EndoWorld

CV 12-E/06-2011

The GORE System

for Percutaneous Spinal Lumbar Endoscopy
The GORE System for Percutaneous Spinal Lumbar Endoscopy

The GORE System

for Percutaneous Spinal Lumbar Endoscopy

a. Targeted fragmentectomy
b. Periradicular instillation of steroids
c. Decompression of lateral and central canal
d. Treatment of backache due to facetal degeneration

Backache and leg pain is very common. About 10% of patients with sciatica need
an intervention due to pain that persists or where natural resolution fails. With the
advent of MRI scanning, which is now gold standard all over the world, it is possible
to assess this cause of sciatica better than before. The disc can undergo changes of
internal derangement or an annular tear and nuclear herniation. With precise inputs
about the changed disc morphology it is now possible to target our efforts to the
fragments causing sciatica. A proper clinical assessment about neurophysiology is
a must and a given.
Once we have an image and symptom matching we direct all our efforts to targeted
minimally invasive fragment removal in cases of sciatica due to this fragment.
Interventions also may be needed in an annular tear which leaks and causes nerve
root inflammation and sensitization. Here a periradicular instillation of steriods may
be of help. In case of claudication due to a lumbar canal stenosis we may have to
decompress the central or lateral canal or perform an annulectomy. With precise
inputs of MRI scans it is possible to be exactly near the fragment to remove it or
near a root to instill steroids, or decompress the lateral or central canal.
The basic philosophy of our efforts is to land inside the disc and make space for
removal of the fragment from inside out. In a majority of cases this is the safest way
to do it, in addition the disc is avascular and aneural so it is painless and bloodless.
The techique is to land in a safe triangle situated in the intervertebral foramen as
described in literature which is subfascial and it can be done under local anesthesia.
Biplanar C arm imaging helps us to land precisely in this triangle. The 3D anatomy
of this triangle is altered in most cases of backache and leg pain. Our efforts are
directed to restore it. Once we have our scope in this area, local altered anatomy
can be better assessed and restored. We expose the annular tear and clean it of the
offending fragment to make the patient symptom free.

Advantages: Intervention is under local anesthesia, minimally invasive, no

blood loss, no IV fluids needed, day care surgery, least morbidity and very
rapid rehab.

Satischandra GORE
MS FABMISS PUNE India
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Minimally Invasive Transforaminal Targeted Fragmentectomy

Technique: How I do it

The following case illustrates the technique of minimally invasive transforaminal

lumbar disc herniation targeted fragmentectomy. The patient is a female aged 28
years. Severe bilateral sciatica left side symptoms are more prominent. Duration
of pain was 8 months. Severity was 8/10 on VAS and activities of daily life were
affected. Adequate non-operative treatment was given without relief of her
symptoms. Her scan showed a central herniation at L45 and additionally a posterior
annular tear seen at L5S1. Plan of treatment was targeted fragmentectomy at L45.
In L5S1 an injection of steroid was given. As this image shows the MRI scan sagittal
image shows the L45 disc is slightly lordotic and L5S1 is more inclined towards the
head. But both discs marking meets at one point. The L34 seems to be vertical. This
understanding helps in planning trajectory for the disc or fragment.

The cross section below shows a large fragment at centre of disc and its down
migration. The location can explain the symptoms of this patient. The plan is to
go inside the disc under the fragment and land in the space which is vacated by
this fragment. If we extrapolate this image analysis on an X-ray we need to be
at centre of disc in AP and with a slight downward direction in lateral, left-sided
approach was chosen as symptoms were more prominent on the LEFT.
The GORE System for Percutaneous Spinal Lumbar Endoscopy

This RED arrow shows how we will be lodging under the facet from the left side
and target the fragment.

