Neurosurgery

15
Cranioplasty Cement

Teknimed

Cranioplasty surgeries (CEMFIX® 1 & CEMFIX® 3) 

 

Teknimed Bone cements:
• Self-hardening PMMA cements.
• Mechanical properties far above the ISO 5833 standard.
• Low monomer release.
• Stable implants fixation.
• A final rapid self-hardening reducing risk of prosthetic micromovements.
• Barium sulfate, an excellent radiopaque agent.
• Easily prepared within a bowl & spatula or in a vacuum mixing system.

Complementary Medical Device:
CEMSTOP® is a bioabsorbable flexible cement restrictor for arthroplasty of hip on primary or revision surgeries:
• Allows the sealing of the medullary cavity before the introduction of acrylic cement.
• Eases the cement pressurization.
• Limits diffusion of cement into the medullary cavity.
• 6 sizes_: 8,10,12,14,16,18 mm.
• Resorption within a few days.
• Application : CEMSTOP® instrumentation.

 

 

 

14

Cranial LOOP 
REINVENTING

REINVENTING CRANIAL FIXATIONS FORCE REQUIRED TO SINK THE BONE FLAP 2 mm
The Cranial LOOP family of cranial fixation devices are a smart system for securely fixing bone flaps resulting from craniotomies.
A fast and easy ‘Pull and tighten’ action allows the surgeon to control and feel the fixation. A standard bone flap with three Cranial LOOP devices can be fixed in less than a minute.
The different members of the Cranial LOOP family produce equivalent fixation strengths to those of other standard metallic NON-instrument-free fixation devices.


 

 

 

REINVENTING CRANIAL FIXATIONS
HIGH STRENGTH & SAFETY
Double locking mechanism
INSTRUMENT-FREE
Fast & Easy implantation
CT/MRI ARTIFACT-FREE
100% PEEK-OPTIMA®
MINIMAL PROFILE
Guaranteed by 3D adaptation

GENERAL INFORMATION
• Supplied ready to use: sterile, no instrument tray needed.
• Artifact-free in X-Ray, CT scan and MRI.
• Reduced risk of soft tissue damage due to the smart design and less aggressive material: PEEK-OPTIMA®.
• Can be used for bone thicknesses between 1.5 and 24 mm.
• Optimal for radiotherapy (less than 1% attenuation).
• Easy to remove using standard Neurosurgery forceps or rongeurs.
• PEEK-OPTIMA® polymer is certified for implantation under ISO 10993 standards and US FDA Drug & DMF.
• CE-mark and FDA clearance.

 

 

 

 

 

SONOCA 400

Minimising

SONOCA 300
Minimising

Minimising risk with ultrasonic dissection

Surgical interventions at the skull and spinal column are especially challenging. Access via the bony shell of the skull requires a precise and selective approach. The impairment of important neuronal and vascular structures in the brain and at the spinal column due to surgery can also lead to severe functional loss for the patient. For these reasons, the development of minimally invasive and microsurgical operative methods has received a highly positive response, especially in the area of neurosurgery.

Indications for interventions at the skull
Tumours are one of the main indications for surgical interventions at the skull. Metastases occur more often than primary brain tumours. This means that more than 20 per cent of cancer patients develop brain metastases during the course of their disease. The most common cerebral metastases occur in the case of lung cancer (30-60 per cent), breast cancer (15-40 per cent) and skin cancer (melanoma, 10 per cent).

Surgical intervention at the skull aims at removing the tumour and metastasis respectively as completely as possible. If this is not possible, surgeons try to reduce the tumour mass as far as possible. The use of neuronavigation as well as intra-operative image data helps determine the exact location of the tumours and thereby reduce the risk of damaging intact tissue and bone structures.

Tumour dissection and fast coagulation with ultrasonic instruments
Risk is minimised even further with the use of ultrasonic instruments for the fine dissection of brain tumours.

Ultrasonic dissectors can resolve tumour mass effectively, while preserving the surrounding vessels and nerves in the process.

