erbejet® 2 - ERBE Elektromedizin GmbH

W A T E R J E T S U R G E R YE r b E J E T ® 2A new Dimension in Waterjet Surgery:The ERBEJET ® 2 in the VIO System.

Waterjet Surgery –A Sparing Oper ative Procedure.Biological tissue such as organs, connective tissue, vessels or nerves can have very differentcellular structures. Waterjet surgery, a new form of dissection which has beensuccessfully used since several years, separates the different tissue types with theirvarying elasticity and firmness, with the help of precisely adjusted water pressure. Thekinetic energy of the waterjet carefully separates the layers of tissue.In hepatic surgery, for example, the procedure selectively differentiates between liverparenchyma, blood vessels and bile ducts. Soft parenchymal tissue is washed out, whilethe network of blood vessels is preserved and can be subsequently treated with littleloss of blood. The operative time is reduced. In urology the selectivity of the waterjetis used to dissect the prostate from its surrounding tissue. Due to the physical propertiesof biological tissue the jet dissects precisely and anatomically along the marginsbetween the different tissue structures.The advantages of the waterjet procedure which range from tissue selectivity tominimal blood loss open up many different areas of application in almost all surgicalspecialties (cf. pages 4 and 5).Advantages of waterjet surgeryat a glanceShorter operating timesSpares blood vessels, nerves and organsMinimized bleeding, controlled managementof bleedingSelectivityBlood vessels and nerves are preserved due to predefined water pressures,while the surrounding tissue is selectively dissected (example taken fromhepatic surgery).High degree of tissue selectivity duringpreparation and dissection of tissue layersPrecise and intact margins along the lineof dissection, no necrosis of the marginsGood visibility at the operative site due tointegrated irrigation and suctionExpansion effectSeparation of tissue layers, e.g. in radical prostatectomies.2

ERBEJET ® 2 – The New Systems Concept.A powerful team – The waterjet and the electrosurgicalworkstationThe ERBEJET 2 was developed to be compatiblewith the ERBE VIO, with respect to both its sizeand functionality. It can be utilized either as amodule of the VIO system or as an autonomousunit on a cart or on suspension arm system tosave space in the operating room. A combinationof the two surgical procedures bothelectrosurgery and waterjet surgery offers thefollowing advantagesShorter operating times as no change ofinstruments is requiredBoth systems can be accommodated withina very small spaceTransfer of data via the ECB(ERBE Communication Bus)Simple operation via the displayThe ERBEJET 2 has an easy-to-operateuser interface. The parameters can beadjusted according to the individualindications and saved in 9 differentprogram settings. The impact of thewaterjet is avail able as finely adjustablesteps which create reproducibledissection results. And the setting caneven be altered during activation.The interface of the ERBEJET 2 is alsoused to enter the settings for thesuction module ESM 2.The pump unit of the ERBEJET 2 allowscontinuous application of thewaterjet.Separating mediumThe separating medium is a sterilesaline solution. It is connected to thesystem in the form of standard infusioncontainers.Activation is carried out via the footswitch with the ReMode function,which allows the unit settings to becontrolled straight from the operatingtable.ESM 2 Suction moduleThe type of activation and the degreeof suction of the ESM 2 are adjustedvia the interface of the ERBEJET 2.Activation occurs either simultaneousto the application of the waterjet oris switched on as required using thefoot switch. The suction pump can beprogrammed to continue running fora certain time after waterjet is no longeractivated. This ensures a good visibilityat the operative site even afterthe waterjet has been deactivated.3

R ange of Applic ations for the ERBEJET ® 2.Hepatic surgeryDuring resection of the liver the blood vessels and bile ducts areprepared and washed free of surrounding tissue. Depending ontheir size, they can then be either coagulated or selectively treatedusing a ligature/clip. The time required for the intervention isshorter than that of comparable surgical interventions and isreduced even more by the simultaneous use of electrosurgery. Theintraoperative blood loss is also reduced and thus the transfusionrequirements are also lower. A cross-clamping of the blood supplyto the organ (Pringle maneuver) is generally not necessary.Additional advantages:Intact, precise margins of dissectionApplication possible in both laparoscopic and open surgeryUrologyThe selectivity of the waterjet reduces the risk of sexual dysfunctionand/or urinary incontinence in prostatectomy procedures. Bloodvessels and nerve cords remain largely intact during resection of theprostate.As with hepatic surgery, when the waterjet is used to carry out apartial nephrectomy this does not lead to necrosis of the resectionmargins. This helps retain as much of the organ’s functionality aspossible. The renal blood vessels are selectively dissected and cansubsequently be treated individually.Additional advantages:Minimized blood loss, less transfusion requirementsDistinctly shorter operating timesLower rate of complicationsColon surgeryTotal mesorectal excision (TME) is another procedure whichbenefits from the advantages of conserving tissue structures.The selective vessel-sparing dissection of the mesorectumlayer by layer reduces postoperative urinary incontinence andsexual dysfunction.Additional advantages:Preservation of blood vessels and nerve structuresBetter visibility in situ due to gentler preparation4