This image below shows the final assembly of instruments to remove the offending
fragment from L45. Our technique at basic level needs only 7 instruments. Puncture
needle, guide wire, dilation sleeve, operation sheath, punching sleeve, grasping
forceps, mallet, in addition to scope, camera and light source.
 2 5
4 3

Patient is lying prone on table, head on

left side of image. C arm is lined up to
exactly centre over the affected area.
Exact AP image is assured by confirming
that both pedicles at L45 are equidistant
from the midline spinous process. The
pedicles are seen end on. All areas
of body likely to have pressure are
properly padded. PATIENT IS AWAKE
AND AWARE throughout the procedure..

A metallic marker is used to mark the

midline under C arm. Skin is marked
with a permanent marker ink pen.
Midline marking is essential for proper
orientation.

Patient is prone on 2 bolsters or padding

material, procedure lasts for about 30
minutes. We stand on the left side of
the patient as the left side is the more
symptomatic side. The video trolley is
on the left, C arm monitor is seen on
right, C arm is in the centre.

Here the disc space is being marked AS

IS SEEN in AP image. It is known that
lower lumbar discs are tilted towards
the head due to the lordosis but at this
stage of marking we mark disc space as
is seen.
The GORE System for Percutaneous Spinal Lumbar Endoscopy

This image shows the marker seen at

disc level. We prefer to have the image
in such a way that the marker is seen in
the left of the screen as it is our side of
approach. This avoids any confusion in
surgery and access.

The C arm is lined up laterally. First step

is to line it up exactly laterally, that is we
remove any parallax between the C arm
and disc end plates. Ensure that both
end plates are parallel to each other. The
marking is done for disc inclination. Here
the disc is vertical but since the fragment
is migrated downwards we will go a little
above. Disc anterior border is where the
tip of the marker is kept. OUR TARGET
is the posterior annulus and not the disc
centre. Normal observation of disc centre
in my patients is 75 mm from the back,
since we want to go in the posterior
aspect of the disc we go more laterally,
so mark the anterior border of the disc.

As can be seen here, disc marking is

done with a marker lined up in line with
the disc seen in C arm.
 46 75

Marker seen overlapping disc with its

tip at anterior border of disc. Note we
are aiming for a downwards migrated
fragment so we will be starting a little
above the disc.

This image shows we are marking the

length of the marker from the back
to its tip and also making it inclined
towards the head so that entry will
be above the line of disc and that will
allow us a targeting of the downwards
migrated fragment. Once this distance is
measured we proceed, with lordosis this
disc inclination may be bigger.

The same distance [as marked on

marker] is taken on a line just above our
first line disc space as is seen line, the
tip of this line will be our point of skin
entry.

The point of entry is marked with a cross

on the skin. This generally is 9 to 10 cms
from midline. The point is above line in
L45 and L5S1 levels and in line of L34
as it is vertical and in L12 and L23 it is
below line. In most cases L45 and L5S1
have the same entry point. We can also
target D12L1 where entry is generally
the same as L12. This point is 6 fingers
from midline in most cases.
The GORE System for Percutaneous Spinal Lumbar Endoscopy

Lateral view shows cross, our entry

point, just above line marking L45 disc
space. In general, rule of thumb is we
should NEVER go on the side of the
patient, but stay on the back.

This picture shows the marker on skin along the likely path and will be seen in lower
pic on C arm image. We note that here we are just above the disc space so we can
target the downwards migrated fragment in the centre of the disc.

The skin is prepared and the patient

is draped. We will not be seeing any
structure until we land on the annulus and
put an endoscope inside the cannula.
Until then this surgery is entirely guided
by C arm images. The 3 dimensional
targeting is done by our ability to think
and visualize in 3D. The left of the image
is the head side.
 8 9

Local anesthetic 2% plain lignocaine

without adrenaline is injected to numb
skin and subcutaneous tissue. A weal is
raised by the injection.

