LASER INSTRUMENTATION

Transcription

1 LASER INSTRUMENTATION Laser Instrumentation (Ebonized) Ossoff-Karlan Laser Instruments Pilling recoends the Ossoff-Karlan Laser Instrumentation presented on the following pages. GRASPING FORCEPS Left, 21 cm working length, ebonized Right, 21 cm working length, ebonized Straight, 21 cm working length, ebonized MICRO SUCTION TUBE Without thumb control Fr., 7 1/2" (21.5 cm) working length, ebonized MICRO-LARYNGEAL PROBES Straight, 26 cm overall length, ebonized Angled, 25 cm overall length, ebonized OSSOFF-KARLAN VOCAL CORD ROLLER This instrument was designed to facilitate greater direct exposure of the infraglottic surface of the true vocal cords cm working length, ebonized 47

2 MILLIMETERS LASER INSTRUMENTATION Laser Instrumentation (continued) Ossoff-Karlan Laser Instruments (continued) LASER MIRRORS (MOST POPULAR) A highly polished stainless front surface mirror. Available in five sizes. Suction available to draw smoke and steam. Shaft is ebonized. 8 1/4" (21 cm) working length diameter mirror diameter mirror diameter mirror diameter mirror diameter mirror LASER PLATFORMS (MOST POPULAR) The platform is inserted into the subglottic larynx above the level of the packed cottonoids. The platform helps to protect the cottonoids, endotracheal tube and cuff, and tissues of the subglottic larynx from any direct or reflected laser beam radiation. Shaft and tip are ebonized. 21 cm working length diameter platform diameter platform diameter platform Jako Laser Instruments FRONT SURFACE MIRRORS For directing the laser beam behind the vocal cord or into other inaccessible areas. Mirrors are made from a highly polished stainless steel and mounted on an aspirating tube, thus allowing the endoscopist to circulate air over the surface of the mirror for defogging or to evacuate smoke and plume. Non-reflective finish on shaft. 23 cm working length diameter mirror diameter mirror diameter mirror ASPIRATING TUBES For removal of smoke and steam created during laser surgery Velvet Eye type, 20 cm working length Open end, 15 cm working length Clip for attaching aspirating tubes to laryngoscope up to 9 Fr. (3 )

3 LASER INSTRUMENTATION Laser Instrumentation (continued) Jako Laser Instruments (continued) ANGLED RETRACTORS For protection of the anterior coissure and the evacuation of smoke and plume during laser surgery. Non-reflective finish on shaft. 23 cm working length Adult, right, 8 diameter Adult, left, 8 diameter Pediatric, right, 4 diameter Pediatric, left, 4 diameter SPATULA RETRACTORS For protection/retraction of the vocal cords and for the evacuation of smoke and plume during laser surgery. 23 cm working length. Non-reflective finish on shaft Adult, right, 10 diameter Adult, left, 10 diameter Pediatric, right, 5 diameter Pediatric, left, 5 diameter Dedo Laser Instruments LASER MIRRORS Used to direct the laser beam behind the vocal cords to other inaccessible areas. The mirrors are highly polished stainless steel mounted on aspirating tubes, allowing the endoscopist to circulate air over the surface of the mirror for defogging or to evacuate smoke and plume. Non-reflective finish on shaft. 22 cm working length diameter mirror diameter mirror diameter mirror 49

4 MILLIMETERS LASER INSTRUMENTATION Shown with probe inserted into handle. Knives and probes can be set to any angle or depth relative to the handle Laser Instrumentation (continued) Feder-Ossoff Microlaryngeal Precision Instruments for Phonosurgery FEDER-OSSOFF PHONOSURGERY SET These instruments were designed specifically for microlaryngeal procedures to retain, restore, or improve voice quality. Ideal for use in delicate mucosal microflap dissection techniques. Delicate Mayo blades on scissors Matte laser finish Angled handles and slender diameter shafts Universal ring handle for knives and probes 23 to 27 cm working length Much smaller than Jako-Kleinsasser Durable storage and sterilization tray items, through (does not include or ) KNIVES AND KNIFE HANDLE All knives have 27 cm maximum working length, tapered shaft. Working length is measured from front portion of handle to tip of instrument Straight sickle, 3 blade Curved sickle, 3 blade Phono circle knife, 3 blade, (optional only) Phono knife round, 1.5 blade, (optional only) Universal ring handled knife handle with camlock PROBE/ELEVATORS These probe/elevators allow for sharp and blunt dissection and elevating of tissue. All probes fit into the camlock handle (506888). 27 cm working length angle, blunt angle, blunt angle, sharp angle, sharp

