Aesculap Endoscopic Technology Endoscopic vascular surgery in the pelvic region Aesculap Competence Endoscopic vascular surgery in the pelvic region 2 Design follows challenge The future does not choose the easiest path The protection principle The introduction of the laparoscopic cholecystectomy in 1987 was greeted as a surgical revolution. Now, endoscopic techniques have also entered the previously untouched field of vascular surgery. In addition to endoluminal procedures, interventions are today being performed on the peripheral and central vascular system using videoendoscopic surgical techniques. The main procedures are aortoiliac bypass operations in occlusive arterial disease and aortic aneurysm resections. The concept of using a video-endoscopic extraperitoneal surgical technique to treat aortoiliac occlusive diseases helps to avoid these problems. The minimal tissue traumatisation shortens the period of convalescence and postoperative hospitalisation. Conventional implantation of an aortofemoral or aortabiiliac graft can give rise to massive operative trauma and typical postoperative complications such as a high level of pain, caused for example by impairment of the intestinal motor response as a result of the transperitoneal access to the aorta and the iliac artery, as well as pain-related restriction of respiration. Advancing the frontiers of surgery naturally requires new instrumentation to attain the best possible results in terms of surgical efficiency and patient safety. Aesculap’s wide range of indication-related instruments is the perfect response to the demands of modern endoscopic vascular surgery. Endoscopic vascular surgery offers many possibilities, principally that of the aortobifemoral bypass with patchplasty and direct suture on the iliac vessels, including endoscopic implantation of a bifurcation graft. 3 Aesculap Competence Endoscopic vascular surgery in the pelvic region 4 Design follows challenge Demand does not create design The basic concept in the laparoscopic approach to the vascular system is to use the conventional surgical technique to a very great extent. This is the background against which Aesculap has developed a special range of basic endoscopic instrumentation, consisting of specialised hollow shaft instruments, special temporary vascular clips and clip applicators, based on its successful range of vascular surgical instruments. Initial attempts demonstrated the problem of an action radius within the abdomen that was too small to perform a differentiated reconstruction technique. Thus it was that optimally designed instruments working in perfect harmony with each other became the precondition for advanced video-endoscopic vascular surgery. Set and match? The Aesculap Major Vascular Set has been specially developed as the basic instrumentation for aortoiliac surgery assisted by videoendoscopy. The surgeon is provided with the instruments already familiar from the conventional operating technique, but modified to satisfy the specific requirements of laparoscopy. They are characterised by ergonomically improved transmission of the wrist movements. Among other items, the instrument set includes aortic and iliac vascular clips, adapted needle holders, special scissors, removable vascular clips and vessel spatulas. In addition, the set contains specialised components for laparoscopic surgery, such as locking handles for safe vascular occlusion, low-volume vascular suction and special laparoscopic needle holders to make vascular sutures much easier to perform. The minimally invasive vascular instrument set provides the ideal supplement to Aesculap’s regular, advanced laparoscopy instruments, and makes it possible to conduct procedures such as totally laparoscopic aortic aneurysm resection or laparoscopically assisted endovascular stenting efficiently as well as video-assisted minilaparotomy. The end result is a modern set of instruments that allows the laparoscopic vascular surgeon to safely perform basic and advanced vascular surgery procedures. 