Confirmatory images with skin on

projected path and checked with images
on C arm. This will be the path which the
needle and then in turn all instruments
will take so it is important to mark and
visualize the likely path.
The GORE System for Percutaneous Spinal Lumbar Endoscopy

The needle is inserted with an angle of 25 degrees to the horizontal. The tip is
advanced to the intervertebral foramen and is visualized all along before proceeding.
If the angle is too shallow it will hit the posterior bony structures and if too vertical it
may go in the peritoneal sac. The AP C arm picture then shows its tip in the medial
pedicle line which it is not supposed to cross. The medial pedicle line is the lateral
edge of the dural sac.
In patients who have chemical radiculitis or who have an annular tear only or when
we need to do a discogram, we follow these steps to target the disc. The disc centre
is then marked in the patient's C arm images. The geometry of this access is: Disc
centre is 75 mm from the back. If we go 75 mm from the midline and go at an angle
of 45 degrees then we will reach the centre of the disc. We are working on the
Pythagoras theorem, and then we know that the length of our hypotenuse will be
the sum of squares of 75 and 75 and its square root. In routine use a spinal needle
with maximum length of 89 mm is adequate to do this needle technique.

The tip of the needle is lateral to the MEDIAL PEDICLE

LINE and in the lower picture which is the lateral C
arm pic it is on the posterior annulus. This is an ideal
placement.
 10
8 11
9

Once we are on the annulus and sure

about the tip then we push the needle
right up to the centre. The angle being 25
degrees or so we are sure that when we
look laterally, the tip of the needle will be
in the posterior quadrant of the disc. WE
ARE NOT IN THE CENTRE of disc and
we are NOT planning central debulking.
We are targeting our efforts to removal
of the fragment. The fragment has a tail
inside the disc and we will be landing
in the space under the herniation which
it has vacated. As we are close to the
fragment base we try and pull it inside
and then remove it.

Once we are sure about the placement

of the needle we proceed. The stylet
of the needle is replaced by the guide
wire. To increase our safety we always
must measure the guide wire against the
stylet so the correct length is pushed in.
Once the guide wire is placed properly
we remove the needle by just pushing
our guide wire with one finger. Rotatory
movement of the needle hub is used and
the needle is pulled out.
The GORE System for Percutaneous Spinal Lumbar Endoscopy

The guide wire is seen inside the disc. It

has come back a little and needs to be
corrected. Now this guide wire will guide
all our activities in the disc. Skin incision
is NOW taken with a number 11 blade
and a dilator which will gently dilate the
muscles is introduced OVER the guide
wire. The tip of the dilator is blunt and is
very safe. The dilator is introduced up to
the annulus. On reaching it, the patient
experiences pain.

When the dilator is going over the guide

wire, a precaution is not to allow it
to angle the wire and bend it. It must
be inline to better reach the annulus.
The lower picture shows the corrected
aligned dilator over the guide wire.
Here it seems to have reached the
intertransverse area.
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12 3

The second hole of the dilator may

now be used to insert the long needle
and use lignocaine over the annulus to
numb it .The second hole also gives us
orientation around the axilla of the nerve
root and other structures. At this stage,
depending upon the target, the long
dilator may be pushed down towards
the floor or lifted up towards the ceiling,
so that the tip will ultimately lodge near
the fragment. Our efforts are entirely
directed to go as near the fragment as is
possible and BELOW it.

The tip is on the posterior annulus and

is in line with the disc space. A mallet is
used to tap this blunt dilator inside the
disc dilating the annulus and making a
blunt entry inside the disc. It is advanced
until we reach below our target fragment.
The image below shows the dilator in
the posterior quadrant of the disc. We
have no intention to go to the central
disc and destabilize it.
The GORE System for Percutaneous Spinal Lumbar Endoscopy

The tip is checked in AP and here it is

lying exactly below the herniation [as
visualized in MRI]. A cannula is now
inserted over this dilator.
IMPORTANT: The cannula always
travels or glides over the dilator - it is
NEVER used alone.

The bevelled end of the cannula is seen

here well. This open window at the end
of the cannula helps in visualization of
the dorsal structures inside the disc as
the scope is also at 25 degrees. We are
always looking up towards the posterior
annulus, tear and fragment. The dorsal
midpoint is taken as 12 o’clock. The
cannula is pushed with the hand with
small rotating movements over the
dilator until we reach the annulus.
 2 15
14 3

The tapper is then threaded over the

dilator and is used to tap the cannula
inside the disc. The cannula is tapped
until we reach the centre of the disc
just below the posterior annulus in this
patient. The tapping of the dilator and
cannula is painful and in addition to use of
lignocaine initially we ask the anesthetist
to use some sedation.The open end of
the cannula can be appreciated here just
below the fragment ready to receive it.

