Highlights in Laparoscopic Surgery

Laparoscopy in Surgery, Gynecology, and Urology

Fluorescence Imaging

IMAGE1 S™ Rubina® – The new 4K-NIR/ICG platform

IMAGE1 S™ Rubina® combines 4K imaging technology with fluorescence imaging in the near infrared range for the display of indocyanine green (ICG) as well as autofluorescence. The technology features very good image quality as well as new NIR/ICG fluorescence modes. The new modes, e.g. the superimposed NIR/ICG signal in the white light image, provide the user with valuable information. In addition, IMAGE1 S™ Rubina® offers an intensity map of the NIR/ICG signal as well as a pure near infrared mode in monochromatic display for the clear delineation of structures.

Special features:

  • Native 4K image resolution with excellent image brightness as well as rich color and detail
  • OPAL1® NIR/ICG technology with new functionalities
  • S-Technologies in white light and the Overlay and Intensity Map overlay modes
  • Enhanced* NIR/ICG telescopes and new models in 45°, 5 mm and 10 mm diameter
  • Laser-free LED light source for white light and NIR/ICG excitation

*in comparison with previous models

Further information on fluorescence imaging is available here.

Source: Prof. Go Wakabayashi, Ageo Central General Hospital, Japan
Source: Prof. Go Wakabayashi, Ageo Central General Hospital, Japan

The selective administration of ICG assists the identification of various liver segments during partial liver resection in both laparoscopic and open surgical procedures. Partial liver resection requires a sound knowledge of the existing course of the vessel and the boundaries of the individual segments while taking the diverse anatomical features of the blood vessels into consideration:

  • The tumor is localized pre- or intraoperatively aided by CT, MRI and ultrasound techniques
  • ICG is injected into the supply vessel of the segment
  • Fluorescence allows easy differentiation of the affected segment from the adjacent non-fluorescing segments

ICG fluorescence can also help to detect bile leakage following liver segmentectomy or liver transplantation procedures.

The New HOPKINS® Rubina® NIR/ICG Telescopes

The new Rubina® NIR/ICG telescopes with HOPKINS® rod lens system feature excellent image quality. The telescopes’ strengths lie in optimizing focus on the tissue of interest and illuminating the surgical field. Optical system specially designed for use in combination with the IMAGE1 S™ 4U Rubina® and the POWER LED Rubina® light source.

  • Optimized illumination of the surgical field
  • No refocusing required when switching between white light and NIR modes
  • Selection of different angles of view, e.g. 0°, 30°, and 45°
  • Available in diameters 5 mm and 10 mm

EndoCAMeleon® Telescope with Variable Direction of View

The ENDOCAMELEON® HOPKINS® telescope with rod lens system and a rigid 10 mm sheath offers a variable direction of view. The viewing direction can thus be adjusted to fit any surgical situation.

Special features:

  • Direction of view can be adjusted between 0° - 90°
  • Enhanced illumination*
  • Control wheel for setting the desired direction of view, now with fin
  • Combines the convenient handling of the proven HOPKINS® telescopes with the advantages and potential of a telescope offering various directions of view
  • Particularly well suited for anatomically tight spaces

*in comparison with previous models


S-PILOT® – modular smoke evacuation system

As an early pioneer in laparoscopy, KARL STORZ has consistently worked to advance the state of the art. A great example is the S-PILOT® modular smoke evacuation management system, with in-line filtration and options for both active and passive applications. Recent guidance from SAGES and EAES recommends “For MIS procedures, use of devices to filter released CO2 for aerosolized particles should be strongly considered”.
While KARL STORZ has not specifically tested the use of KARL STORZ smoke evacuation devices and SARS-CoV-2, there are data on KARL STORZ filters and its effectiveness against other bacteria and viruses.    
The filter efficiency of KARL STORZ filters was tested using the most common test methods with microorganisms known as “Virus Filtration Efficiency (VFE)” and “Bacterial Filtration Efficiency (BFE)”. These types of tests are considered to be the most similar to clinical scenarios. A test aerosol with a mean particle size of 3 +/- 0.3 µm and a virus bacteriophage ɸX174 of 0.027 µm (at VFE) or bacteria Staphylococcus aureus (at BFE) were used. Test results confirmed a filter efficiency of more than 99.9999 %.1,2
The Most Penetrating Particle Size is typically in a range of 0.1-0.3 µm. These particles are the most difficult to trap by the filter. The test aerosol DEHS (= Di-2-Ethylhexyl-Sebacat) with a size of 0.3 µm was therefore used for non-microbiological tests. A filter efficiency of more than 99.9994 % was achieved.3

Contact your local KARL STORZ representative for a solution that meets your individual needs or for more details regarding the smoke evacuation portfolio available.
The S-PILOT® with in-line filtration is part of the extensive array of KARL STORZ products designed in consultation with active laparoscopic surgeons. The complete repertoire covers the full range of diagnostic and surgical laparoscopic procedures for adult and pediatric patients. 

1 Nelson Laboratories Inc., Salt Lake City, USA: “Virus Filtration Efficiency Test (VFE) at an Increased Challenge Level” Lab. No. 846021-S01, 07 Dec. 2015 (internal reference: SAP ID 300000338072).

2 Nelson Laboratories Inc., Salt Lake City, USA: “Bacterial Filtration Efficiency Test (BFE) at an Increased Challenge Level” Lab. No. 846022-S01, 02 Dec. 2015 (internal reference: SAP ID 300000338073).