5 The Major Vascular Set, practice-orientated instrument design: The technology of manoeuvrability 6 Design follows challenge Ideal conditions One of the Major Vascular Set’s crucial advantages is that the instrumentation can be completely disassembled, totally satisfying all hygiene requirements. The instruments are easy to take apart, ensuring that individual components can be quickly exchanged if necessary. This lengthens the instruments’ useful life. Furthermore, the modular design means that the surgeon can construct his or her ideal instrument. If the standard solution provided in the instrument programme does not correspond to the surgeon’s individual preferences, he or she can put together a personal set of instruments from the individual components. All the instruments are designed with a shaft length of at least 310 mm. This gives them optimum manoeuvrability with a 1:1 ratio between the intra- and extra-corporeal section of the shaft. Thus the centre of gravity of the instrument at its entry into the abdominal wall lies roughly in the middle of the shaft, with the degree of movement at the instrument handle corresponding to the transfer of the function to the instrument tip. Thanks to this minimum length, the instrument tips can meet at an angle of 40 –180° in an abdominal cavity expanded with CO2 from nearly any entry point. The position of the optic trocar in relation to the other working trocars forms an isoceles triangle, with the two equal sides at least 10 cm long. This provides maximum freedom of movement during preparation and suturing. 7 Further developments in instrument design Competencies brought to the point Together with one of the initiators of endoscopic vascular surgery in Germany, Prof. Dr. Samir Said in Koblenz, Aesculap has developed a complete range of instrumentation for this new operating technique. Four years were spent in intensive development, including animal trials, from the original idea in 1992 to the first surgical intervention on a human patient using the instruments created during this development period. The result is a set of basic instrumentation to meet the requirements of video-endoscopically orientated vascular surgeons in their daily practice. Right from the beginning, highly specialised instrumentation is primarily responsible for the success and future development of this operating technique. Developed in co-operation with: Prof. Samir Said, M.D. Ev. Stift St. Martin Abt. für Viszeral- und Gefäßchirurgie Johannes-Müller-Str. 7 56068 Koblenz 8 Endoscopic angled scissors Endo vascular scissors with angled (45°) blades have been created in particular to achieve good laparascopic access to the retroperitoneal vessels which run nearly parallel to the abdominal wall, while avoiding damage to the rear wall. The angled vascular scissors are used for arteriotomy after the incision has already been made with the retractable scalpel and blade holder described. These vascular scissors are similar to the conventional Potts-de-Martell angled vascular scissors. Needle holder The laparascopic needle holder has undergone a complex development process. Its main characteristic is the swan’s neck curvature which makes it easier to hold the first knot. Whereas the needle holding surface of the lower jaw is concave, the upper needle holding surface has been designed with transverse serrations. This ensures that the needle aligns itself at 90° to the instrument jaw. Endo suture grasping forceps A special endo suture grasping forceps has been developed to reduce micro-traumatisation of the suture and the vessels. The forceps is used as a combination instrument during vessel suture, on the one hand to grasp the thread and tissue, on the other hand to receive the needle. Satinsky Clamp The Satinsky clamp, with its conventional, double angled jaw presupposes the use of flexible trocars. The angles of the jaw are designed on the one hand to allow the instrument to be introduced into the abdominal cavity through a 12 mm trocar, and on the other hand to permit both the aorta and the iliac vessels to be clamped off tangentially over the longest possible area. The clamp’s shape guarantees good vision into the vessel lumen, permitting a precise suturing technique Endo clip forceps and temporary vascular clips The development of an endo clip applicator, an endo with the appropriate stitching direction, despite the fact that the side walls are pressed closely against each other through the tangential clamping of the vessel. clip remover and temporary vascular clips has introduced a fundamentally new method of working in laparoscopic vascular surgery. Thus, once the selfholding vascular clips have been applied, a trocar can be freed to receive other instruments which serve an active function, such as preparation, suturing or temporary tissue fixation. 