Titanium Anchors 3.0 and 5.0/6.5

Transcription

1 ART /2018-E Titanium Anchors 3.0 and 5.0/6.5 for use in reconstructive surgery

2 Titanium Anchors 3.0 and 5.0/6.5 for use in reconstructive surgery KARL STORZ offers high quality titanium anchors in 3.0, 5.0 and 6.5 mm diameter for reconstructive surgery. The titanium anchors come sterilized with two preloaded MEGAFIBRE #2 sutures, loaded on a disposable inserter. The special MEGAFIBRE suture is a braided, non-absorbable, ultra-high molecular weight polyethylene suture. Characterized by low tissue drag and its flat design, this suture offers increased knot strength compared to other sutures made of polyester or polyblend. Accessories for use with titanium anchors are reusable and produced in typical KARL STORZ quality and thus meet highest demands. Special characteristics: Preloaded disposable inserter Use of the special MEGAFIBRE suture Patented suture eyelet and single suture guidance for maximum suture stability Orientation aids for suture position Special anchor for patients with osteoporosis 2

3 Titanium Anchors 3.0 The titanium anchor 3.0 comes with two preloaded MEGAFIBRE #2 sutures. Thanks to its unique thread design and its patented suture eyelet, maximum suture stability is ensured. Self-cutting anchor 3.0: To permit safe placement of the anchors and optimal gliding of MEGAFIBRE, the disposable inserters include orientation aids. Two laser-etched marks at the distal end identifiy the position of the MEGAFIBRE. 3

4 Titanium Anchor 3.0 Anatomical reconstruction of the labrum-capsule complex in a Bankart injury BCT SGHL Labrum MGHL Diagram of a Bankart lesion. Tear of the middle glenohumeral ligament (MGHL) and of the anterior part of the inferior glenohumeral ligament (IGHL). Glenoid PIGHL Subscapularis tendon AIGHL Bankart lesion After positioning the SPS-Secure Portal System in the anterior-superior and anterior-inferior portals, the labrumcapsule complex is mobilized using a sharp elevator BB or BC. 4

5 Titanium Anchor 3.0 Anatomical reconstruction of the labrum-capsule complex in a Bankart injury Insertion of the glenoid guide and preparation of the implant bed with the threaded drill TT (The selftapping anchor does not require this step). Insertion of the 3.0 titanium anchor via the inferior cannula to the laser mark on the disposable inserter. 5

6 Titanium Anchor 3.0 Anatomical reconstruction of the labrum-capsule complex in a Bankart injury Retrieval of the white and blue-white sutures located superiorly via the anterior-superior cannula and retrival of the white an blue-white sutures via the anterior-inferior cannula. Puncture of the labrum-capsula complex with a suture hook and forwarding of a shuttle suture. The blue shuttle suture is exited via the anterior-interior cannula and tied extracorporeally with the blue-white anchoring suture of the inferior cannula. Passing of the blue-white suture the blue support suture through the labrumcapsule complex and exiting the suture through the anterior-superior cannula. Again puncturing of the labrum-capsule complex with a suture hook via the anterior-inferior cannula. Passing of the shuttle suture through the anteriorsuperior cannula and extracorporeal taying of the white anchoring suture. Passing of the white anchoring suture through the labrum-capsule complex and exiting the suture through the anterior-inferior cannula. 6

7 Titanium Anchor 3.0 Anatomical reconstruction of the labrum-capsule complex in a Bankart injury Preperation of arthroscopic sliding knots and placement of additional titanium anchors. Reconstructed Bankart injury. 7

8 Titanium Anchor 5.0 and 6.5 The 5.0 and 6.5 titanium anchors were developed for use in reconstructive rotator cuff surgery. Both anchors come with two pre-loaded MEGAFIBRE #2 sutures. The disposable inserters of these two anchors also feature laser marks for orientation purposes. Equipped with a self-tapping screw thread, these two anchors require no preparatory measures whatsoever. However, the KS bone punch can be used to facilitate insertion, if desired. The titanium anchor 6.5 was developed especially for the treatment of patients with osteoporosis and features larger thread wings, which ensure better support in lower bone quality. 8

9 Titanium Anchor 5.0 and 6.5 Anatomical reconstruction of an L-shaped tear in the rotator cuff Lateral view: Dorsal and ventral portals are placed. Puncture of the longitudinally ruptured rotator cuff. a) Retrieval of monofilament support suture b) Extracorporeal tying of the support suture with a multifilament suture Passing support suture through rotator cuff tear. Retrieval of the suture and knotting of the first side-toside suture. Application of further side-toside sutures. Support suture thread retrieved dorsally Preparation of the supraspinatus tendon insertion/ footprint. If desired, an acromionizer burr may be used, which minimizes bleeding a Placing of the titanium anchor in the area of the footprint (b). If desired, a pilot hole can be prepared with the KS bone punch (a) to facilitate screwing in the anchor (b). b 9