5 LASER INSTRUMENTATION Laser Instrumentation (continued) Feder-Ossoff Microlaryngeal Precision Instruments for Phonosurgery (continued) FEDER-OSSOFF MICRO-LARYNGEAL FORCEPS This series of forceps includes both alligator grasping jaw and cup biopsy jaws. The grasping forceps provide secure hold for delicate traction. The round cups provide a sharp, smooth cutting surface for precise biopsies. All forceps have matte laser finish and shafts that taper from 2.0 to 0.5. Double action grasping forceps with coarsely serrated jaws and a suction channel. The 1.0 suction channel has a Luer- Lok proximal fitting and extends to 6.5 from distal end. Grasping forceps finely serrated jaws, 1.1 wide tapering to 0.6, 4.0 long, working length 23 cm. Cup forceps round biopsy cups with 1.0 jaw, working length 23 cm Grasping Forceps, double action, straight, with suction Grasping Forceps, angled up Grasping Forceps, straight Cup Biopsy, 1, straight Cup Biopsy, 1, up angled 51

6 MILLIMETERS LASER INSTRUMENTATION Laser Instrumentation (continued) Feder-Ossoff Microlaryngeal Precision Instruments for Phonosurgery (continued) FEDER-OSSOFF MICRO-LARYNGEAL SCISSORS All blunt scissors have Mayo type dissecting blades tapering to a 1 tip. All scissors 23 cm working length, 2 diameter shaft, 5 bend at handle. Blunt Scissors Straight blades, vertical action Curved blades, horizontal action, open left Curved blades, horizontal action, open right Angled up, vertical action Angled down, vertical action Angled up, double action Sharp Scissors Straight blades, vertical action Curved blades, horizontal action, open left Curved blades, horizontal action, open right Angled up, vertical action Angled down, vertical action Double action

7 LASER INSTRUMENTATION Laser Instrumentation (continued) Feder-Ossoff Microlaryngeal Precision Instruments for Phonosurgery (continued) SUCTIONS 23 cm working length, with thumb control, laser finish Fr. diameter Fr. diameter Fr. diameter FEDER-OSSOFF PHONOSURGERY INSTRUMENT STERILIZING TRAY With individual instrument housing. The tray is a durable construction, protecting the delicate instruments. This tray may be stacked for storage and withstands flash autoclaving. It also withstands temperature of multiple cycles of steam sterilization, ethylene oxide sterilization, and gaa radiation, chemical cold sterilizing agents, disinfectants and germicides Inside dimensions: 11 3/4" (29.8 cm) x 15 1/4" (38.7 cm) x 3" (7.6 cm) at handles MICRO-LARYNGEAL FORCEPS The serrated triangular jaw allows for a larger surface area of tissue to be grasped within the 3 wide tips. These forceps have 23 cm working length and have a non-reflective finish for use with lasers. Jaws are uniquely angled and fenestrated to better grasp along the longitudinal surface of the respective chord, 2.75 wide triangular jaw, serrated jaw, 2 shaft. Fits adult laryngoscopes without interfering with microscope, 5 bend at the handle. Non-reflective finish, can be used in laser surgery Triangular fenestrated, serrated jaw forceps, right, 23 cm working length Triangular fenestrated, serrated jaw forceps, left, 23 cm working length 53

