LASER INSTRUMENTATION

509201 509202 509204 509205 509206 509207 509203 LASER INSTRUMENTATION Laser Instrumentation (Ebonized) Ossoff-Karlan Laser Instruments Pilling recoends the Ossoff-Karlan Laser Instrumentation presented on the following pages. GRASPING FORCEPS 509201 Left, 21 cm working length, ebonized 509202 Right, 21 cm working length, ebonized 509203 Straight, 21 cm working length, ebonized MICRO SUCTION TUBE Without thumb control. 509204 7 Fr., 7 1/2" (21.5 cm) working length, ebonized MICRO-LARYNGEAL PROBES 509205 Straight, 26 cm overall length, ebonized 509206 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. 509207 21 cm working length, ebonized 47

11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 MILLIMETERS LASER INSTRUMENTATION 48 509208 509214 509002 509012 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. 509208 4 diameter mirror 509209 6 diameter mirror 509210 8 diameter mirror 509212 10 diameter mirror 509213 14 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. 509214 4 diameter platform 509215 6 diameter platform 509216 8 diameter platform Jako Laser Instruments 509013 509014 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. 509001 6 diameter mirror 509002 8 diameter mirror 509003 10 diameter mirror ASPIRATING TUBES For removal of smoke and steam created during laser surgery. 509012 Velvet Eye type, 20 cm working length 509013 Open end, 15 cm working length 509014 Clip for attaching aspirating tubes to laryngoscope up to 9 Fr. (3 )

509006 509010 509102 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. 509004 Adult, right, 8 diameter 509005 Adult, left, 8 diameter 509006 Pediatric, right, 4 diameter 509007 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. 509008 Adult, right, 10 diameter 509009 Adult, left, 10 diameter 509010 Pediatric, right, 5 diameter 509011 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. 509101 6 diameter mirror 509102 8 diameter mirror 509103 10 diameter mirror 49

11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 MILLIMETERS LASER INSTRUMENTATION 50 506888 506880 506884 506830 506842 506882 506886 Shown with probe inserted into handle. Knives and probes can be set to any angle or depth relative to the handle. 506832 506844 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 506800 28 items, 506802 through 506890 (does not include 506884 or 506886) KNIVES AND KNIFE HANDLE All knives have 27 cm maximum working length, 3.2 1 tapered shaft. Working length is measured from front portion of handle to tip of instrument. 506880 Straight sickle, 3 blade 506882 Curved sickle, 3 blade 506884 Phono circle knife, 3 blade, (optional only) 506886 Phono knife round, 1.5 blade, (optional only) 506888 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. 506830 30 angle, blunt 506832 60 angle, blunt 506842 30 angle, sharp 506844 60 angle, sharp

506856 506860 506862 506858 506864 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. 506856 Grasping Forceps, double action, straight, with suction 506858 Grasping Forceps, angled up 506860 Grasping Forceps, straight 506862 Cup Biopsy, 1, straight 506864 Cup Biopsy, 1, up angled 51

11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 MILLIMETERS LASER INSTRUMENTATION 52 506824 506802 506806 506810 506812 506816 506820 506804 506808 506822 506814 506818 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 506802 Straight blades, vertical action 506804 Curved blades, horizontal action, open left 506806 Curved blades, horizontal action, open right 506808 Angled up, vertical action 506810 Angled down, vertical action 506822 Angled up, double action Sharp Scissors 506812 Straight blades, vertical action 506814 Curved blades, horizontal action, open left 506816 Curved blades, horizontal action, open right 506818 Angled up, vertical action 506820 Angled down, vertical action 506824 Double action

506874 506890 506950 506952 LASER INSTRUMENTATION Laser Instrumentation (continued) Feder-Ossoff Microlaryngeal Precision Instruments for Phonosurgery (continued) SUCTIONS 23 cm working length, with thumb control, laser finish. 506870 3 Fr. diameter 506872 5 Fr. diameter 506874 7 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. 506890 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. 506950 Triangular fenestrated, serrated jaw forceps, right, 23 cm working length 506952 Triangular fenestrated, serrated jaw forceps, left, 23 cm working length 53

LASER SUBGLOTTISCOPES AND INSTRUMENTATION 522244 522245 507065 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 502599 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 350-400 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. 522244 Adult Female 229 7.3 22.0 x 13.0 11.0 32.0 522245 Adult Male 229 9.5 21.0 x 13.0 12.0 33.0 7.3 22 522244 13 9.5 21 522245 13 Complete Sanders Venturi System listed on pages 8 through 11. REPLACEMENT VENTILATING NEEDLE 502600 14 gauge REPLACEMENT LIGHT CARRIER 527860 For either scope, 522244 and 522245 ASPIRATING TUBE, THUMB VALVE CONTROL Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.), 507065 4 (12 Fr), 35 cm working length, long enough for adult subglottiscopes 43