Gastroenterology* Endoscopic submucosaldissection** Endoscopic mucosalresectionMore safety during ESD* and EMR** procedures with waterjet elevation of themucosa. The separation medium creates a submucosal fluid cushion, elevatingthe mucosal lesion (e.g. early carcinoma). This tissue elevation offers both mechanicaland thermal protection during resection.The instrument for ESD procedures: HybridKnife – offering both electrosurgicaland waterjet surgery functions. All four steps of the resection procedure:marking of the lesion, elevation, incision/dissection, and coagulation – can beperformed without a change of instruments.Additional advantages:Safe resection, as the separation medium can be replenished at any timeSelective elevation of mucosal layersThe advantages of the ERBEJET 2Simple, handy and easy-to-use systemEasy to integrate, compatible with existingsystems Can be combined with the VIO electrosurgicalsystemNo thermal trauma to the margins ofthe incision, the surrounding tissue isleft intactExtremely uniform waterjet; delicate,precise and reproducible effectsIntegrated suction with individuallyadjustable run-on timeErgonomically designed single-useinstruments for immediate use in theoperating roomFoot switch with ReMode function: remotecontrol straight from the operatingtableAreas of applicationfor the ERBEJET 2.Programs can be individually stored5

Rigid and Flexible Applic ators.For Open Surgery and L aparoscopic Interventions.The applicators of the ERBEJET 2 are available as sterile single-use instruments. Theycan be used immediately and offer consistently high standards of quality and safety.Their ergonomic shape and the length of the tubing allow the physician to operatecomfortably with a great degree of freedom.The range of instruments includes both instruments for open surgery and for laparoscopicsurgery – with different shaft lengths and shapes.20150-03820150-02620150-02520150-030ERBEJET probe, flexiblelength 2.2 m, Ø 1.3 mm No. 20150-020Applicator, curved tiplength 183 mm, Ø 5 mm No. 20150-02520150-04120150-020Applicator, curved tiplength 336 mm, Ø 5 mm No. 20150-026Applicator, straightlength 65 mm, Ø 6 mm with suction No. 20150-030Applicator, straightlength 306 mm, Ø 6 mm with suction No. 20150-038Applicator, bayonetlength 90 mm, Ø 2.8 mm with suction No. 20150-041One-pedal foot switch with ReMode No. 20150-101Two-pedal foot switch with ReMode No. 20150-100Pump (single use) No. 20150-3006

Technic al Data.ERBEJET 2 No. 10150-000Supply voltageMains currentFrequencyMains fusePressure generationPressure range with 120μm jet nozzle (± 20%)Volume flow (±10%)Effect settingsActivationWidth x Height x DepthWeightSeparation mediumJet nozzle diameter of the applicators120 – 240 V0,4 – 1,2 A50 Hz / 60 Hz2 x T 3,15 ASterile single-use double piston pump1 – 80 bar (100 – 8000 kPa)1 – 55 ml/minParameters adjusted according to individualspecifications with storage space for 9 program settingsFoot switch410 mm x 130 mm x 370 mm11 kgSterile physiological saline solution120 μmESM 2 Suction module No. 10340-000Max. negative pressure (± 50 mbar)Suction capacity (± 10%)Adjustable from –100 to –800 mbar (sea level)Depends on the setting of max. negative pressure max. 25 l/minClassification of ERBEJET 2 and ESM 2Protective class acc. to EN 60 601-1Type acc. to EN 60 601-1Class acc. to the EC-Directive 93/42/EECICFIIb7

E L E C T R O S U R G E R YV e s s e l S e a l i n ga r g o n - p l a s m a c o a g u l a t i o nC R Y O S U R G E R YW A T E R J E T S U R G E R YERBE Elektromedizin GmbHWaldhoernlestrasse 1772072 TuebingenGermanyPhone +49 7071 755-0Fax +49 7071 755-179sales@erbe-med.dewww.erbe-med.com85150-100 03.10 © ERBE Elektromedizin GmbH 2010