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Gynecology

Creating Certainty: Diagnostics and Treatment Outside the OR

Solutions for office hysteroscopy

Office hysteroscopy allows the diagnosis of any abnormalities in the uterine cavity while 5 Fr. instruments 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 possible obstacles to implantation prior to IVF treatment.

  • Outsourcing diagnostic services and minor hysteroscopic procedures expands the capacity of the OR
  • CAMPO TROPHYSCOPE® with a diameter of only 2.9 mm allows a primary approach to the uterine cavity under visualization
  • HYSTEROMAT E.A.S.I.® automatically maintains a stable uterine cavity
  • Compact and mobile TELE PACK X LED imaging unit for universal use with integrated documentation

Intrauterine BIGATTI Shaver (IBS®) in Combination with HYSTEROMAT E.A.S.I.®

The Intrauterine BIGATTI Shaver (IBS®) enables the purely mechanical removal of intrauterine pathologies such as polyps, myomas (G0-G1) or placental remnants under clear visualization at all times. The tissue fragments removed are directly suctioned by the shaver blade. Not using HF current lowers the risk of complications and results in a faster learning curve for the operating surgeon. The automatic HYSTEROMAT E.A.S.I.® double roller system maintains a stable cavity and optimal vision.

  • Mechanical removal of intrauterine pathologies without HF current
  • Clear visualization at all times thanks to direct suction of the resected tissue
  • Faster learning curve than for conventional resection
  • Fully reusable system, including shaver blades
  • Hysteromat E.A.S.I.® can be used for all hysteroscopic and laparoscopic procedures

Bipolar Resectoscopes

Cutting, coagulation, and vaporization in physiological saline solution

The use of saline solution significantly reduces the risk of TUR syndrome. KARL STORZ offers bipolar resectoscopes with diameters of 22 and 26 Fr. The 22 Fr. resectoscopes are particularly well suited for infertility patients as the cervical canal can be dilated up to Hegar 7.5. Together with the AUTOCON® III 400 HF generator, effective resection, coagulation or vaporization is achieved.

Special Features:

  • Real bipolar system with current not returned via the sheath
  • Minimal tissue penetration
  • Precise cutting and initial cutting without delay
  • Self-cleaning loops due to plasma formation
  • Available in 22 and 26 Fr.

VITOM®

Extracorporeal visualization, magnification, and documentation

The VITOM® telescope is an optical system which – unlike an endoscope – is not inserted into the body but placed at a working distance of 25-75 cm above the surgical field. The VITOM® system can be used for the visualization and documentation of colposcopic interventions. Furthermore, the VITOM® system magnifies the surgical site and provides an excellent view of the epithelial border, e.g., during loop excision.

Special Features:

  • Magnified imaging in colposcopy and conization
  • VITOM® system with integrated green filter
  • Ideal for training purposes and the documentation or transmission of interventions
  • When used with an endoscopic FULL HD video system (e.g., IMAGE1 S), the VITOM® system delivers images in high resolution

 

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 NIR/ICG system

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 provide a useful contribution to this field.1 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 %

 

1 Papadia 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 – Use for vulvar carcinoma

The VITOM® II ICG 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 NIR system).

  • NIR visualization with the VITOM® II ICG – 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 an exoscope 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 (package of 10)
  • 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

Extraordinarily versatile

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.

Special Features:

  • New 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

SupraLoop – Bipolar Loop Now Available

For laparoscopic supracervical hysterectomy

In addition to the well-known SUPRALOOP unipolar loop, we now offer 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