Advantages of the Söring ultrasonic instruments:
• Precise and efficient reduction of tumour tissue
• Prevent damage to the surrounding tissue
• Applicable to different tissue structures such as hard, medium-hard and soft brain tumours
• Safe handling
• Large repertoire for different anatomical locations

SONOCA 400

• 3 working frequencies in one compact generator
• Controlled tissue dissection (25/35 kHz) preserving nerves, vessels and collagen structures
• Cutting and coagulation effects (55 kHz) on tissue with special ultrasonic instruments
• Applications in Ultrasonic-Assisted Wound Debridement and liposuction
• The generator works simultaneously with integrated aspiration and irrigation functions
• The SONOCA is processor-controlled and features automatic instrument detection with automatic preselection of the performance parameters

SONOCA 300

• 3 working frequencies in one compact generator
• Controlled tissue dissection (25/35 kHz) preserving nerves, vessels and collagen structures
• Cutting and coagulation effects (55 kHz) on tissue with special ultrasonic instruments
• The generator works simultaneously with integrated aspiration and irrigation functions
• The SONOCA is processor-controlled and features automatic instrument detection with automatic preselection of the performance parameters

 

 

 

 

TheSöring

Micro handpiece (ENP, according to Gaab)

TheSöring1

Micro handpieces with external aspiration
aspiration

The Söring Micro handpieces:for neurosurgery

Meanwhile the tissue-selective removal of cranialand spinal tumours using ultrasonic technologyhas become gold standard. The ultrasonic dis-sectors by Söring allow the surgeon to proceed precisely and efficiently without traumatising the surrounding tissue. They are suited to hard,medium-hard and soft tumours and are safe to handle.
Söring offers a great repertoire of instruments with different working lengths, sonotrode diameters and with or without intregrated aspiration for the most varying anatomical conditions. The choice of the instrument depends on the localisation, size and consistency of the tumour as well as on personal preferences of the surgeon.

All Söring Micro handpieces excel with an ex-tremely robust, highly ergonomic design made from medical grade titanium. They are fully reusable and exceptionally long-lasting.

Ultrasonic aspirator for endoscopic neurosurgery: 92 series (Micro handpiece, ENP, according to Gaab)
• Minimially invasive tumour aspiration to the cranium
• Access to specific areas of the brain without damaging critical structures
• Low weight for highly comfortable working
• Applicable in combination with the neuroendoscope model Gaab (Karl Storz GmbH)
• Particularly suitable for the removal of intraventricular tumours

The most delicate and lightest ultrasonic handpieces used with external aspiration: 91 series

• Smallest and lightest ultrasonic handpiece worldwide for delicate preparation and maximum comfort
• Ergonomic design
• Sophisticated construction allows access to the highly sensitive areas of the brain
• Removal of soft to hard brain tumours whilst preserving the surrounding structures
• Particularly suitable for the dissection of superficial brain tumours
• Available in two different working lengths


 

PenumbraSMART

 

 

Penumbra SMART COIL®
The Penumbra SMART COIL® System is a platinum embolization device comprised of complex Standard and Soft coils that change softness profile within the span of a single coil. These families of SMART COIL integrate aneurysm framing, filling, and finishing in that the coil becomes progressively softer as it is deployed. These coils can be used to pack even the most delicate aneurysms. All SMART COILS feature UltraHD Fiber designed to provide stretch resistance and flexibility at the coil/pusher interface.

Features
Multiple softness levels: Standard, Soft, Extra Soft
Consistent, instant mechanical detachment
Compatible with .0165" and .017" inner diameter microcatheters
Available in secondary diameters from 1 mm to 8 mm and lengths of 1 cm to 30 cm

 

 

Neurovascular Embolization

PenumbraCoil


 

 

Penumbra Coil 400™
The Penumbra Coil 400™ (PC 400) is a platinum detachable embolization coil system, characterized by its large primary diameter compared to conventional coils. Given its size and handling, PC 400 can typically achieve higher packing densities with fewer coils per aneurysm than most conventional coils.

Features
Offering includes multiple shapes and softness levels:
Complex Standard
Complex Soft
Complex Extra Soft
J Soft
Curve Extra Soft

 

 Broad range of secondary coil diameters (2 mm to 30 mm) and lengths (1 cm to 60 cm)
Compatible with the PX SLIM™ Delivery Microcatheter

Neuron

 

 

Neuron™ System
The Neuron™ Intracranial Access System allows for rapid distal placement into the neurovasculature, providing both robust intracranial support and a wide range of device compatibility.

