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Gynecology

Creating Certainty: Diagnostics and Treatment Outside the OR

Solutions for office hysteroscopy

Hysteroscopy allows accurate diagnosis of any abnormalities in the uterine cavity while 5 Fr. instruments often make immediate treatment possible. Narrow-lumen hysteroscopes enable procedures to be performed outside the OR without anesthesia or dilation of the cervix. Furthermore, hysteroscopy can be used to rule out any obstacles to implantation prior to IVF treatment.

  • The CAMPO TROPHYSCOPE® with a diameter of only 2.9 mm allows an atraumatic primary approach to the uterine cavity under visualization
  • The irrigation function of the ENDOMAT® SELECT provides a better overview thanks to the constant maintenance of intracavitary pressure
  • Outsourcing diagnostic services and minor hysteroscopic procedures extends the capacity of the OR to the clinical outpatient setting
  • TELE PACK X LED combines a monitor, light source, camera control unit and data management in a single unit to provide a portable, mobile solution

Resection to Perfection

The new bipolar 15 Fr. office resectoscope

In addition to bipolar resectoscopes with diameters of 22 and 26 Fr., KARL STORZ now offers a 15 Fr. resectoscope. Due to its small diameter, this resectoscope offers the possibility to perform resection outside the OR. Infertility patients or those suffering from abnormal bleeding can thus be treated in the doctor’s office or clinical outpatient setting, even without anesthesia. Together with the AUTOCON® III 400 HF generator, effective resection, coagulation or vaporization is achieved.

  • Minimal outer diameter
    • Possible to perform resection in the doctor’s office or clinical outpatient setting, even without anesthesia
    • Little or even no dilation required (depending on the patient)
  • Can be used as a diagnostic hysteroscope in conjunction with semirigid 5 Fr. instruments (optional)
  • Real bipolar system with current not returned via the sheath
  • Self-cleaning loops due to plasma formation

Rapid Tissue Ablation with a Small Diameter

19 Fr. Intrauterine BIGATTI Shaver (IBS®) with HYSTEROMAT E.A.S.I.®

With an optical system that features an outer diameter of only 6 mm, the Intrauterine BIGATTI Shaver (IBS®) is inserted into the minimally dilated cervix. Thanks to the 4 mm shaver blade, the immediate removal of intrauterine pathologies is now possible outside the OR, e.g., in office settings and clinical outpatient departments or IVF centers.

  • Mechanical removal of intrauterine pathologies such as polyps, myomas or placental remnants
  • Immediate suction of the resected tissue via the HYSTEROMAT E.A.S.I.® provides a comfortable work environment without disturbing tissue chips in the uterine cavity
  • HYSTEROMAT E.A.S.I.® can be used for all hysteroscopic interventions
  • Less risk of complications as HF current is not used
  • Fully reusable system

VITOM® – Visualization System for Gynecology

The VITOM® system provides excellent depth of field, optimal magnification, good contrast and excellent color reproduction, which are the ideal prerequisites for the best possible visualization of colposcopic findings, conizations and open surgical interventions. Furthermore, the VITOM® system magnifies the surgical site and provides an excellent view of the epithelial border, e.g., during loop excision.

  • Magnified images during colposcopy or conization
  • VITOM® system with integrated green filter
  • Ideal for training, documentation or streaming of interventions
  • Ergonomic work
  • Enhanced light in the field of view due to the integrated illuminator
  • Compact design requiring minimal space
  • Compatible with the IMAGE1 S™ camera platform

Visualizing the lymphatic system with ICG in tumor surgery*

The KARL STORZ Near Infrared (NIR/ICG) system and the marker indocyanine green (ICG) enables non-radioactive visualization of the entire lymphatic system surrounding a tumor in real time, e.g., in a laparoscopic manner.

The system offers the following advantages:

  • Non-radioactive lymph node detection method
  • Multidisciplinary use
  • Xenon-based technology (no laser safety measures necessary)
  • Intuitive switchover between standard white light and fluorescence mode via footswitch
  • Physicians describe their surgical experience with the system as follows: The NIR/ICG system allows the reduction of radical lymphadenectomy and, at the same time, visual control makes the en-bloc resection of lymph nodes easier.


*The intradermal administration of indocyanine green for (S)LN has already been approved in Italy (breast cancer), Japan and Russia. Please inform yourself in advance about the potential for the off-label use of ICG in your hospital / country.