9 Special instrumentation The elevated art of the peripheral A very important contribution to the development of special endoscopic clips was made by the French surgeon Prof. Dr. Yves S. Alimi. Since 1999, he and Aesculap have been cooperating in the development of additional instruments for videoendoscopic vascular surgery. Developed in co-opertation with: Prof. Yves S. Alimi, M. D. 10 Vascular clamps Additional and auxiliary instruments have an important part to play alongside specialised basic instrumentation in minimally invasive vascular surgery. For example, one particular problem in videoendoscopic vascular surgery was caused at first by using conventional vascular clamps which were too weak to close the aorta. The jointly designed clamps can be used for both transperitoneal and retroperitoneal access to the aorta. Reconstruction made easier Another very important precondition for a sound vascular surgery technique is adequate exposure of the operating site to allow fast and accurate reconstruction. Various retractors and hooks which can be angled inside the body are available for this purpose. Vessel spatulas have been designed for the mobilisation of endoluminal structures. These are once again on a par with the conventional models. 11 Basic instrumentation for videoendoscopic vascular surgery in the pelvic region The basic instrumentation for videoendoscopic vascular surgery is of modular construction and is based on the AdTec monopolar range. This means that every jaw part can be combined with every handle according to the user’s requirements. 12 Scissors 1:1 METZENBAUM Scissors, serrated, tips curved to the left with carbide inserts Instrument complete Jaw inserts Insulated outer tube PO004R PO603R PM973R PO950R Handle PM710R PM973R PO950R PO682R PM992R PO950R Working length 310 mm, diam. 5 mm 1:1 MINI-METZENBAUM Scissors, serrated, tips curved to the left with carbide inserts, PEEK insulation of the distal shaft Working length 310 mm, diam. 5 mm 1:1 POTTS-de MARTELL acc. to Said Endo vessel scissors PO014R Working length 310 mm, diam. 10 mm Protection Sleeve in combination with PO014R for a safe introduction of the Potts-DeMartell scissors through the 12.5 mm trocar PM941R 13 Basic instrumentation for videoendoscopic vascular surgery in the pelvic region For more information please also ask for our brochure C 766 14 Dissecting Forceps 1:1 MARYLAND Fixation and dissecting forceps, curved Instrument complete Jaw inserts Insulated outer tube Handle PO608R PM973R PO950R PM659R PM973R PM954R PO141R PO661R PM975R PO950R PO103R PO606R PM975R PO950R PO189R PO734R PM973R PO950R PO102R Working length 310 mm, diam. 5 mm 1:1 OVERHOLT Dissecting clamp Working length 310 mm, diam. 5 mm 1:1 OVERHOLT Dissecting clamp, 60° Working length 310 mm, diam. 10 mm 1:1 OVERHOLT Dissecting clamp, 90° Working length 310 mm, diam. 10 mm 1:1 MASSOUD Delicate forceps for lateral fixation of structures and vascular grafts during dissection and anastomosis Working length 310 mm, diam. 5 mm for use with flexible trocars only diam.12.5 mm 15 Basic instrumentation for videoendoscopic vascular surgery in the pelvic region The basic instrumentation for videoendoscopic vascular surgery is of modular construction and is based on the AdTec monopolar range. This means that every jaw part can be combined with every handle according to the user’s requirements. 