8 LASER SUBGLOTTISCOPES AND INSTRUMENTATION Laser Subglottiscopes OSSOFF ADULT SUBGLOTTISCOPES Designed to view and access beyond the vocal cords for standard and laser procedures for subglottic stenosis and subglottic lesions. Extended length with tapered tube (longer than standard laryngoscope). Wide proximal end. Matte finish inside lumen to reduce possible reflection of laser beam. Integral, distally opened smoke evacuation channel. Removable 14 gauge, 3 7/8" (9.8 cm) ventilating needle. Needle locking mechanism and tubing clip on the handle. Single, one piece design fiberoptic light carrier/cable. Adult size laryngoscope handle. Includes Needle Luer-Lok Adapter to Sanders Tubing. Passes easily through the vocal cords to reach the subglottic area. Provides binocular vision with use of a microscope with lens. Less chance of burning unintended tissue. Allows for removal of laser plume rapidly. Allows for Venturi ventilation (order separately). Assures proper placement and hold of ventilating needle while keeping tubing out of the way. Provides optimum distally delivered light. Allows use of laryngoscope holder (502245), or Tobey Laryngoscope Holder (502248) for two-handed surgery. NOMINAL MAX. O.D. CATALOG OVERALL MIN. PROXIMAL AT DISTAL MAX. NUMBER SIZE LENGTH I.D. DIMENSIONS TIP O.D Adult Female x Adult Male x Complete Sanders Venturi System listed on pages 8 through 11. REPLACEMENT VENTILATING NEEDLE gauge REPLACEMENT LIGHT CARRIER For either scope, and ASPIRATING TUBE, THUMB VALVE CONTROL Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.), (12 Fr), 35 cm working length, long enough for adult subglottiscopes 43

9 MILLIMETERS LASER SUBGLOTTISCOPES AND INSTRUMENTATION Laser Subglottiscopes (continued) MICROSUBGLOTTIC INSTRUMENTS Designed for laser microsurgery of the entire subglottic space and upper cervical trachea, this instrumentation includes forceps, scissors, suction tube, probe, mirror and platform, (all 28 cm in length and laser finished) Operating Platform, Front Surface Mirror, Micro Suction Tube, 6 Fr Straight Probe Grasping Forceps, Straight Angled Cup Forceps Straight Scissors Set of 7 instruments ( )

10 LASER SUBGLOTTISCOPES AND INSTRUMENTATION Laser Subglottiscopes (continued) HEALY-JAKO PEDIATRIC SUBGLOTTISCOPE The Healy-Jako Subglottiscope was designed specifically for the pediatric patient. The small tapered 6 distal tip allows the subglottiscope to pass farther down the airway and give access to lesions below the level of the vocal cords, while still being able to utilize the operating microscope. Supplied with light carriers permanently attached to fiberoptic cables. Features: Non-reflective, matte interior finish. This finish decreases the chance of the laser beam reflecting off the inside of the scope and burning unintended tissue. The subglottiscope is most useful when the carbon dioxide laser is used. Disconnect handle. Subglottiscope can be held by standard laryngoscope holder When the handle is unscrewed, the subglottiscope can be easily inserted and manipulated. Large fiberoptic light carriers. The large cables allow for maximum illumination and light intensity for still and cine color photography. Includes Luer-Lok hub adapter to Sanders tubing. NOMINAL NUMBER LENGTH I.D. DIMENSIONS O.D. CARRIER x R* L* Complete Sanders Venturi System listed on pages 8 through 11. REPLACEMENT VENTILATING NEEDLE For Venturi ventilation on these three subglottiscopes gauge, angled blunt REPLACEMENT LUER-LOK HUB ADAPTER To Sanders hub adapter to Sanders tubing * R indicates right light carrier L indicates left light carrier Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.), 45