11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 MILLIMETERS LASER SUBGLOTTISCOPES AND INSTRUMENTATION 44 509302 509303 509304 509305 509306 509307 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). 509301 Operating Platform, 3 509302 Front Surface Mirror, 3 509303 Micro Suction Tube, 6 Fr. 509304 Straight Probe 509305 Grasping Forceps, Straight 509306 Angled Cup Forceps 509307 Straight Scissors 509300 Set of 7 instruments (509301 509307)

LASER SUBGLOTTISCOPES AND INSTRUMENTATION 522242 502600 502599 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 502245. 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 502599 Luer-Lok hub adapter to Sanders tubing. NOMINAL NUMBER LENGTH I.D. DIMENSIONS O.D. CARRIER 522242 155 5.7 18.5 x 10.0 29.0 527830R* 527835L* 5.7 18.5 522242 10 Complete Sanders Venturi System listed on pages 8 through 11. REPLACEMENT VENTILATING NEEDLE For Venturi ventilation on these three subglottiscopes. 502600 14 gauge, angled blunt REPLACEMENT LUER-LOK HUB ADAPTER 502599 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 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 MILLIMETERS LASER SUBGLOTTISCOPES AND INSTRUMENTATION 46 522280 522285 522281 522282 522287 3 11.7 4 12.5 7.9 8 * 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 522280 Ossoff Neonatal Subglottiscope Set* 522281 3 Subglottiscope tube 522282 4 Subglottiscope tube 522283 5 Subglottiscope tube 522284 6 Subglottiscope tube 522285 Handle assembly 2-piece 522286 Sterilizing Tray 522287 Venturi ventilation needle, 20 gauge, with retaining clip 526210 Fiberoptic light carrier Complete Sanders Venturi System listed on pages 8 through 11. 522283 522284 5 11.2 6 11.4 8.5 8.7 Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.),

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 502248, 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

11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 MILLIMETERS LASER LARYNGOSCOPES 38 522290 522292 522291 Laser Laryngoscopes (continued) PILLING-DEDO DOUBLE-ACTION ANTERIOR COMMISSURE LARYNGOSCOPES CLOSED NOMINAL CLOSED NUMBER SIZE LENGTH I.D. DIMENSIONS O.D. CARRIER 522290 Adult 179 13.2 22.0 x 20.0 33.0 527860 522292 Adolescent 136 9.8 21.0 x 26.0 32.0 527863 13.2 22 522290 12.7 22 522291 20 9.8 21 522292 Removable handle for attachment to laryngoscope holder 26 26 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 522291 Adult 178 12.7 22.0 x 26.0 33.0 527860 Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.),

522228 522243 13.4 522228 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 522228 Adult 178 13.4 20.0 x 19.0 32.0 527860 20 12.6 20 522243 19 20 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 522243 Adult 197 12.6 20.0 x 20.0 32.0 527860 Extra Long Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.), 39

11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 MILLIMETERS LASER LARYNGOSCOPES 40 522231 522237 522238 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 522231 Adult 178 11.9 22.0 x 20.0 35.0 527860 522237 Child 130 9.8 18.0 x 18.0 30.0 527863 522238 Adolescent 152 9.7 21.0 x 20.0 33.0 527862 11.9 22 522231 20 9.8 18 522237 18 9.7 21 522238 20 Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.),

522232 522233 LASER LARYNGOSCOPES Laser Laryngoscopes (continued) OSSOFF-KARLAN-JAKO NOMINAL NUMBER SIZE LENGTH I.D. DIMENSIONS O.D. CARRIER 522232 Adult 178 15.6 28.0 x 19.0 38.0 527805R* 527800L* 15.6 28 522232 12.3 22 522233 19 19 * 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 522233 Adult 178 12.3 22.0 x 19.0 35.0 527860 Drawings illustrate Nominal Proximal Internal Dimensions and Minimum Internal Diameter (I.D.), 41

11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 MILLIMETERS LASER LARYNGOSCOPES I A B C G J D E F K H 522229 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 42 522241 522240 502599 502594 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 522229 Adult 177 12.0 19.0 x 19.0 28.0 527586R* 527587L* 12 18.4 522229 19 Ventilating Needles, Adapters and Clips for 522229 are listed below. Complete Sanders Venturi System listed on pages 8 through 11. REPLACEMENT VENTILATING NEEDLES 522241 12" blunt REPLACEMENT CLIPS 522240 For ventilating needles REPLACEMENT ADAPTER 502599 Needle Luer-Lok hub to Sanders tubing VENTURI VENTILATING BLUNT NEEDLES 502594 4" (10.1 cm), 14 gauge 502600 4" (10.1 cm), 14 gauge, bent 90 502596 4" (10.1 cm), 16 gauge 502598P 4" (10.1 cm), 18 gauge 502590 4" (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.),