16 Grasping Forceps 1:1 Modell BABCOCK Tissue-grasping forceps Instrument complete Jaw inserts Insulated outer tube Handle PO741R PM977R PO951R PM651R PM977R PO951R PM172R PM712R PM992R PM957R PO118R PO624R PM977R PO951R PM689R PM973R PM957R PO196R Working length 370 mm, diam. 10 mm 1:1 DE BAKEY Atraumatic clamp, jaw length: 30 mm Working length 370 mm, diam. 10 mm 1:1 DE BAKEY Atraumatic clamp, length of jaw: 50mm Working length 220 mm, diam. 10 mm 1:1 DE BAKEY Atraumatic clamp, length of jaw: 50mm Working length 370 mm, diam. 10 mm 1:1 DE BAKEY acc. to. LINDER Atraumatic fixation forceps, s-shaped Working length 310 mm, diam. 5 mm 17 Basic instrumentation for videoendoscopic vascular surgery in the pelvic region 38 mm m 51 For more information please also ask for our brochure C 766 18 m Grasping Forceps 1:1 CRAFOORD Endo-vascular clamp Instrument complete Jaw inserts Insulated outer tube Handle PM173R PM713R PM973R PM957R PO152R PO684R PM976R PO951R PM171R PM711R PM973R PM957R Working length 310 mm, diam. 5 mm 1:1 CRAFOORD Endo-vascular clamp Working length 370 mm, diam. 5 mm 1:1 SATINSKY Atraumatic clamp Working length 310 mm, diam. 5 mm for use with flexible trocars only 1:1 SATINSKY Atraumatic clamp PM616R PM973R PM957R Working length 310 mm, diam. 5 mm for use with flexible trocars only 1:1 HEINEN Atraumatic clamp for parallel clamping of the aorta and lumbar vessels PM715R PM977R PM957R Working length 370 mm, diam. 10 mm 19 Basic instrumentation for videoendoscopic vascular surgery in the pelvic region For more information about our axial AdTec needle holder please also ask for brochure C 004 11 20 Needleholder Instrument complete Jaw inserts Insulated outer tube Handle 1:1 SAID DUROGRIP Needle holder, crimped PO553R PO662R PM992R PO951R Working length 310 mm, diam. 10 mm 1:1 DUROGRIP Needle holder, straight PL407R Working length 310 mm, diam. 5 mm 1:1 DUROGRIP Needle holder, curved left PL408R Working length 310 mm, diam. 5 mm 1:1 DUROGRIP Needle holder, curved left PL412R Working length 310 mm, diam. 10 mm 1:1 Thread-guiding tube acc. to SAID for modular endoscopic needle holder with diam. 5 mm only, suitable for intracorporal, continuous ligature techniques, with integrated thread-guiding tube diam. 1mm and thread-fixating device 5/10 mm PM972P Thread -guiding tube 310 mm clamping yoke Mandrin 21 Special instrumentation for videoendoscopic vascular surgery in the pelvic region 60 m m 73 m m 60 mm For improved force transfer, the vascular clamps of the supplementary instruments are of non-modular construction. The instruments have a rinsing port for cleaning. Since the instruments are practically never exchanged during surgery, they can be used directly transcutaneously. 22 Vascular Clamps diam. Length Total length 1:1 SATINKSKY, acc. to ALIMI Atraumatic distal and proximal clamp, for clamping the area of the anastomosis. PL210R 10 mm 360 mm 516 mm 1:1 SATINKSKY, acc. to ALIMI Atraumatic distal and proximal clamp, for clamping the area of the anastomosis. PL211R 10 mm 375 mm 531 mm 1:1 DE BAKEY, acc. to EDOGA Atraumatic proximal clamp. The design of the curved jaw fulfils the requirements while clamping the calcified aorta. PL212R 10 mm 365 mm 521 mm 23 Special instrumentation for videoendoscopic vascular surgery in the pelvic region 73 mm 79 mm m 80 m 80 mm For improved force transfer, the vascular clamps of the supplementary instruments are of non-modular construction. The instruments have a rinsing port for cleaning. Since the instruments are practically never exchanged during surgery, they can be used directly transcutaneously. 24 60 mm Vascular Clamps diam. Length Total length 1:1 DE BAKEY, mod. ALIMI Atraumatic distal clamp, for parallel clamping of the aorta and lumbal vessels. PL213R 10 mm 335 mm 491 mm 1:1 DE BAKEY, mod. ALIMI Atraumatic proximal and distal clamp. The curvage allows extended space for the anastomosis of the graft. PL214R 10 mm 355 mm 508 mm 1:1 DE BAKEY, mod. ALIMI Atraumatic proximal and distal clamp, jaws 10° angled PL215R 10 mm 341 mm 496 mm 1:1 DE BAKEY Atraumatic vascular clamp, straight shaft with straight jaw PL216R 10 mm 295 mm 530 mm 1:1 DE BAKEY Atraumatic vascular clamp, straight shaft with curved jaw PL217R 10 mm 310 mm 504 mm 25 Special instrumentation for laparoscopicassisted surgery in the pelvic region 26 Vascular Clamps 1:1 RYDER, mod. SAID Strong needle holder, length 330 mm PL090R 1:1 SATINSKY, mod. SAID Atraumatic clamp, ratchet could be locked, length 375 mm PL091R 1:1 SATINSKY, mod. SAID Atraumatic clamp, ratchet could be locked, length 370 mm PL092R 1:1 DE BAKEY, mod. SAID Atraumatic clamp, ratchet could be locked, length 330 mm PL093R 1:1 CRAFOORD, mod. SAID