Overview

Neuron™ MAX 088
6F long sheath purposely designed for neurovascular use
.088" lumen allows for wide range of device compatibility
Optimized proximal shaft for support throughout aortic arch
Soft, atraumatic tip for distal placement
Full distal shaft radiopacity for optimal visualization throughout procedure
Compatible with Penumbra 6F Select™Catheters for rapid delivery to final position

Neuron™ 070
Built with hybrid coil design that allows for dual device delivery via .070" lumen
Full radiopaque platinum distal shaft
Compatible with Penumbra 5F Select Catheters for rapid delivery to final position eliminating an over-the-wire exchange

Neuron™ 053
.053" lumen for primary device delivery
6F proximal to 5F distal tapered OD

 

 

BENCHMARK

 

BENCHMARK™
The BENCHMARK™ 071 Intracranial Access Catheter combines Penumbra’s innovative tracking technology, driven largely by advances in ischemic stroke therapy, with its original Neuron™ intracranial access concept. The result is a next-generation 6F guide catheter built for delivery of today’s most complex therapies.

Overview
.071" lumen allowing dual device delivery
Optimized shaft for support throughout aortic arch
Full radiopaque distal shaft
Offered pre-packaged with Penumbra 5F Select™ Catheter for rapid delivery to final position eliminating an over-the-wire exchange

 

DistalDelivery

 

 

Distal Delivery Catheters (DDC)
The Penumbra 5MAX™ and 4MAX™ Distal Delivery Catheters (DDC) are designed to simplify therapy delivery to the most distal, tortuous anatomy. Additionally, the unique tapered inner shaft maximizes the effective flow lumen to facilitate exceptional angiographic roadmapping. DDC is offered in three lengths to enable a wide variety of device compatibility.

Overview

5MAX™ DDC and 4MAX™ DDC

5MAX DDC 115 is compatible with neurovascular microcatheter, balloon and stent/flow diverter delivery systems
4MAX DDC has a distal profile, useful in smaller, more distal anatomy

Built with MAX™ Tracking Technology
5MAX DDC effective flow lumen—.062"
4MAX DDC effective flow lumen—.053"
Distal radiopaque marker band
Polished atraumatic tip
Lengths include: 115 cm, 125 cm, and 130 cm

 

 

PenumbraSelect

 

 

 

Penumbra Select™ Catheters
The Penumbra Select™ Catheters enable primary delivery of our access devices, facilitating rapid, atraumatic placement to final position without the need for an over-the-wire exchange.

Overview

Allows easy selection off of arch into desired vessel, and immediate final placement
Facilitates atraumatic placement into distal vasculature
Can be used for diagnostic angiogram—.040" lumen
Compatible with all .035"-.038" guidewires
Seamless transition zone with no shelf for atraumatic advancement
6F Select™ designed for use with Neuron™ MAX 088
5F Select designed for use with Neuron™ 070 and BENCHMARK™ 071

 

 

 

PX

 

 

 

 

PX SLIM™

The PX SLIM™ Microcatheter is optimized for trackability and support when delivering Penumbra’s large-volume coils (Penumbra Coil 400™and POD®)

Overview

.025" lumen
2.95F proximal OD to 2.6F distal OD
150 cm length with dual radiopaque markers
Available in straight, 45o, 90o, and 130oshapes
Compatible with Penumbra Coil 400™ and POD® System

 

 

 

 

4  
Transcranial Doppler Neurosurgery Package 
Non-invasive and Accurate Assessment of Blood Flow Velocities in the Brain
 Wide

 

 

 

Wide Range of Clinical Applications

Diagnosis of extracranial and intracranial stenosis and occlusion
Detection and monitoring of vasospasm following Subarachnoid Hemorrhage (SAH)
Detection of patent Foramen Ovale (PFO)/ right to left shunts (RLS)
Detection and counting of microemboli
Evaluation of the brain vasomotor reserve
Reliable brain death diagnosis and assessment
Monitoring during carotid endarterectomy or carotid stenting
Monitoring during coronary artery bypass grafting
Monitoring during tPA treatment for acute stroke patients, identifying the point in time at which recanalization occurs
Screening children with sickle cell disease

 

 

 

 
Digi-LiteTM
 
Digi-LiteIP

Digi-LiteTM

 

 

Digi-LiteTM provides clinicians with a complete transcranial Doppler (TCD) solution for bedside diagnosis and monitoring. Based on Rimed’s Sixth generation TCD technology, Digi-LiteTM enables a reliable and non-invasive assessment of blood flow velocities in the brain.
Proven Transcranial Doppler (TCD) Technology