The tip of the cannula is seen in the

lateral C arm image inside the disc in the
posterior quadrant. Since we are sure
about this lodgement of the cannula we
can then be sure of our targeting. Up
until now we have done all our surgery
entirely under C ARM IMAGES. The
cannula is seen in the image below
ready to receive the scope.
The GORE System for Percutaneous Spinal Lumbar Endoscopy

This shows ideal use of our set, the

cannula is taking the scope inside,
and the working channel accepts the
grasper, which will aid the removal of
the fragment. The image below is the
first glimpse of the fragment which is
the base of the fragment. 12 o’clock is
dorsal, 3 is towards the leg, 6 is ventral
and 9 is towards the head. The axilla of
the root is the 9 o’clock position.

The grasper grabs the fragment and then

removes it. The fragment is seen here.
The procedure has tests of adequacy
of the removal. Three important tests
are: fragment is red at the tip due
to epidural vascular reaction, it starts
oozing through from epidural veins into
the disc so disc inside becomes red,
and if we ask patient who is awake to
extend their spine the normal pain that
was present generally is relieved at this
stage.
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16 3

The grasper inside the disc as is seen

in the AP image is well appreciated
as it is just below the fragment base.
The image below shows the length of
incision, markings on the instrument
are 10 mm apart. The incision is 8 mm.
This is minimally invasive transforaminal
targeted fragmentectomy. The skin is
taped. Procedure is over.
The GORE System for Percutaneous Spinal Lumbar Endoscopy

1 2 3 4 5 6 8 9 0 q w

e r t z u i o
 182 319

1 28163 PLT Puncture Needle, long, diameter 1.2 mm, working length 25 cm, with 0.8 mm opening
for guide wire
2 28163 GWT Guide Wire, blunt on both sides, diameter 0.7 mm, working length 41 cm,
package of 5 pcs.
3 28163 FHI Dilation Sleeve, OD 6.8 mm, ID 1.4 mm, length 22 cm, with two ports, color code: red
4 28163 FTM Trephine, inner diameter 1.6 mm, outer diameter 2.7 mm, working length
30 cm, with edged handle
5 28163 FTK Trephine, inner diameter 3.2 mm, outer diameter 4.2 mm, length 250 mm
6 28163 CM COTTLE Mallet, with nylon replacement, length 22.5 cm
7 28163 FWO Operation Sheath, ID 6.8 mm, OD 7.5 mm, distal 45° oblique, integrated irrigation lock,
working length 15 cm, color code: red
8 28163 FEH Punching Sleeve, for use with operating sheaths
9 28163 BFA H® Wide Angle Straight-Forward Telescope 25°, angled eyepiece, length
18 cm, autoclavable, fiber optic light transmission incorporated, with instrument
channel for 3.5 mm instruments, color code: red
495 NA Fiber Optic Light Cable, diameter 3.5 mm, length 230 cm (not pictured)
0 28163 FBC Angled Bipolar Probe, diameter 2.5 mm, working length 36 cm,
including:
Bipolar Probe insert
Sheath for probe
Bipolar Spring Handle
Depending on the device used, please add a Bipolar High Frequency Cord,
e.g. 26176 LE
q 28163 FDW Dissector, diameter 2.6 mm, working length 36 cm, distally angled 45°
w 28163 UH Palpation Hook, distally angled 45°, diameter 2 mm, working length 34 cm
e 28163 FBH c Palpation Hook, angled 90°, with distal ball, diameter 3.5 mm, working
length 36 cm, including:
Outer Sheath with working insert palpation hook
Metal Handle without ratchet
r 28163 FZ Grasping Forceps with 90° opening, single action jaws, diameter 3.5 mm, working
length 36 cm
t 28163 FZI c Forceps with distal hook, rotatable, single action jaws, size 3.5 mm, working
length 36 cm, including:
Plastic Handle, without ratchet, with connector pin for unipolar coagulation
Biopsy Forceps Insert with distal hook, working length 36 cm, diameter 3.5 mm
28163 FBM Grasping forceps, double action jaws, diameter 2.7 mm, working length 36 cm, with
LUER connector (not pictured)
28163 FSI BLAKESLEY c Grasping Forceps, rotatable, single action jaws, size 3.0 mm,
working length 36 cm, including:
Plastic Handle, without ratchet, with connector pin for unipolar coagulation
BLAKESLEY Forceps Insert, working length 36 cm, diameter 3.0 mm (not pictured)
z 28163 FAP Deflectable Punch, diameter 3.5 mm, working length 360 mm, color code: red-blue
u 28163 FAS Deflectable Forceps, diameter 3.5 mm, working length 360 mm, color code: red-blue
i 28163 FPG Dismountable Punch, 90°, working length: 30 cm,
including:
Punch Insert
Outer Sheath
Handle
o 28163 FPW Dismountable Punch, 45°, working length 30 cm,
including:
Punch Insert
Outer Sheath
Handle
28163 FRL X-Ray Ruler, with special marking for midline and 2 mm- and cm-slots for radiologic
measurement, total length 30 cm (not pictured)
The GORE System for Percutaneous Spinal Lumbar Endoscopy