Vascular clamp, ratchet could be locked, length 360 mm PL094R 27 MÜLLER BT 626 R Retractor, 250 x 30 mm/60 mm 28 Instruments, long patterns 1:1 MÜLLER DUROGRIP Needleholder, length 360 mm BM089R 1:1 MÜLLER DUROGRIP Needleholder, length 350 mm BM106R 1:1 MÜLLER DUROGRIP Suture forceps, length 300 mm BD185R 1:1 Atraumatic forceps, length 350 mm FB409R 1:1 DUROTIP Fadenschere, length 360 mm BC298W 29 Special instrumentation for videoendoscopic vascular surgery in the pelvic region Atraumatic endo-vessel-clips acc. to SAID (temporary) Cat. No. Closing force Jaw length Jaw shape Colour coding PL550S 250 g 25 mm straight gold PL552S 300 g 45 mm straight gold PL555S 350 g 25 mm straight – PL557S 450 g 45 mm straight – Cat. No. Closing force Jaw length Jaw shape PL580S 200 g 25 mm curved gold PL582S 300 g 45 mm curved gold PL585S 350 g 25 mm curved – PL587S 450 g 45 mm curved – Colour coding Venous endoscopic vessel clips with reduced closing force are especially marked at the end (gold). 30 Clip forceps PL502R Applicator for endo vessel clip acc. to SAID 12.5 mm 350 mm PL507R Removal forceps for endo vessel clip acc. to SAID 12.5 mm 350 mm 31 Additional instrumentation for videoendoscopic vascular surgery in the pelvic region diam. Scalpel handle for knife blades BB060R length included blade, blade retractable 5 mm 330 mm Blades must be ordered separately Suture hook BB361R package of 10 pieces, sterile BB362R package of 10 pieces, sterile BB363R package of 1 piece, sterile BB364R package of 10 pieces, sterile BB365R package of 10 pieces, sterile BB367R package of 10 pieces, sterile BB369R package of 1 piece, sterile diam. Shaft length PO193R 5 mm 330 mm PL 432 R 5 mm 310 mm 1 mm 4,8 mm Knot guide instrument Intracorporal knot pusher according to Kuthe 1 ⁄1 32 diam. Endo-dissector to get around vessels PL669R 5 mm 310 mm Endo vessel spatula PL657R 5 mm Dissection spatula, semi-sharp PL659R 5 mm Retraction instrument for fine structures. PL661R 5 mm 400 mm Proximal instrument end can be manually angled (30°, 45°, 75°, 90°) PL662R 10 mm 400 mm Spreadable retractor PL680R 10 mm 310 mm Retraction instruments for holding away organs and tissue structures, with one-hand operation for easy activation or release of the retention mechanism 33 Flexible trocars for curved instruments and for special jaw types Flexible Trocars complete 100 mm length (with valve and obturator) Ø 7 mm Ø 12.5 mm For more information please also ask for our brochure C 357 34 EJ800R EJ820R for the use of curved instruments with diam. 5 mm for the use of curved instruments with diam. 10 mm Rigid trocars with silicone flap valve MIT Trocar System Standard Trocar complete 110 mm length (without obturator) Ø 5.5 mm Ø 10 mm EJ701R EJ751R Ø 12.5 mm EJ771R with insufflation connection Obturator, 110 mm length Ø 5 mm Ø 10 mm Ø 12 mm EJ715R EJ755R EJ785R Triangular EJ716R EJ756R EJ786R Sharp EJ718R EJ558R EJ788R Blunt 35 Equipment and endoscopes for minimal invasive surgery The Aesculap Visual System offers impressive, true to life reproduction as well as all the advantages one would expect of a modern digital system. The high quality components, such as the digital camera, endoscope and light source, are perfectly coordinated to produce the best possible picture. For more information please also ask for our brochure C 467 36 Visual System / Units Endoscopes Cat.-No. Direction of view diam. Length ● autoclavable up to 134°C , 2 bar Full screen image ● Integrated rod lens system ● Steris/Sterrad compatible PE889A PE909A PE969A 0° 30° 45° 10 mm 10 mm 10 mm 33 cm 33 cm 33 cm - 3 Chip-Camera with digital SDI video signal output PV420 PAL System PV422 NTSC System ● consisting of: Camera control unit, camera head and RGB video signal cables Accessories: PV122S, Endolens, f = 25-50mm, focusable PV123S, Endolens, f = 30 mm, focusable Xenon Light Source OP930 180 W Accessories: Light guide cable, autoclavable, diam. 4.8 mm: OP906 OP913 OP914 Length: 180 cm Length: 250 cm Length: 350 cm Medical Monitors PV939 PV937 PV915 PV919 PAL, NTSC, PAL, NTSC, PAL, NTSC, PAL, NTSC, 14“ (34 cm), CRT Monitor 20“ (51 cm), CRT Monitor 15“ (38 cm), Flat Screen Monitor 19“ (49 cm), Flat Screen Monitor 37 Uni-Graft® K DV ...the safe choice Uni-Graft® K DV, Giemsa, Mag. 100 x. Uni-Graft® K DV offers all you would expect from a safe and reliable vascular prostheses. Over many years Uni-Graft® K DV has been used in hundred thousands of patients, for thoracic, abdominal and peripheral indications, all over the world. The clinical records are proof of an outstanding performance. 