Designed for Clinician’s Convenience
Fully mobile, complete bedside TCD solution
Designed for the modern stroke, ICU* and neurosonology labs
Intuitive 15” LED touchscreen user-interface for simple and easy operation
Multiple language capability for local market use

Accurate and Fast Detection and Identification of Abnormalities
Highly sensitive Doppler with advanced, power M-mode
8 spectrums displayed in 8 different depths simultaneously for a complete diagnostic picture
Advanced emboli detection software and proprietary Doppler technology enable accurate emboli detection (via HITS**)

Comprehensive Flow Diagnosis and Continuous Monitoring
Complete range of probes for all uses: 2MHz, 4MHz, 8MHz and 16MHz***
Intraoperative 16MHz probe for accurate blood vessel detection during neurosurgical procedures
High-resolution, color flow imaging module: Digi-Lite IPTM for quick and detailed extracranial and intracranial investigations within one single system (optional)
Extensive speciality monitoring tests (optional):
• VMR (Vasomotor Reactivity) / CO2 Reactivity Test for reliable evaluation of cerebral autoregulation

• Detection of recanalization time during tPA treatment
• Bubble test to diagnose patent foramen ovale (PFO)

Customizable and Time saving Reporting
Unique two-layer customizable reporting system
DICOM & Modality work list for real time data sharing
Easily transfer and export reports in various formats including PDF

First layer report: Customizable spectral summary screen and easy-to-interpret colourful graphics help shorten diagnosis time

Second layer report: Comprehensive final patient reports with ability to write clinical diagnosis interpretation save time when providing documentation to the referring physician

One combined TCD and color flow imaging
 

 

 

Digi-OneTM
 
Digi-OneTM

Outstanding Transcranial Doppler (TCD) Technology in One Kg!

Digi-OneTM is an extremely lightweight (weighs one kg/2.2 lb) portable transcranial doppler solution to safely and non-invasively assess blood flow velocities in the brain.

It combines Rimed’s outstanding Digi-Lite™ Doppler technology* and interface including power M-mode, simultaneous multi-depth and spectrum displays, easy-to-operate software, customizable reporting and fast patient data export.

Flexible, Portable and Designed for Ease of Use
Advanced and cost-effective solution for clinicians whether in their clinic, hospital or mobile services
Developed for repeated long-term use in contrast to other techniques
Connects rapidly to your tablet, laptop or PC
Exports and sends patients’ diagnosis quickly to the referring physician
Removable silicon probe basket for easy and rapid cleaning
Be Completely Equipped Wherever You Are
Lightweight One Kg device (2.2 Ib)
Sensitive Doppler technology
Supports all probes: 2 MHz, 4MHz, 8MHz and 16 MHz** probes
Optional speciality monitoring tests: VMR, tPA and Bubble test

 
Digi-OneTM

Digi-Lite IP TM

High Resolution Color Flow Imaging Module for Complete Extracranial Investigations

Combining High Sensitivity Carotid Color Flow Imaging

Digi-Lite IPTM’s high-resolution color flow imaging module enables faster diagnosis of possible vascular disorders within the carotid arteries, and supports wider clinical applications. Combined with Digi-LiteTM, the device provides clinicians with an all-in one solution to quickly, and accurately perform investigational techniques in both the intracranial and extracranial blood vessels.

Cost-Effective and Easy-to-Operate

Digi-Lite IPTM is a compact, cost-effective and integrated solution for the ICU and modern neurosonology and neurovascular labs. The easy-to-operate Digi-Lite IPTM probe enables the clinician to scan the carotid system, extracranial vertebrals and the ocular system in a complete triplex mode including B Mode, Color flow and Doppler
.
Key Features:
High resolution imaging for fast and accurate diagnosis
Dedicated software integrated in to Digi-LiteTM
Custom probes for different clinical applications including extra and intracranial stenosis

LMY

Transforming Transcranial Doppler Monitoring into an Easy Procedure

Stability and Accuracy During Continous Monitoring Rimed’s third generation head set provides maximum stability and accuracy during continuous monitoring through its innovative ‘One Click’ locking operation. Its unique fixation device enables the probe to be easily aligned and quickly ‘locked’ in place to its optimal Doppler signal. The head set is especially suitable for functional monitoring of patients during emboli detection & counting, bubble test exams, tPA administration, carotid endarterectomy and cardiovascular surgery

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  +94117545515
  +94117545515
  No. 07, Manel Place, Srimal Uyana, Ratmalana, Sri Lanka