Access System
With the new dilation sleeve 28163 FHI there is no more sequential dilation, instead the dilation
sleeve is introduced directly after the puncture needle and the guide wire. When designing the
dilation sleeve (OD 6.8 mm), extra thought was given to including two inlets (ID 1.4 mm); this
allows the injection of a local anesthetic or a contrast medium while still maintaining the access
via the guide wire and the dilation sleeve. In addition, the second inlet can be used to change
the access direction of the dilation sleeve without the need to reinsert the guide wire.

28163 PLT Puncture Needle, long, diameter 1.2 mm, working

length 25 cm, with 0.8 mm opening for guide wire

28163 GWT Guide Wire, blunt on both sides, Ø 0.7 mm, working
length 41 cm, package of 5 pcs

28163 FHI Dilation Sleeve, OD 6.8 mm, ID 1.4 mm, length 22 cm,
with two ports, colour code red

Operation Sheath
Only one operation sheath is still available, which is pushed over the dilation sleeve without any
gap. Distally, the 45° chamfer is leveled to avoid blocking the telescope's view.

28163 FWO Operation Sheath, ID 6.8 mm, OD 7.5 mm, distal 45° oblique,
integrated irrigation lock, working length 15 cm, colour code: red
 20 21

Telescope 28163 BFA

28163 BFA H® Wide Angle Straight-Forward Telescope 25°,

angled eyepiece, length 18 cm, autoclavable,
fiber optic light transmission incorporated,
with instrument channel for 3.5 mm instruments,
color code: red

Article no. 28163 BFA includes the instrument adaptor 28163 AA and the irrigation adaptor
28163 FIA. The irrigation adaptor is required for connection to a washer.

Angled Bipolar Probe

This distally angled bipolar HF probe for use in the working channel is reusable and available
with a spring handle similar to other HF probes. The bipolar probe allows not just spot
coagulation of small hemorrhages under endoscopic vision but the distal angulation can also
be used to palpate and explore tissue.

28163 FBC Angled Bipolar Probe, Ø 2.5 mm,

working length 36 cm,
including:
Bipolar Probe Insert
Sheath for probe
Bipolar Spring Handle

Depending on the device used, please add a Bipolar High

Frequency Cord e.g. 26176 LE
The GORE System for Percutaneous Spinal Lumbar Endoscopy

Palpation Instrument Set

A flexible palpation hook which can be distally angled up to 90° has been developed for the
palpation and dissection of disc tissue. We recommend the metal handle with the broadened
supporting surface 33161.
In addition, a new dissector 28163 FDW with a distal 45° chamfer has been adopted in the set.