38 Vascular protheses Uni-Graft® K DV Dog, Uni-Graft® K DV, 2 weeks, Giemsa, Mag. 340 x. Dog, Uni-Graft® K DV, 24 hours, Giemsa, Mag. 200 x. Uni-Graft® K DV shows uncompromised healing. A polyester double velour warp-knit construction ensures good graft incorporation in the surrounding tissue at the site of implantation. The unique Uni-Graft® gelatin impregnation makes the prostheses absolutely impermeable to blood. The gelatin used for the impregnation is a less thrombogenic material. It is cross-linked in a patented procedure without the use of formaldehyde or glutaraldehyde resulting in a non-cytotoxic and biocompatible implant. The porous knit permits ingrowth of cells and ensures integration with the surrounding tissue. The inner velour provides the basis for a firm adhesion of the developing neointima. In the initial phase after implantation a fine fibrin layer covers the inner surface of the prostheses. This natural fibrin film provides the initial interface between the blood and the prosthetic wall. It also is the basis for the formation of a stable inner capsule which in clinical conditions in most cases is the final blood contact surface. With Uni-Graft® K D the gelatin will be infiltrated already two weeks after implantation by myofibroblasts. No white blood cells are present, proving that the gelatin is absorbed without any immunological response or hypersensitivity. 39 Vascular protheses Uni-Graft® K DV Uni-Graft® product range Further sizes and configurations are available upon request. Please contact your local representative. Sale in Germany through BBD Aesculap GmbH only. 40 Bifurcations, usable length 40 cm Cat. No. 12 x 6 mm diameter 110 4535 12 x 7 mm diameter 110 4519 14 x 7 mm diameter 110 4527 14 x 8 mm diameter 110 4551 16 x 8 mm diameter 110 4560 16 x 9 mm diameter 110 4578 18 x 9 mm diameter 110 4586 18 x 10 mm diameter 110 4594 20 x 10 mm diameter 110 4608 20 x 11 mm diameter 110 4616 22 x 11 mm diameter 110 4624 24 x 12 mm diameter 110 4640 Straight tubes, usable length 15 cm Cat. No. 10 mm diameter 110 1102 12 mm diameter 110 1129 14 mm diameter 110 1145 16 mm diameter 110 1161 18 mm diameter 110 1188 20 mm diameter 110 1200 22 mm diameter 110 1226 24 mm diameter 110 1242 Straight tubes, usable length 30 cm Cat. Nr. 10 mm diameter 110 2109 12 mm diameter 110 1137 14 mm diameter 110 4144 16 mm diameter 110 4160 18 mm diameter 110 4187 20 mm diameter 110 4209 22 mm diameter 110 4225 24 mm diameter 110 4241 41 The new polyester generation specially designed for vascular surgery Braided and coated, non-absorbable suture made of polyester Needle length mm HR Thread length cm 5/0 USP metric 4/0 3/0 1 1,5 2 45 C0026009 C0026010 C0026029 C0026030 C0026843 C0026844 C0026845 C0026004 C0026005 HR 10 1/2 circle round bodied needle green HR 13 45 green 2xHR 13 75 green HR 17 75 green 2xHR 17 75 C0026804 green 2xHR 17 90 C0026903 C0026904 C0026905 C0026024 C0026025 green HR 22 75 green 2xHR 22 Further sizes and configurations are available upon request. Please contact your local representative. 90 C0026731 green 2xHR 26 HR 26 75 C0026014 2xHR 26 75 Sale in Germany through BBD Aesculap GmbH only. C0026015 green C0026738 green 2xHR 26 90 C0026814 C0026815 green HR 30 75 C0026056 green HRT 2xHRT 17 1/2 circle round bodied needle with trocar point 2xHRT 17 Pledgets 3x3 mm 8x75 MULTI PACK green/white Pledgets 7x3 mm 8x75 MULTI PACK green/white M0027787 M0027788 2xHRT 17 90 green 42 C0026413 C0026414 C0026415 PremiCron® green/white Needle length mm HRT 2xHRT 22 1/2 circle round bodied needle with trocar point 2xHRT 22 Thread length cm Pledgets 3x3 mm 8x75 MULTI PACK green/white Pledgets 7x3 mm 8x75 MULTI PACK green/white 5/0 USP metric 4/0 3/0 1 1,5 2 M0027797 M0027798 HRT 26 75 C0026335 green 2xHRT 26 75 C0026435 green 2xHRT 26 90 C0026445 green DR 2xDR 8 45 3/8 circle round bodied needle C0026822 green 2xDR 8 45 C0027822 white DR 12 45 C0026121 