VITOM® A Unique Visualization System for

Vaginal Hysterectomy in the Operating Room

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The VITOM® System for your Exoscopy in the Operating Room

Dear Colleagues,

When feasible, the vaginal approach is the preferred approach to the benign hysterectomy because

it provides the patient with faster recovery and less complications. Despite evidence, however,

vaginal hysterectomies performed are not yet accepted widely because of the surgical challenges in

performing the procedure. These challenges include difficulties in exposure, visualization and lack

of adequate training.

In my opinion, the Vitom 90 degree scope is essential in facilitating safety, efficiency and teaching in

vaginal surgery because it:

· provides superior lighting when working in a deep space

· allows simultaneous projection to an overhead external monitor as in laparoscopy and robotics so that

surgical assistants can visualize to better facilitate the procedure. In addition, the Anesthesia and OR

team are able to anticipate the next steps for flow and efficiency

· creates an opportunity to film and record the procedure for teaching, which can otherwise be difficult in

vaginal surgery.

Yours,

Dr. Rosanne Kho

Columbia University Medical Center Division of Gynecologic Surgery Assistant Professor of Obstetrics and Gynecology Section Director, Urogynecology Co-Director, MIGS Fellowship Program

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Use of the System The VITOM® telescope is an exoscope which, unlike an endoscope, is not inserted into the body but placed at a working distance of 25-75 cm above the surgical field. The VITOM® system can be used in the OR for the visualization and documentation of vaginal hysterectomy procedures. In addition, the VITOM® system greatly enhances image quality through the features of the KARL STORZ IMAGE1 S video platform.

Enhanced visualization and illumination using VITOM® with CLARA enhancement for Vaginal Hysterectomy procedures.

Depth of field, illumination, magnification, and excellent color reproduction play a decisive role in vaginal hysterectomy. The VITOM® visualization system with CLARA image enhancement is perfectly suited to fulfilling these requirements.

Compatibility of the VITOM® SystemThe VITOM® system, consisting of the VITOM® telescope and a holding system, can be used with a standard KARL STORZ endoscopy tower (cf. p. 8).

The camera components can be used for laparoscopic and endoscopic interventions i.e., cystoscopy following a vaginal hysterectomy.

New TechnologyConventional Visualization Experience

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VITOM®

The already established generation of VITOM® 0˚ telescopes is extremely useful for the visualization and documentation of a variety of open procedures and delivers brilliant image quality.

The second generation expands the first-generation VITOM® telescopes with a 90˚ version which enables a more ergonomic positioning, especially for gynecological procedures.

For the vaginal hysterectomy procedure, the VITOM® 90˚ telescope is suggested to be arranged vertically. This provides the surgeon with a comfortable working environment and more freedom of movement.

The VITOM® 90˚ telescope has a fully integrated illuminator. This integrated illuminator, with two condensor lenses, delivers considerably more light and ensures optimal illumination of the surgical site.

Vaginal Hysterectomy procedure image capture using VITOM® Exoscope and CLARA enhancement.

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KARL STORZ Mechanical Holding Arm Product Characteristics:

• rotating rail clamp allows for optimal positioning for angle

• adjustable extension rod allows for optimal positioning for distance

• Ball Joint Clamp allows fast and easy corrections during surgery

• mounting on bed rail does not require additional footprint

Versatile and adaptable

The KARL STORZ Mechanical Holding Arm with the Extension Rod and Ball Joint Clamp allow the VITOM® 90˚ Exoscope system to be optimally positioned, minimizing any interference during the procedure.

The VITOM® 90˚ telescope in one of the preferred vertical positions.

Positioning of the VITOM® 90˚ telescope

Vaginal Hysterectomy operating room setup with VITOM® Exoscope illumination

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Benefits of the VITOM® SystemDue to its slim and compact design, the VITOM® system provides a good overview of the surgical field and reduces space requirements in the OR.

The VITOM® system allows the surgeon to work comfortably looking at a high definition monitor, and provides the ability to document the intervention in high resolution at the same time. This provides the surgeon with an ergonomic working environment. Furthermore, the monitors enable the surgeon, as well as the assistants and the entire OR team, to view the surgical site. The VITOM® system is also very useful in the teaching and training of residents and students as visualization of the surgical field is not obstructed by the surgeon or the OR staff.