28163 FBH c Palpation Hook, angled 90° with

distal ball, diameter 3.5 mm, working
length 36 cm, including:
Outer Sheath with working insert
Palpation hook
Metal Handle without ratchet

28163 FDW Dissector, diameter 2.6 mm, working length 36 cm,

­distally angled 45°.

28163 UH Palpation Hook, distally angled 45°, diameter 2 mm,

working length 34 cm
 22 23

Grasping Forceps
The raven's beak forceps are used in the interlaminar approach to open the ligamentum flavum.

28163 FZI c Biopsy Forceps with distal hook,

rotatable, single action jaws,
size 3.5 mm, working length 36 cm,
including:
Plastic Handle, without ratchet, with connector pin
for unipolar coagulation
Biopsy Forceps insert with distal hook,
working length 36 cm, diameter 3.5 mm

The following grasping forceps can be used to grip tissue fragments. The instruments cannot
be dismounted, but have a LUER-Lock connection for cleaning purposes.

28163 FZ Grasping Forceps with 90° opening, single action

jaws, diameter 3.5 mm, working length 36 cm

28163 FBM Grasping Forceps, double action jaws,

diameter 2.7 mm, working length 36 cm,
with LUER connector
The GORE System for Percutaneous Spinal Lumbar Endoscopy

28163 FSI BLAKESLEY c Grasping Forceps,

rotatable, single action jaws, size 3.0 mm, working
length 36 cm, including:
Plastic Handle, without ratchet, with connector pin
for unipolar coagulation
BLAKESLEY Forceps Insert, working length 36 cm,
diameter 3.0 mm

The distal end can be angled by turning the proximal wheel. The handle tips are used to close
the jaws, the jaws also return to the horizontal position to be able to be retracted through the
working channel.

28163 FAP Deflectable Punch, diameter 3.5 mm, working

length 360 mm, colour code: red-blue

28163 FAS Deflectable Forceps, diameter 3.5 mm, working

length 360 mm, colour code: red-blue
 24 25

Lateral Punches
We also offer the following, dismountable, lateral punches for opening the ligamentum flavum,
which have been developed with the new SpinoFIT mechanism.

28163 FPW Dismountable Punch, 45°, working length: 30 cm,

including:
Punch Insert
Outer Sheath
Handle

28163 FPG Dismountable punch, 90°, working length: 30 cm,

including:
Punch Insert
Outer Sheath
Handle

Trephines
The new trephine 28163 FTM (OD 2.7 mm) can be inserted through the working channel
28163 BFA. The trephine 28163 FTK (OD 4.2 mm) is employed through the operation sheath
of a telescope.

28163 FTM Trephine, inner diameter 1.6 mm, outer diameter 2.7 mm,
working length 30 cm, with edged handle.

28163 FTK Trephine, inner diameter 3.2 mm, outer diameter 4.2 mm,
length 250 mm
The GORE System for Percutaneous Spinal Lumbar Endoscopy

To use through the working channel of scope 28163 BFA with DrillCut-X® II handpiece we offer
the following high speed drill with side and distal protection:

41201 FD Suction Burr, with integrated irrigation,

straight, sterilizable, cylindrical cutter head
with lateral and distal protection, shaft
diameter 3.5 mm, length 30 cm, for use with
DrillCut-X® II handpiece

Accessories
As sterilization containers we recommend the container 39314 G for the telescope and the
container 39360 BK for the instruments.

Cold Light Fountain

20133101-1 Cold Light Fountain XENON 300 SCB®

with integrated KARL STORZ SCB, integrated Anti-Fog
pump, one 300 Watt Xenon Lamp and one KARL STORZ
light outlet,
power supply: 100–125/220–240 VAC, 50/60 Hz
including:
Mains Cord
Silicone Tubing Set, length 250 cm
SCB-Connecting Cable, length 100 cm
 26 27

UNIDRIVE® NEURO

40 711701-1 UNIDRIVE® NEURO with KARL STORZ SCB,

with colored display, touch screen operation, two
engine exits, with integrated irrigation pump and
integrated SCB-module,
power supply 110-120/230-240 VAC, 50/60 Hz
System requirements: SCB-R-UI-software-release