green 2xDR 12 75 C0026853 C0026854 green DR 18 75 C0026104 green 2xDR 18 75 C0026863 C0026864 C0026865 green 2xDR 18 90 C0026858 green DRT DRT 12 75 3/8 circle round bodied needle with trocar point C0026327 green DRT 18 75 C0026343 C0026344 C0026345 C0026484 C0026485 green 2xDRT 18 75 green C Box of 36 units B Box of 24 units G Box of 12 units M Box of 6 multipacks 43 The perfect combination for vascular sutures Monofilament, non-absorbable material made of blue polypropylene Needle length mm HR 5/0 USP metric 4/0 3/0 1 1,5 2 Thread length cm 75 C0090500 75 C0090954 HR 13 1/2 circle round bodied needle 2xHR 13 2xHR 13 90 C0090750 HR 17 75 C0090012 C0090013 C0090014 90 C0090901 C0090902 C0090903 75 C0090029 C0090030 90 C0090976 C0090977 75 C0090040 C0090041 90 C0090907 C0090908 2xHR 17 HR 22 2xHR 22 HR 26 2xHR 26 DR DR 12 3/8 circle round bodied needle 75 C0090530 75 C0090917 2xDR 12 DR 18 75 Further sizes and configurations are available upon request. Please contact your local representative. Sale in Germany through BBD Aesculap GmbH only. 44 C0090120 2xDR 18 90 C0090919 C0090920 C Box of 36 units B Box of 24 units G Box of 12 units M Box of 6 multipacks Premilene®. Thread quality you can rely on. Needle length mm HRT 5/0 USP metric 4/0 3/0 1 1,5 2 75 C0090312 C0090313 90 C0090925 C0090926 Thread length cm HRT 17 1/2 circle round bodied needle with trocar point 2xHRT 17 C0090927 HRT 22 75 C0090325 90 C0090935 2xHRT 22 C0090936 2xHRT 26 90 DRT C0090937 DRT 12 3/8 circle round bodied needle with trocar point 75 C0090307 75 C0090764 75 C0090319 2xDRT 12 DRT 18 C0090320 C0090321 90 C0090945 C0090946 75 C0090533 0090534 2xDRT 18 DRT 26 2xDRT 26 90 HRC C0090949 2xHRC 17 1/2 circle round bodied needle with short cutting tip 2 90 C0090570 C0090571 2xHRC 22 90 DRC 3/8 circle round bodied needle with short cutting tip C0090580 C0090581 DRC 12 75 C0090551 45 Aesculap competence The knowledge advantage – conquer the future with competence Complications having far reaching consequences can only be avoided by using an endoscope and sophisticated instrumentation to make surgery to the aortoiliac vessels as non-traumatic as possible if the surgeon and the operating team performing the endoscopic procedure have truly mastered this new technique. Both theoretical and practical training in the videoendoscopic treatment of aortoiliac vessels, which is still in an experimental phase, is therefore absolutely essential. In modern and architecturally interesting surroundings, you can absorb yourself in current topics, learning or perfecting the latest operating techniques, for instance in laparoscopy, gynaecology, endoscopic vascular surgery or neuroendoscopy. Our programme of courses is directed both to beginners in the various techniques and to the experienced surgeon who wishes to become familiar with more advanced endoscopic methods. The AESCULAPIUM, the new forum for communication in medicine, offers all technical possibilities for workshop demonstrations of new operating techniques and highlights in medical technology as they are used in practice, and for transmitting operations by satellite into the AESCULAPIUM auditorium. 46 Video conferences can be staged at any time. Exchanges of experience and interdisciplinary dialogue with recognised international leaders of opinion are regular items in the AESCULAPIUM’s calendar of events. You can request the current programme of events offered by the AESCULAP AKADEMIE GmbH by telephone (++49(0)7461-95-2001) or via the Internet under www.aesculap-akademie.de. Visit our homepage Dry practice sessions: clamping off, cutting, suturing - the endoscopic method demands from the surgeon a totally different handling technique. 47 All it takes to operate. Aesculap AG & Co. KG All rights reserved. Technical alterations are possible. This leaflet may be used for no other purposes than offering, buying and selling of our products. No part may be copied or reproduced in any form. In the case of misuse we retain the rights to recall our catalogues and pricelists and to take legal actions. Brochure No. C 365 02 Am Aesculap-Platz 78532 Tuttlingen Phone +49 7461 95-0 Fax +49 7461 95-2600 www.aesculap.de 1204/2.0/5
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