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ART 53 03/2014-E
BITER™
A Compact System for Safe Biceps Tenodesis
BITER™
One Hand Grip to Success
Introduction
Biceps tenodesis is a surgical procedure in which the biceps tendon is arthroscopically
transected (biceps tenotomy) and subsequently fixated with an anchor. To perform this
procedure in a straightforward and atraumatic way, a unique instrument was developed for
easy and safe biceps tenotomy – the BITER™ (BIcepsTEndonReleaser).
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2 3
Product Description
The BITER™ was specially developed for arthroscopic biceps tenotomy.
The instrument can safely grasp and cut the biceps tendon at the same time, preventing the
tendon from slipping during transection.
The BITER™ also enables terminal cutting (as far as the glenoid) which results in minimal
tendon residue in the joint. Fixation of the biceps tendon with the knotless POWERLOCK
PEEK anchor offers a high degree of safety due to its high pull-out strength.
Special Features:
• Combined cutting and grasping instrument
• Anatomic design for optimal use
• Separate versions are available for the left and right shoulders
• No subsequent resection of the biceps tendon required due to terminal cutting
• Fine serration of the jaw prevents the biceps tendon from slipping
• A pin inside the jaw ensures secure grasping of the biceps tendon
• BITER™ can also be used in open surgery
Fig. 1
BITERTM
for use in the left shoulder
Fig. 2
BITERTM
for use in the right shoulder
Example of use
Fig. 3
Step 1
The arthroscopic procedure is
performed using the 3-portal
technique:
1) Posterior portal
2) Anterolateral portal
3) Anteroinferior portal
Fig. 4
Fig. 5
Step 2
The tendon is pulled into the joint
with a palpation hook. This makes
it easier to create an anterolateral
portal in the case of intact interval
structures. The portal is widened to
approx. 1.5 cm (Figs. 4 and 5).
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Fig. 6
Step 3
The BITER™ in closed position is
introduced via a 1.5 cm incision and
passed through the anterolateral
portal (Fig. 6).
Subsequently, the biceps tendon is
threaded (Fig. 7) and the BITERTM is
advanced as far as the biceps tendon
insertion (Fig. 8)
Fig. 7
Fig. 8
Fig. 9
Step 4
The biceps tendon is detached with
the BITERTM, removed from the joint
and the degeneratively changed part
is resected (Figs. 9 and 10).
The end of the biceps tendon is
armed with a baseball stitch suture
(Fig. 11).
Fig. 10
Fig. 11
6 7
Fig. 12
Step 5
After the bone is freshened up with
a burr and the anchor insertion is
prepared with a bone punch, fixation
of the biceps tendon is performed.
The knotless POWERLOCK PEEK
anchor is inserted in the joint with a
rotating motion (Fig. 12). In this way,
the anchor fixates the biceps tendon
in an epiosseous manner.
Any protruding suture material is cut
off (Fig. 13).
Fixation of the biceps tendon with the
POWERLOCK PEEK anchor offers a
high degree of safety due to its high
pull-out strength (Fig. 14).
Fig. 13
Fig. 14
Instrumentation
28184 MSL
B
ITER™, for the arthroscopic, terminal cutting of the biceps tendon, for the left shoulder
28184 MSR
B
ITER™, for the arthroscopic, terminal cutting of the
biceps tendon, for the right shoulder
2870514 CG KARL STORZ POWERLOCK, PEEK Suture Anchor, diameter 5.2 mm, length 14 mm,
with 2 MEGAFIBRE® USP 2 sutures, with inserter, sterile, for single use
2870514 KP Bone Punch, for use with PEEK Suture Anchors
2870514 CG and 2870515 PC
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Notes
Notes
10 11
Notes
It is recommended to check the suitability of the product for the intended procedure prior to use.
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KARL STORZ Endoscopy-America, Inc.
2151 East Grand Avenue
El Segundo, CA 90245-5017, USA
Phone:
+1 424 218-8100
Phone toll free: 800 421-0837 (US only)
Fax:
+1 424 218-8525
Fax toll free:
800 321-1304 (US only)
E-Mail:
[email protected]
96152050 ART 53 03/2014/EW-E
KARL STORZ GmbH & Co. KG
Mittelstraße 8, 78532 Tuttlingen, Germany
Postbox 230, 78503 Tuttlingen, Germany
Phone: +49 (0)7461 708-0
Fax:
+49 (0)7461 708-105
E-Mail: [email protected]
www.karlstorz.com