THE ERBEJET® 2 IN THE VIO SYSTEM. - Elmed

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 Water Jet Surgery:The ERBEJET ® 2 in the VIO System.Perfection for Life

Water Jet Surgery –A Sparing Operative Procedure.Biological tissue such as organs, connective tissue, vessels or nerves can have verydifferent cellular structures. Water jet surgery, a new form of dissection whichhas been successfully used since several years, separates the different tissue typeswith their varying elasticity and firmness, with the help of precisely adjustedwater pressure. The kinetic energy of the water jet carefully separates the layersof tissue.In hepatic surgery, for example, the procedure selectively differentiates betweenliver parenchyma, blood vessels and bile ducts. Soft parenchymal tissue is washedout, while the network of blood vessels is preserved and can be subsequentlytreated with little loss of blood. The operative time is reduced.In urology the selectivity of the water jet is used to dissect the prostate fromits surrounding tissue. Due to the physical properties of biological tissue thejet dissects precisely and anatomically along the margins between the differenttissue structures.The advantages of the water jet procedure which range from tissue selectivityto minimal blood loss open up many different areas of application in almost allsurgical specialties (cf. pages 4 and 5).Advantages of water jet surgery at a glanceShorter operating timesSpares blood vessels, nerves and organsMinimized bleeding, controlled managementof bleedingHigh degree of tissue selectivity duringpreparation and dissection of tissue layersSelectivityBlood vessels and nerves are preserved due to predefinedwater pressures, while the surrounding tissue is selectivelydissected (example taken from hepatic surgery).Precise and intact margins along the line ofdissection, no necrosis of the marginsGood visibility at the operative site due tointegrated irrigation and suctionExpansion effectSeparation of tissue layers, e.g. in radicalprostatectomies.2

ERBEJET ® 2 – The New Systems Concept.A powerful team – The water jet and theelectrosurgical workstationThe ERBEJET 2 was developed to becompatible with the ERBE VIO, withrespect to both its size and functionality.It can be utilized either as a module ofthe VIO system or as an autonomous uniton a cart or on suspension arm system tosave space in the operating room.A combination of the two surgicalprocedures both electrosurgery andwater jet surgery offers the followingadvantagesShorter operating times as no changeof instruments is requiredBoth systems can be accommodatedwithin a 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 the water jet isavailable as finely adjustable stepswhich create reproducible dissectionresults. And the setting can even bealtered during activation.The interface of the ERBEJET 2 is alsoused to enter the settings for thesuction module ESM 2.The pump of the ERBEJET 2 allowscontinuous application of the water jet.Separating mediumThe separating medium is a sterile salinesolution. It is connected to the system inthe form of standard infusion containers.Activation is carried out via thefoot switch with the ReModefunction, which allows the unitsettings to be controlled straightfrom the operating table.ESM 2 Suction moduleThe type of activation and the degree ofsuction of the ESM 2 are adjusted via theinterface of the ERBEJET 2. Activationoccurs either simultaneous to theapplication of the water jet or is switchedon as required using the foot switch.The suction pump can be programmedto continue running for a certain timeafter waterjet is no longer activated. Thisensures a good visibility at the operativesite even after the water jet has beendeactivated.3

Range of Applications for the ERBEJET ® 2.Hepatic surgeryDuring resection of the liver the blood vessels and bileducts are prepared and washed free of surroundingtissue. Depending on their size, they can then be eithercoagulated or selectively treated using a ligature/clip.The time required for the intervention is shorter than thatof comparable surgical interventions and is reduced evenmore by the simultaneous use of electrosurgery.The intraoperative blood loss is also reduced and thus thetransfusion requirements are also lower. A cross-clampingof the blood supply to the organ (Pringle maneuver) isgenerally not necessary.Additional advantages:Intact, precise margins of dissectionApplication possible in both laparoscopic and opensurgeryUrologyThe selectivity of the water jet reduces the risk of sexual dysfunctionand/or urinary incontinence in prostatectomy procedures. Blood vesselsand nerve cords remain largely intact during resection of the prostate.As with hepatic surgery, when the water jet is used to carry out a partialnephrectomy this does not lead to necrosis of the resection margins. Thishelps retain as much of the organ’s functionality as possible.The renal blood vessels are selectively dissected and can subsequently betreated individually.Additional advantages:Minimized blood loss, less transfusion requirementsDistinctly shorter operating timesLower rate of complicationsColon surgeryTotal mesorectal excision (TME) is another procedurewhich benefits from the advantages of conserving tissuestructures. The selective vessel-sparing dissection of themesorectum layer by layer reduces postoperative urinaryincontinence and sexual dysfunction.Blood vessels and nerve structures in the pelvis arelargely preserved.4

NeurosurgeryPrecise preparation and dissection along the margins betweenthe tumor and cerebral structures. Tumor resection is selectivewithout trauma to healthy cerebral parenchyma and nervestructures are preserved. There is no necrosis along the marginsof the resected area.Potential indications in neurosurgery:GliomasMetastasesEpileptic surgeryOrthopedic surgeryIn percutaneous discotomyprocedures for herniated disks thesoft core tissue is selectively dissectedfree without damage to thesurrounding structures such as theannulus fibers or nerve tissue.The postoperative rate ofcomplications is lower.The advantages of the ERBEJET 2Simple, handy and easy-to-use systemEasy to integrate, compatible with existingsystemsCan be combined with the VIO electrosurgicalsystemNo thermal trauma to the margins of theincision, the surrounding tissue is left intactExtremely uniform water jet; delicate, preciseand reproducible effectsIntegrated suction with individually adjustablerun-on timeErgonomically designed single-use instrumentsfor immediate use in the operating roomFoot switch with ReMode function: remotecontrol straight from the operating tablePrograms can be individually storedAreas of applicationfor the ERBEJET 2.5

Technical Specifications. Order Numbers.ERBEJET 2 No. 10150-000Supply voltageMains currentFrequencyMains fusePressure generation120 – 240 V0,4 – 1,2 A50 Hz / 60 Hz2 x T 3,15 Asterile single-use double piston pumpPressure range with 120μm jet nozzle (± 20%)1 – 80 bar (100 – 8000 kPa)Volume flow (±10%)Effect settingsActivationWidth x Height x DepthWeightSeparation medium1 – 55 ml/minParameters adjusted according to individualspecifications with storage space for 9 programsettingsFoot switch410 mm x 130 mm x 370 mm11 kgsterile physiological saline solutionJet nozzle diameter of the applicators 120 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 pressuremax. 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

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