10 Titanium Anchor 5.0 and 6.5 Anatomical reconstruction of an L-shaped tear in the rotator cuff Removal of disposable inserter and arranging of the sutures (Lateral arthroscopic view): Knotting and passing the After one of the suture is support suture with the suture retrieved dorsally with a through the rotator cuff suture catcher, the rotator cuff is punctured from ventrally and the support suture is exited dorsally The same is now repeated with the remaining pair of sutures Complete reconstruction of an L-shaped rotator cuff tear 10

11 Instruments CR High-Flow Arthroscope Sheath, with snap-in coupling mechanism, diameter 6 mm, working length 13.5 cm, two stopcocks, rotatable, for use with HOPKINS telescopes 0, 30, 70 and Obturators BC/BT/BS, O, color code: red BT Obturator, semisharp, for use with Arthroscope Sheaths DR, CR, CR/R/B, CR, CR and EC, color code: green-red-yellow BX Changing Rod, length 23 cm, package of 6, for use with arthroscope sheaths with inner diameter 4 mm NEW ST Titanium Suture Anchor, diameter 3 mm, length 9 mm, with two MegaFibre sutures USP 2, pre-assembled, self-tapping, with inserter, sterile, for single use TI Titanium Suture Anchor, diameter 5 mm, length 12.5 mm, with 2 MEGAFIBRE threads USP 2, pre-assembled, self-tapping, with inserter, sterile, for single use TI Titanium Suture Anchor, diameter 6.5 mm, length 12.5 mm, with 2 MEGAFIBRE threads USP 2, pre-assembled, self-tapping, with inserter, sterile, for single use 11

12 Instruments KS Bone Punch, for use with Titanium Suture Anchors TI, TI and ST I Crochet Hook, working length 15 cm NEW KP Knot Pusher and Suture Cutter, for cutting sutures up to size USP 2, including: Insert and Blade Handle KP Knot Pusher, working length 18 cm SC Suture Cutter, for cutting sutures size USP GG Glenoid Guide, working length 12.5 cm, for use with BioPlug BP and BP and Drills 28179TB/TD 12

13 Instruments GH HALF PIPE, long, working length 9.5 cm OB Obturator, for use with GK/GH SGN SILGRASP Suture Grasping Forceps, straight jaws, sheath diameter 3 mm, straight, handle with cleaning connector, working length 14 cm AGN SILGRASP Alligator Grasping Forceps, straight jaws, sheath diameter 3 mm, straight, handle with cleaning connector, working length 12 cm AGSN SILGRASP Alligator Grasping Forceps, straight jaws, serrated, with ratchet, sheath diameter 3 mm, straight, handle with cleaning connector, working length 12 cm PGN SILGRASP Foreign Body Grasping Forceps, aggressive, straight jaws, sheath diameter 3 mm, straight, handle with cleaning connector, working length 14 cm PGSN SILGRASP Foreign Body Grasping Forceps, aggressive, with ratchet, straight jaws, sheath diameter 3 mm, straight, handle with cleaning connector, working length 14 cm 13

14 Instruments BB Elevator, width 4 mm, 15 curved upwards, working length 15 cm BC Elevator, width 4 mm, 30 curved upwards, working length 15 cm CB Glenoid Rasp, width 5.5 mm, 30 curved upwards, working length 15 cm CC S.L.A.P Rasp, width 5.5 mm, 30 curved downwards, working length 15 cm 14

15 Instruments WH WONDERHOOK Handle, complete, for transporting monofilament threads up to size USP 1 including: Transport Cassette NEW NEW NEW NEW NEW NG WONDERHOOK Suture Attachment, for use with monofilament threads up to size USP 1, straight, working length 15 cm, for use with Handle WH, color code: blue NGL Same, long NA WONDERHOOK Suture Attachment, for use with monofilament threads up to size USP 1, distal tip slightly curved upwards, working length 15 cm, for use with Handle WH, color code: gold MR WONDERHOOK Suture Attachment, for use with monofilament threads up to size USP 1, distal tip curved 25 right, working length 15 cm, for use with Handle WH, color code: green ML Same, distal tip curved 25 left NEW NEW NR WONDERHOOK Suture Attachment, for use with monofilament threads up to size USP 1, distally strongly curved to right, working length 15 cm, for use with Handle WH, color code: red NL Same, distally strongly curved to left RA Cleaning Adaptor, for use with Suture Attachments NR/NL/MR/ML/NA/NG/NGL 15

16 Instruments P Handle, with thumb release, with 4 locking positions, for use with Suture Attachments LA/LC/LL/LR/LRG LA SHOULDER PRO Suture Attachment, for punching soft tissue and suture management in shoulder arthroscopy, sheath diameter 3.5 mm, curved upwards, working length 15 cm, for use with Handle P, color code: black LC SHOULDER PRO Suture Attachment, for punching soft tissue and suture management in shoulder arthroscopy, sheath diameter 3.5 mm, straight, working length 15 cm, for use with Handle P, color code: blue 16