Vaginal Hysterectomy procedure using the VITOM® system for Visualization during surgery

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Product Characteristics of the VITOM® System• Possibility of using existing video systems, e.g., IMAGE1 S, IMAGE 1 HUB™ HD,

IMAGE1 S H3-Z camera head, and FULL HD monitor from KARL STORZ

• Documentation of any open urogynecological procedure

• The entire procedure or single images can be transmitted during training sessions/workshops

• Visualization of site for training and consultation purposes

• Compact, slim design

• Comfortable, ergonomic working via the monitor

• Large working distance

VITOM® System

Working distance: 25-75 cm

Depth of field at working depth of: 25 cm 75 cm approx. 3.5 cm approx. 10 cm

Width of image field at working distance of: 25 cm 75 cmH3-Z camera zoom 1x: 5 cm 15 cm H3-Z camera zoom 2x: 3.5 cm 10.5 cm

Image scale at working distance of: 25 cm 75 cm 26" monitor: H3-Z camera zoom 1x: approx. 8 x approx. 3 x H3-Z camera zoom 2x: approx. 16 x approx. 6 x

Technical specifications are subject to change without prior notice.

Technical Data of the VITOM® System

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For use with your Existing Endoscopy TowerThe VITOM® system can be used universally with your existing endoscopy tower. If an endoscopy tower is already available, you will only need a VITOM® telescope and a holding system to perform the procedure. If a documentation system is also required, a camera control unit (with integrated connection) can be used (for example, KARL STORZ IMAGE1 S). Alternatively, you can use a camera control unit with a separate documentation system (for example, KARL STORZ AIDA®).

The following shows an example of an endoscopy tower with its components.

List of Components:

CART with articulating arm26" FULL HD MonitorIMAGE1 S H3-LINKIMAGE1 S Connect ModuleIMAGE1 S H3-Z Three-Chip FULL HD Camera Head KARL STORZ XENON 300W Cold Light SourceKARL STORZ AIDA® HD CONNECT KARL STORZ INSUFFLATOR

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VITOM® System Components

20916025 DA VITOM® 90˚ Telescope with Integrated Illuminator, VITOM® HOPKINS® 90˚ Telescope, working distance 25-75 cm, length 11 cm, autoclavable, with fiber optic light transmission incorporated and condensor lenses, color code: blue

Accessories

Accessories include the VITOM® distance rod and sterilization tray

39501 A2 Wire Tray for Storage of two rigid endoscopes and one light guide cable, including holder for light post adaptors, silicone telescope holders and lid

20918020 VITOM Distance Rod, length 25 cm

495 NE Fiber Optic Light Cable, highly heat resistant, diameter 4.8 mm, length 300cm

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Note: For a fully functional system, an order must be placed for all five components.

Mechanical Holding System

28172 HR Rotation Socket, to clamp to the operating table, with one mounted Butterfly Nut 28172 HRS, for European and US standard rails, with lateral clamp for height and angle adjustment of the articulated stand

28172 HM Extension Rod, 50 cm, with lateral clamp for reach adjustment of the articulated stand, for use with articulated stands 28272 HA, 28272 HB, or 28272 HC and socket 28172 HK and 28172 HR

28272 CN Clamping Cylinder, folding, for flexible mounting of 10 mm telescopes to telescope sheath, autoclavable. The clamping cylinder allows vertical movement and rotation of the telescope. For use with Clamping Jaw 28272 UGN, 28272 UGK and POINT SETTER® universal adaptor 10-15 mm.

28172 HC Articulating Stand, L-shaped, long, reinforced version, large swivel range, with one mechanical central clamp for all five joint functions, height 48 cm, swivel range 66 cm, with quick release KSLOCK® (female)

28272 UGK Clamping Jaw, with ball joint, large, clamping range 16.5-23 mm, with quick release coupling KSLOCK® (male), for use with all square-headed KARL STORZ HOPKINS® telescopes

28172 HM

28172 HR

28172 HC28172 UGK

28272 CN

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Notes

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: communications@karlstorz.com

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KARL STORZ SE & Co. KG Dr.-Karl-Storz-Straße 34, 78532 Tuttlingen/Germany Postbox 230, 78503 Tuttlingen/Germany Phone: +49 (0)7461 708-0 Fax: +49 (0)7461 708-105 E-Mail: info@karlstorz.com

www.karlstorz.com