3 GVS Filter Technology UK, Lancashire LA3 3EN, UK: Activity Report REP: 0698/16, 21. January 2016 (internal reference: SAP ID 300000351254).

The New Trocar Generation from KARL STORZ

The new trocar generation combines single-use and reusable components. In line with the KARL STORZ company philosophy, the cannulas and trocars were designed with reusable components in mind. The valve seal is intended for single use.

Special Features:

  • One-piece sealing system, sterile
  • Minimal friction between the valve seal and the instrument
  • Reduced overall weight thanks to the newly designed plastic trocar housing
  • Color coding for identification of different sizes
  • Available in the sizes 2.5 mm – 13.5 mm

CLICKline® Laparoscopic Instruments

Rotatable, disassemblable, laparoscopic instruments

The CLICKline® series continues the development of instruments which have proven their value for years. When the rear handle is positioned horizontally, the handle can be separated from the outer sheath and the working insert at the press of a button. The HF connection is mounted at a 45°angle on the upper side of the handle, thereby guiding the high frequency cable away from the field of operation.

CLICKline® Instruments

  • Precision craftsmanship
  • Design your own instruments from thousands of possible combinations
  • Modular components
  • Manufacturer’s warranty

Available in size 2 to 10 mm, CLICKline® instruments can be completely disassembled into separate components:

  • Handle
  • Outer sheath/outer sheath with working insert
  • Working insert

CLICKline Single-use Scissors

Simply sharp!

The single-use scissor inserts can be combined with all reusable handles in the KARL STORZ CLICKLINE series, providing a practical solution for regular use or as a backup system.

Special Features:

  • Inserts packaged sterile in individual blister packs and delivered in packages of 10 in a dispenser box
  • Proven scissor blade designs
  • Cost-effective solution: "single-use meets re-usable"
  • Color coding allows clear identification of the single-use components


Instrument Set for Minilaparoscopy

Minilaparoscopy – alone or in hybrid procedures with standard instruments (5 mm diameter) has become a popular surgical method because users can master it quickly and patients enjoy enhanced cosmetic results.

Special Features:

  • Complete instrument set for minilaparoscopy (3.5 mm diameter): trocars, unipolar and bipolar instruments, suction-irrigation systems, suture and ligature instruments
  • Modular concept: CLICKLINE instruments can be disassembled into three parts, allowing better hygiene and variability
  • Diverse combination possibilities thanks to a wide range of jaws with various outer sheaths and CLICKLINE handles
  • Rotating bipolar instruments (3.5 mm diameter)


Rotating Bipolar Grasping Forceps and Scissors in sizes 3.5 mm and 5 mm

The ROBI® instruments allows precise work on tissue. The enhanced instrument design and the materials used ensure the highe mechanical stability.

Special Features:

  • Available in sizes 3.5 and 5 mm
  • Ideal in combination with the high-end AUTOCON® III 400 HF unit
  • Can be disassembled into individual components

NATHANSON Liver Retractors

The new NATHANSON liver retractors are particularly characterized by a large and atraumatic surface area.

Special Features:

  • Large contact area for liver retraction
  • Fatigue-free retraction when used in conjunction with a mechanical holding system
  • Available in three sizes

Retractors for Laparoscopic Colorectal Procedures

Advanced laparoscopic surgery and particularly laparoscopic rectal surgery are extremely technically challenging.

One of the key requirements for successfully performing these procedures while respecting oncological principles is optimal exposure and, consequently, good visualization of the surgical site.

Special features:

  • Helps to display the various structures in difficult anatomical situations (particularly in obese male patients)
  • Various retractor shapes for different anatomies
  • Robust design
  • Easy to use thanks to angle adjustment dial


Needle Holder with Righting Function

KARL STORZ has expanded its portfolio to include a new needle holder with a needle righting function. The needle, which is clamped flat in the needle holder, can be raised in the site by means of the rotary wheel.

Special features:

  • Righting function for the clamped needle via the rotary wheel
  • Axial handle
  • The precisely settable ratchet facilitates secure positioning of the needle

Flexible Video-Choledochoscopes

The flexible video choledochoscopes from KARL STORZ allow exploration of both the intra- and extrahepatic bile ducts as well as the surgical removal of gallstones.

Special Features:

  • "Chip-on-the-tip" technology for high image quality
  • integrated LED light source
  • Compatible with the IMAGE1 S™ platform
  • available in the sizes 5.3 mm and 2.8 mm (outer diameter)
  • Menu navigation via camera head (e.g., Picture-in-Picture)
  • Hand movements transmitted directly through to the distal end


Scope Warmer for Single Use

For warming the scope for fog-free work

  • Warmer activated to heat endoscope via a metal plate
  • Suitable for all rigid endoscopes
  • Available in two different sizes (12 x 20 cm and 12 x 36 cm)
  • No other heat source (electricity, warm water, etc.) required
  • Product is sterile on delivery and is ready for immediate use 
  • Two scopes can be heated in the warmer at the same time

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ENDOBAG Extraction Bags

Special features:

  • Each extraction bag pre-packaged in an insertion aid for insertion through a 10 mm trocar
  • Once the insertion aid is removed, the trocar is free to use with other instruments
  • Memory wire for opening and closing the extraction bag
  • Smaller-diameter container section of the bag for straightforward ENDOBAG retrieval through the incision
  • Transparent material
  • Available in 2 sizes:
    • Work volume 260 ml, filling volume 62 ml
    • Work volume 200 ml, filling volume 53 ml

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