17 28180 LL SHOULDER PRO Suture Attachment, for punching soft tissue and suture management in shoulder arthroscopy, sheath diameter 3.5 mm, curved to left, also curved to left in sheath, working length 15 cm, for use with Handle P, color code: red LR SHOULDER PRO Suture Attachment, for punching soft tissue and suture management in shoulder arthroscopy, sheath diameter 3.5 mm, curved to right, also curved to right in sheath, working length 15 cm, for use with Handle P, color code: green LRG SHOULDER PRO Suture Attachment, for punching soft tissue and suture management in shoulder arthroscopy, sheath diameter 3.5 mm, retrograde opening, also curved upwards in sheath, working length 15 cm, for use with Handle P, color code: white 17

18 SPS Secure Portal System Recommended Set EB EO EC EP FB FO FC FP DB DO DW DL DG OG SA/SB SC/SD DF Optional: For the respective sets, Handle DF is available to facilitate the insertion of the Dilator DL. 18

19 SPS Secure Portal System Recommended Set E Basic Set for SPS Secure Portal System including: Positioning Needle Obturator Guide Wire, package of 6 Dilator Handle, for Dilator DL A workable instrument set requires the following supplementary sets: 1. For inner diameter 6.1 mm, working length 7 cm EB Dilator, with handle EO Obturator, diameter 4 mm, for use with Dilator EB SA Cannula, with thread, transparent, for single use 2. For inner diameter 6.1 mm, working length 8.5 cm EC Dilator, with handle EP Obturator, diameter 4 mm, for use with Dilator EC SB Cannula, with thread, transparent, for single use 3. For inner diameter 8.25 mm, working length 7 cm FB Dilator, with handle FO Obturator, diameter 4 mm, for use with Dilator FB SC Cannula, with thread, transparent, for single use 4. For inner diameter 8.25 mm, working length 8.5 cm FC Dilator, with handle FP Obturator, diameter 4 mm, for use with Dilator FC SD Cannula, with thread, transparent, for single use Optional: GS Set of Gaskets, 10x 2 sealing caps, sterile, for use with Valve Housing DG/OG GU Set of Gaskets, 10x 2 sealing caps, unsterile, for use with Valve Housing DG/OG OG Valve Housing, without LUER-Lock, for use with Cannulas and Set of Gaskets GU/GS 19

20 Instruments BG Suture Catcher, with inserter, sterile, package of 10, for use with Suture Attachments PA PH and NA NG, Wheel Attachment HR and Handle HG HG Handle, for use with monofilament threads size USP 2-0 to 2, for use with Suture Attachments PA PH, NA NG, and Wheel Attachment HR and Wheel R HR Wheel Attachment, for use with monofilament threads size USP 2-0 to 2, for use with Handle HG and Wheel R R Wheel, for use with monofilament threads size USP 2-0 to 2, for use with Wheel Attachment HR 20

21 28179 PA PA Suture Attachment, distal tip curved, straight, 5 mm in height, working length 150 mm, for use with Handle HG PB Same, 7 mm in height PC Same, 8 mm in height PD Same, distal tip curved hook like, 8.0 mm in height PE/PF PE/PF PE Suture Attachment, hook-shaped distal tip, straight, 8.7 mm in height, working length 15 cm, for use with Handle HG PF Same, 10 mm in height PG Suture Attachment, distal tip angled 30 to right, straight, 8 mm in height, working length 15 cm, for use with Handle HG PH Same, distal tip angled 30 to left R1 Cleaning Adaptor, for use with Suture Attachments PA PH and NA NG R2 Cleaning Adaptor, for use with Handles HG 21

22 Additional Literature: ENDOWORLD : BioPlug 3.5 and 4.2 for use in reconstructive surgery (ART 26) BioPlug 5.2 SPS Secure Portal System For use in reconstructive shoulder surgery on the humeral head (ART 27) ARTHROPUMP Power The Clever System for Arthroscopic Fluid Management (ART 42) UNIDRIVE S III ARTHRO Your Complete Solution for Arthroscopy (ART 46) ENDOGRAM: WONDERHOOK New Suture Shuttle System for Shoulder Arthroscopy (ART 4 09/2014) Doctor to Doctor Manuals: G. Lajtai, G. Aitzetmüller, G. Pörtsch, H. Panger: Shoulder Arthroscopy Part I Positioning and Approaches, Part II Instabilities and their Treatment, Part III Subacromial Impingement Syndrome and its Treatment DVD: Shoulder: Arthroscopy and Anatomy (KS 664) The Shoulder Anatomical Knowledge Update (KS 705) The Shoulder Anatomical Update 2010 (KS 724) Anterior Instability Repair (KS 629) 22

23 Notes It is recommended to check the suitability of the product for the intended procedure prior to use. 23

24 KARL STORZ SE & Co. KG Dr.-Karl-Storz-Straße 34, Tuttlingen/Germany Postbox 230, Tuttlingen/Germany Phone: +49 (0) Fax: +49 (0) ART /2018/EW-E