407120 50 DrillCut-X® II Shaver Handpiece,

for use with Unidrive® S III ECO/ENT/NEURO/
OMFS

Equipment Cart

29003 LC Equipment Cart LC,

including:
Basic Equipment Cart, rides on 4 anti-static dual
wheels, 2 equiped with locking brakes, 2 fixed shelves, 1
drawer unit with lock, 1 set of non-sliding stands,
1 camera head mount including integrated small cable
conduit in both boom,
Powerbox with 12-times socket board 12 grounding
plugs

Dimensions:
Equipment cart: 700 mm x 1450 mm x 686 mm (w x h x d)
Shelf: 630 mm x 480 mm (w x d)
Caster diameter: 125 mm
IMAGE 1 HD
HD HUB Camera Control Unit

• 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
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

22 2010 11U102 IMAGE 1 HUB™ HD Camera Control Unit (CCU)

with SDI Module

for use with IMAGE 1 HD and standard one- and three-chip camera ­heads,
max. resolution 1920 x 1080 pixels, with integrated KARL STORZ­SCB and
22 2010 20-1xx integrated digital Image Processing Module, color systems PAL/NTSC, power
supply 100 – 240 VAC, 50/60 Hz
including:
Mains Cord
3x BNC/BNC Video Cable, length 180 cm
S-Video (Y/C) Connecting Cable, length 180 cm
Special RGB Connecting Cable
2x Connecting Cable, for controlling peripheral units, length 180 cm
DVI Connecting Cable, length 180 cm
SCB Connecting Cable, length 100 cm
Keyboard, with English character set

Specifications:

Signal-to-noise ratio AGC Video output Input

IMAGE 1 HUB™ HD
Three-chip camera systemsM 60 dB
Micro­- - Composite signal to BNC socket Keyboard for title generator,
processor- - S-Video signal to 4-pin Mini DIN socket (2x) 5-pin DIN socket
controlled - RGBS signal to D-Sub socket
- SDI signal to BNC socket (only IMAGE 1 HUB™ HD with 
SDI module)(2x)
- HDTV signal to DVI-D socket (2x)

Dimensions
Control output /input Weight (kg) Power supply Certified to:
w x h x d (mm)
-  ARL STORZ SCB at 6-pin Mini DIN socket (2x)
K 305 x 89 x 335  2.95 100-240 VAC, IEC 601-1, 601-2-18, CSA 22.2
- 3.5 mm stereo jack plug (ACC 1, ACC 2), 50/60 Hz No. 601, UL 2601-1 and CE acc. to
- Serial port at RJ-11 MDD, protection class 1/CF
- USB port (only IMAGE 1 HUB™ HD with ICM) (2x)

SDI – Serial Digital Interface: optimized to display medical images on flat screens, routing with OR1™ and
digital recording with AIDA-DVD-M
ICM: USB-connector for recording video streams and stills on USB storage media or for connection of USB
printers for direct printing of the recorded stills
 28 29
IMAGE 1 HD
HD Camera Head

22 2200 55-3 50 Hz IMAGE 1 H3-Z,

60 Hz Three-Chip HD Camera Head
max. resolution 1920 x 1080 pixels, progressive scan, soakable, gas­and
plasma ­sterilizable, with integrated Parfocal Zoom Lens, focal length
f = 15 – 31 mm (2x), 2 freely programmable camera head buttons,
22 2200 55-3 for use with color system PAL/NTSC

Specifications:

Image sensor 3x 1/3" CCD-Chip

Pixel output signal H x V 1920 x 1080
Dimensions Diameter 32-44 mm, length 114 mm
Weight 246 g
Min. sensitivity F 1.4/1.17 Lux
Lens Integrated Parfocal Zoom Lens,
f = 15-31 mm
Grip mechanism Standard eyepiece detector
Cable Non-detachable
Cable length 300 cm

Max. screen
resolution Video input
KARL STORZ
HD Flat
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9524 NB 24"
Wall mounted
with VESA
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9526 NB 26"
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9524 N 24"
Desktop with
pedestal
9526 N 26"

The following accessories are included:

400 A Mains Cord
9523 PS External 24VDC Power Supply
9419 SF Pedestal
Data Management and Documentation
KARL STORZ AIDA® compact NEO (HD/SD)
Brilliance in documentation continues!