11 MILLIMETERS LASER SUBGLOTTISCOPES AND INSTRUMENTATION * Patent No. 4,799,485 and D 304, 494 Design Pat. No. Laser Subglottiscopes (continued) OSSOFF NEONATAL SUBGLOTTISCOPE SET* For the treatment of upper respiratory distress in premature and neonatal infants caused by: Stenosis of the larynx or trachea Choanal atresia Laryngeal webs Malformations of the larynx or trachea Excessive mucous or fluid in the airway The Ossoff Neonatal Subglottiscope is used for: Manually opening the airway Providing an opening for the removal of mucous and fluids Diagnosing the cause for airway distress Surgically removing or ablating, with a laser, the stenotic tissue The Ossoff Neonatal Subglottiscope set consists of: Four interchangeable scope tubes, 3 to 6 inside diameters, 10.5 cm working length, see drawings for nominal proximal dimensions One interchangeable fiberoptic, distally delivered light carrier One interchangeable Venturi needle, 20 gauge for ventilation Two-piece handle assembly to accept the interchangeable scope tubes One fiberoptic light cable Sterilizing tray Ossoff Neonatal Subglottiscope Set* Subglottiscope tube Subglottiscope tube Subglottiscope tube Subglottiscope tube Handle assembly 2-piece Sterilizing Tray Venturi ventilation needle, 20 gauge, with retaining clip Fiberoptic light carrier Complete Sanders Venturi System listed on pages 8 through Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.),

12 Top thumb screw lower blade separation Removable handle mechanism Thumb lever lower blade distal expansion Fiberoptic light cable Attached smoke evacuation channel Double-action type with lower blade separated Double-action type with lower blade separated and expanded LASER LARYNGOSCOPES The use of lasers for ablative surgery for tissue removal has become increasingly popular. To meet the demand, Pilling has a complete line of laryngoscopes and accessories available for use in laser surgery. All of our laser instruments have a non-reflective, dull finish to reduce the chance of the laser beam reflecting off the instrument. Pilling is continuing to work with leading surgeons in the development of more advanced instruments for use in laser surgery to meet this ever-increasing demand. Refer to Scope Measurement Chart for definition of provided Scope Dimensions on pages 416, 417 and 418. Laser Laryngoscopes PILLING BIVALVE LASER LARYNGOSCOPES These special scopes are modified designs of the Dedo-Pilling Anterior Coissure and Ossoff Posterior Coissure micro and laser laryngoscopes. The Dedo Anterior Coissure scopes provide minimal chance of teeth breakage, yet offers optimum microscopic visibility. The Ossoff Posterior Coissure scopes provide the ability to lift the endotracheal tube and permit entrance and microscopic visibility beyond the vocal cords. These scopes provide increased visibility at the surgical site through expansion and distension of the split tubes. PILLING-DEDO DOUBLE-ACTION LASER LARYNGOSCOPES Features: Lower blade separation provides an increased operative area for ease of instrumentation. Distal expansion of the lower blade allows maximum visibility of the cords and beyond. Non-reflective internal surface minimizes laser beam deflection. Removable handle reduces weight during insertion. This handle can be attached to the standard laryngoscope holder (502245), or Tobey Laryngoscope Holder , or adapted for use with the Boston University System (502260). Smoke evacuation channel is permanently attached and extends distally for maximum removal of laser plume. One large fiberoptic light carrier is supplied with attached cable for optimum distal lighting. Both styles of bivalve Laser Larynogoscopes have O.D. measurements which can exceed the anatomical limits for their intended patient size. A thumb operated lever allows the physician to tactily gauge the degree of pressure exerted. 37

13 MILLIMETERS LASER LARYNGOSCOPES Laser Laryngoscopes (continued) PILLING-DEDO DOUBLE-ACTION ANTERIOR COMMISSURE LARYNGOSCOPES CLOSED NOMINAL CLOSED NUMBER SIZE LENGTH I.D. DIMENSIONS O.D. CARRIER Adult x Adolescent x Removable handle for attachment to laryngoscope holder Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.), PILLING-OSSOFF DOUBLE-ACTION POSTERIOR COMMISSURE LARYNGOSCOPE CLOSED NOMINAL CLOSED NUMBER SIZE LENGTH I.D. DIMENSIONS O.D. CARRIER Adult x Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.),