Laparoscopic Visualization of the Lymphatic System in Gynecology with the OPAL1® NIR/ICG Technology

In gynecology, the degree of tumor involvement in the sentinel lymph node (SLN) is of great importance as it provides medical information about the tumor stage and is thus one of the main prognostic factors. In breast cancer surgery, SLN detection with the radioactive tracer 99mTc is the gold standard. In other areas of gynecological tumor surgery, its benefits in comparison to elective lymph node dissection is the subject of discussion. As a new, non-radioactive imaging technique, NIR imaging with ICG can prove useful, e.g., in the case of vulvar, endometrial, cervical or mammary carcinoma.1 Laparoscopic SLN mapping of endometrial carcinoma yielded the following results (radioactive tracer 99mTc vs. ICG):

 

Radioactive Tracer 99mTc

ICG

Total SLN
detection rate

Bilateral SLN

Total SLN detection rate

Bilateral SLN
Study 12  83 %  61 %  95,5 %  95,5 %

 

1Papadia et al., Doctor-to-Doctor Manual ENDO-PRESS®, ICG-enhanced Fluorescence-guided SLN Mapping in Gynecological Malignancies (ISBN 978-3-89756-932-4)

2 Imboden et al., Surg. Oncol. 2015

VITOM® II ICG – Fluorescence Imaging in Open Surgery

Use for vulvar carcinoma

The VITOM® II ICG system from KARL STORZ provides an optimal solution for the sentinel lymph node mapping in the case of vulvar carcinoma. VITOM® II ICG is an exoscope that combines the benefits of both endoscopy and microscopy. It is used with the same camera system that is employed in endoscopy (IMAGE1 S™ camera platform). The high-quality visualization under white light is, of course, also preserved with VITOM® ICG telescopes.

  • NIR/ICG visualization with the VITOM® II ICG system – in addition to technetium and blue dye – offers the surgeon a straightforward method for the detection and selective removal of sentinel lymph nodes (SLN) in the case of vulvar carcinoma.
  • Possibility for the integration of VITOM® II ICG by means of a holding arm into the gynecologist’s operating field.

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:

  • Ergonomic shape of the trocar ensures safe and comfortable handling during placement of the trocar
  • One-piece sealing system for single use
  • Minimal friction between the valve seal and the instrument
  • Considerably reduced weight and good balance thanks to the newly designed plastic trocar housing
  • Color coding for clear identification of different sizes
  • Available in the sizes 2.5 mm – 13.5 mm

KECKSTEIN Uterine Manipulator

The versatile KECKSTEIN uterine manipulator makes gynecological surgery in the lower pelvis easier and safer. Presentation of the operative field during hysterectomy as well as organ-preserving surgery, e.g. in the case of endometriosis, is greatly enhanced in comparison to conventional manipulators thanks to the possibility of anteflexion and retroflexion of the distal tip and cap. Various configurable atraumatic inserts for interventions in reproductive medicine or oncology offer the operating surgeon completely new surgical possibilities.

  • Reusable seal for Total Laparoscopic Hysterectomy
  • Anteflexion and retroflexion of the distal tip and the cap
  • Atraumatic inserts for organ-preserving interventions and surgical oncology

SCHÄR Manipulator

THE instrument for laparoscopic descensus surgery

For laparoscopic sacrocolpopexy, which has increasingly become the standard procedure for treating various forms of prolapses characterized by a descensus of the vaginal vault or uterus, KARL STORZ now offers a multifunctional instrument – the SCHÄR manipulator.

Thanks to the variable adjustable working insert, it provides optimal support for performing the following procedures:

  • Supracervical hysterectomy
  • Sacrocervicopexy surgery after supracervical hysterectomy
  • Sacrocolpopexy of the vaginal stump after a previous hysterectomy
  • Sacrohysteropexy (sacrocolpopexy with uterine preservation)

The flat shape of the manipulator allows optimal visualization and dissection of the front and back walls of the vagina in order to fixate the mesh with a suture.

SupraLoop – Bipolar Loop Now Available

For laparoscopic supracervical hysterectomy

In addition to the well-known SUPRALOOP unipolar loop, KARL STORZ now offers a bipolar SUPRALOOP for the removal of the uterus in supracervical hysterectomy.

Special features:

  • No neutral electrode necessary for the bipolar SUPRALOOP
  • Loop available in two sizes
  • Reduced operating time thanks to quick removal of the uterus
  • Additional cost savings thanks to reusable handle and outer sheath

Bipolar Electrodes for the Resectoscope System

Special features:

  • Universally usable for 12° and 30° telescopes
  • Easy product matching thanks to color coding
  • Guaranteed functionality due to single use
  • Sterile, 5-year shelf life

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