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.

Data acquisition
Still images, video sequences and audio comments can be recorded
easily during an examination or intervention on command by either
pressing the on screen button, voice control, foot switch or pressing the
camera head button. All captured images will be displayed on the right
hand side as a “thumbnail” preview to ensure the still image has been
generated.
The patient data can be entered by the on-screen keyboard or by a
AIDA compact NEO: standard keyboard.
Voice control

Flexible post editing and data storage

Captured still images or video files can be previewed before final storage
or can be edited and deleted easily in the edit screen.
Reliable storage of data
 Digital saving of all image, video and audio files on DVD, CD-ROM,
AIDA compact NEO: USB stick, external/internal hard-drive or to the central hospital storage
Review screen
possibilities over DICOM/HL7
 Buffering ensures data backup if saving is temporarily not possible
 Continuous availability of created image, video and sound material for
procedure documentation and for research and teaching purposes.

Efficient data archiving

AIDA compact NEO: Automatic
creation of standard reports
After a procedure has been completed, KARL STORZ AIDA® compact
HD/SD saves all captured data efficiently on DVD, CD-ROM, USB stick,
external hard-drive, internal hard-drive and/or the respective network on
the FTP server. Furthermore the possibility exists to store the data directly
on the PACS respective HIS server, over the interface package AIDA
communication HL7/DICOM.
Data that could not be archived successfully remains in a special buffered
procedure until it is finally saved. A two-line report header and a logo can
be used by the user to meet their needs.

Multi-session and Multi-patient

AIDA compact NEO: Efficient data archiving is assured as several treatments can be saved
Efficient archiving on a DVD, CD-ROM or a USB stick.
 30 31

Features and Benefits

 Digital storage of still images with a resolution of 1920 x 1080 pixels, video sequences in 720p and audio files with
AIDA compact NEO HD
 Optional interface package DICOM/HL7
 Sterile, ergonomic operation via touch screen, voice control, camera head buttons and/or foot switches
 Auto detection of the connected camera system on HD-SDI/SD-SDI input
 Efficient archiving on DVD, CD-ROM or USB stick, multi-session and multi-patient
 Network saving
 Automatic generation of standard reports
 Approved use of computers and monitors in the OR environment as per EN 60601-1
 Compatibility with the KARL STORZ Communication Bus (SCB) and with the KARL STORZ OR1™ AV NEO
 KARL STORZ AIDA® compact NEO HD/SD is an attractive, digital alternative to video printers, video recorders and
dictaphones.

20 0409 10 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
20 0409 11 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
20 0406 10 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
20 0406 11 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

Specifications:
Video Systems - PAL Video Formats - MPEG2
- NTSC Audio Formats - WAV
Signal Inputs - S-Video (Y/C) Storage Media - DVD+R
- Composite - DVD+RW
- RGBS - DVD-R
- SDI - DVD-RW
- HD-SDI - CD-R
- DVI - CD-RW
Image Formats - JPG - USB stick
- BMP
 EndoWorld®
www.karlstorz.com

KARL STORZ GmbH & Co. KG KARL STORZ Endoscopy-America, Inc.

Mittelstraße 8, 78532 Tuttlingen, Germany 2151 East Grand Avenue
Postfach 230, 78503 Tuttlingen, Germany El Segundo, CA 90245-5017, USA
Phone: +49 (0)74 61 708-0 Phone: +1 424 218-8100, +1 800 421-0837
Fax: +49 (0)74 61 70 8-105 Fax: +1 424 218-8526
E-Mail: info@karlstorz.de E-Mail: info@ksea.com
www.karlstorz.com
EW CV 12-E/06-2011