the CMP boundaries and remain unaffected by the pedal position. The pulse intensity corresponds to the pedal position. Ideal for bimanual MICS.
Continuous linear PULSE modulation BURST modulation
* Pulse modulation is recommended for lowest energy consumption.
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18CataRhex®swisstech – Bipolar function
Bipolar Functions: More than simply DiathermyMicro-incision surgery also requires the back-up of a modern bipolar function. Oertli® has been a pioneer in this fi eld since
1973. CataRhex®swisstech offers the most up-to-date developments.
• Linear macro-haemostasis
• Linear endo-diathermy
• Coaptation of the conjunctiva
• RF capsulotomy
• STT glaucoma surgery
• IDK glaucoma surgery
The haemostasis function can be activated at any time by pull-ing the pedal sideways (instant diathermy) or pressing the DIA key. The CAPS key brings immediate access to the capsulotomy function, the GLAU key enables application of STT or IDK glau -coma surgery.
STT Sclerothalamotomy(Bojan Pajic)With this ab interno method direct access can be established bet ween the anterior chamber and the Schlemm’s canal, wher -e by the effl uent fl ow resistance of the trabecular network is avoided. The diathermy STT tip is led through a corneal 1.2 mm paracentesis and by means of diathermy 4 sclerotomies (thalami) of 0.3 x 0.6 mm are formed through the trabecular network and the Schlemm’s canal.
IDK Intrastromal Diathermal Keratostomy(Vend V. Kessing)The intervention includes three steps: A corneal incision pa -ral lel to the limbus, a corneoscleral tunnel incision into the subconjunctival area, and fi nally a diathermal tunnel incision is made with the IDK tip up to the Schwalbe’s line.
IDK Glaucoma tipSTT Glaucoma tip
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Klöti RF Capsulotomy: Safety for Diffi cult CasesFew talk about it, many use it! Despite capsulorhexis and means of capsule staining, the Klöti RF capsulotomy is a welcome method again and again that has proven itself in hundreds of thousands of cases since 1991. RF capsulotomy melts the capsular bag. There is no tearing with forceps or needle. Simply gliding over the tissues with the capsulotomy tip is enough. Even under the iris! Long clinical experience has shown that the characteristics of the resulting edge of the capsule meet all requirements, intra-operative and long term.
• No fundus refl ex
• Hypermature cataract
• Traumatic cataract
• Intumescent cataract
• Juvenile cataract
• Narrow pupil
• Rhexis phimosis
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Module Composition
Fluidics System• Peristaltic pump• Tubing system with integrated, closed pressure sensor• Auto Venting• Restrictable refl ux
Control• Control panel with glass covering, luminous display and
silicon keys• Linear multifunctional pedal• Individual programming with ParaProg® for up to 9 surgeons• Self-testing function and preop function• Audio signals
I/A Function• 2 program memories with DirectAccess®
• Vacuum override function• Continuous irrigation
CataRhex®swisstech – Module
Phaco Function• 3 program memories with DirectAccess®
• Ultrasound phaco with auto tuning• Hexadisq® handpiece with 6 piezos• Linear, PULSE, CMP, BURST• Occlusion mode• easyPhaco® , CO-MICS and MICS technique• Override function
Anterior Segment Vitrectomy• 3 program memories• Electrically driven SUS guillotine cutter• 20G, 23G• Linear 30 to 1200 cuts/min• Individual cuts• Irrigation/aspiration/cut• Irrigation/cut/aspiration
Bipolar Functions• Endo-diathermy• Macro-diathermy• Conjunctival coaptation• Instant diathermy function • RF capsulotomy• STT glaucoma sclerothalamotomy• IDK glaucoma intrastromal diathermal keratostomy
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Technical Data
CataRhex®swisstech
I/A SystemPeristaltic: 0 to 600 mmHg, 5 mmHg increments,
1 to 50 ml/min, 1 mml/min increments, rise time < 0.6 s (50 ml/600 mmHg)
Refl ux: from bottle, pedal defl ection backwards or sidewards
Memories: 2, proportional override functionTubing System: closed with integrated pressure sensor,
single use or autoclavable
Ultrasound PhacoFrequency: 28 kHz, piezo driverControl: Autotuning (50 times/s), linear, pulsed,
CMP cool micro pulse, burst, occlusion modePower: 1 to 100% in steps of 1%,
max. defl ection 1.2 μm Burst: duration 10 ms to 500 ms, pause 2 s
to continuous Pulse: pulse frequency 0.5 to 40 Hz,
pulse duration 0.25 to 1800 ms Memories: 3Counter: effective (relevant to energy delivered),
0.1 s increments
Bipolar DiathermyFrequency: 500 kHz, pulsedPower: max. 8 Watt at 50 Ohm
RF CapsulotomyFrequency: 500 kHz, pulsedPower: max. 9.9 Watt at 50 Ohm,
automatic regulation, 2 ranges
VitrectomyControl: I/A/Cut or I/Cut/A Drive: electric, 30 to 1200 cuts/minMemories: 3
Power RequirementsElectric: 100-240 V, 50-60 Hz,
power consumption 200 VA
Dimensions and WeightDimensions: 200 x 241 x 164 mm
(without carrying handle) Weight: 5.6 kg (pedal 2.7 kg)
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DisclaimerAll details in this publication were correct at the time of publication. There may be changes without notice as a result of enhancements to the design or safety of products. The details specifi ed in the relevant quotation or delivery documentation shall apply.
www.oertli-instruments.com
22CataRhex®swisstech – Disclaimer
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Sovereignty Made in Switzerland, for everyone, everywhere
OS3
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Oertli Instrumente AG, CH-9442 Berneck, Switzerland, Phone +41 (0)71 747 42 00, Fax +41 (0)71 747 42 90
www.oertli-instruments.com [email protected]
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