14 LASER LARYNGOSCOPES Laser Laryngoscopes (continued) DEDO LASER MICRO-LARYNGOSCOPES The Dedo Laser Micro-Laryngoscope was designed specifically for use with the CO2 laser. Supplied with two light carriers permanently attached to fiberoptic cables. Features: Non-reflective, dull interior finish. Large oval light carriers to provide maximum illumination for photography. Integral aspirating channel for automatic smoke and steam evacuation. The same narrow dimensions as the standard Dedo-Pilling Micro-Laryngoscope allows its use in many cases in which larger micro-laryngoscopes are contraindicated. NOMINAL NUMBER SIZE LENGTH I.D. DIMENSIONS O.D. CARRIER Adult x Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.), DEDO LASER LARYNGOSCOPE EXTRA LONG The Dedo Laser Laryngoscope, Extra Long was designed for the patient with a great distance between the teeth and vocal cords. NOMINAL NUMBER SIZE LENGTH I.D. DIMENSIONS O.D. CARRIER Adult x Extra Long Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.), 39

15 MILLIMETERS LASER LARYNGOSCOPES Laser Laryngoscopes (continued) OSSOFF-KARLAN LASER MICRO-LARYNGOSCOPES The Ossoff-Karlan Laser Micro-Laryngoscopes are modifications of the Dedo and Jako Micro-laryngoscopes with additions of special features for laser surgery. The Posterior Coissure scope is a special design of Drs. Ossoff and Karlan. Supplied with two light carriers permanently attached to cables. Features: Bifurcated smoke evacuation channels. Non-reflective, dull interior finish. Large oval light carriers for photography. OSSOFF-KARLAN-DEDO NOMINAL NUMBER SIZE LENGTH I.D. DIMENSIONS O.D. CARRIER Adult x Child x Adolescent x Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.),

16 LASER LARYNGOSCOPES Laser Laryngoscopes (continued) OSSOFF-KARLAN-JAKO NOMINAL NUMBER SIZE LENGTH I.D. DIMENSIONS O.D. CARRIER Adult x R* L* * R indicates right light carrier L indicates left light carrier Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.), OSSOFF-KARLAN POSTERIOR COMMISSURE NOMINAL NUMBER SIZE LENGTH I.D. DIMENSIONS O.D. CARRIER Adult x Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.), 41

17 MILLIMETERS LASER LARYNGOSCOPES I A B C G J D E F K H H LEGEND G K A,C,D,F Channels for ventilating needle up to 14 gauge B, E Channels for light carriers or ventilating needles G, H Ventilating needles and adapters I, J Light carriers K Luer-Lok hubs to fit tubing adapter Laser Laryngoscopes (continued) ABRAMSON-DEDO MICRO-LARYNGOSCOPE The Abramson modification of the Dedo-Pilling Micro-Laryngoscope was designed to increase the efficiency of Venturi type ventilation. It provides the physician with a choice of six positions for placement of the Venturi Needle (up to 14 Ga.). The inside is a non-reflective finish for use in laser surgery. 14 Ga. blunt needles may be used for smoke evacuation. Supplied with a set of right and left light carriers, two 12" 14 Ga. blunt needles, and two Luer-Lok adapters to bare Sanders system tubing. NOMINAL NUMBER SIZE LENGTH I.D. DIMENSIONS O.D. CARRIER Adult x R* L* Ventilating Needles, Adapters and Clips for are listed below. Complete Sanders Venturi System listed on pages 8 through 11. REPLACEMENT VENTILATING NEEDLES " blunt REPLACEMENT CLIPS For ventilating needles REPLACEMENT ADAPTER Needle Luer-Lok hub to Sanders tubing VENTURI VENTILATING BLUNT NEEDLES " (10.1 cm), 14 gauge " (10.1 cm), 14 gauge, bent " (10.1 cm), 16 gauge P 4" (10.1 cm), 18 gauge " (10.1 cm), 20 gauge Complete Sanders Venturi System listed on pages 8 through 11. * R indicates right light carrier L indicates left light carrier Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.),