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Aesculap® Neuroendoscopy

Intraventricular, Endoscope-Assisted, Transnasal/Transsphenoidal Neuroendoscopic Equipment

With comments from international experts in the field of neuroendoscopy and minimally-invasive
neurosurgery.

Aesculap Neurosurgery
Aesculap Neuroendoscopy

Michael Fritsch Jeremy Greenlee André Grotenhuis Nikolai Hopf Peter Nakaji
Neubrandenburg, Germany Iowa City, USA Nijmegen, Netherlands Stuttgart, Germany Phoenix, USA

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Aesculap Neurosurgery

" In 1924, the famous general and neurological


surgeon William Halsted expressed his belief “…that
achieve deep seated regions without approach
related traumatization of sensitive neurovascular
the tendency will always be in the direction of exer- structures.
cising greater care and refinement in operating”.
The endoscopic image allows illumination and
Today, within the third millennium this fundamen-
inspection of angles in hidden parts of the surgical
tal philosophy of minimally invasive therapy should
field with the and clear depiction of anatomical
be emphasized more than ever before, operating
details. In addition, due to the enormous optical
with a minimum of iatrogenic trauma while achie-
depth of field of modern endoscopes, endoscopes
ving maximum surgical efficiency.
provide a three dimensional aspect of anatomic
Recent improvements in preoperative imaging and structures. Recently, the intraoperative use of full
surgical instrumentation allow neurosurgeons to high definition (HD) image quality offers a new
treat more complex pathologies through customi- area in endoscopic neurosurgery with an increased
zed less invasive approaches. range of indications in minimally invasive
neurosurgery.
Using the advanced diagnostic tools of digital sub-
traction angiography, 3D angiography, computed There are three main indications of endoscopic
tomography and magnetic resonance imaging, one neurosurgery: the intraventricular, transcranial and
is able to demonstrate and elucidate preoperative- transnasal application. In this brochure, contem-
ly the individual anatomy and pathology of the porary endoscopic equipment and instrumentation
patient. Therefore, anatomically preformed surgi- is presented in a comprehensive way. International
cal dissection can be described preoperatively and experts in the field of minimally invasive and end-
may so be included into the planning of surgery. oscopic neurosurgery comment the different
With the individual anatomic details of a specific applications, giving remarks with important tips
patient, it becomes possible to perform a tailored and ideas, thus providing valuable instructions for
surgical procedure reducing the size of the skin in- the use of endoscopes in the field of minimally in-
cision, the craniotomy, and the extent of brain sur-
face traumatization and retraction to a necessary
vasive neurosurgery.
"
minimum limit. These advantages of minimally
invasive microsurgery contribute to improved post- The Aesculap Advisory Board for “Minimally-
operative results, including shorter hospitalization Invasive Neurosurgery & Neuroendoscopy”
time because of reduction of the risk for compli-
Michael Fritsch, Neubrandenburg, Germany
cations.
Jeremy Greenlee, Iowa City, USA
However, small sized minimally invasive approa- Andre Grotenhuis, Nijmegen, Netherlands
ches cause two important limitations: the Nikolai Hopf, Stuttgart, Germany
significant loss of optical control and limited Peter Nakaji, Phoenix, USA
maneuverability of microsurgical instruments. The Robert Reisch, Zurich, Switzerland
intraoperative use of endoscopes and dedicated Mark Souweidane, New York, USA
minimally invasive instruments overcome these Charles Teo, Sydney, Australia
restrictions, thus enabling neurosurgeons to Ron Young, Indianapolis, USA

Robert Reisch Mark Souweidane Charles Teo Ron Young


Zurich, Switzerland New York, USA Sydney, Australia Indianapolis, USA

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Neuroendoscopy
Intraventricular
Intraventricular Neuroendoscopy

5
MINOP®
Intraventricular Neuroendoscopic System

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Neuroendoscopy
Intraventricular
Aesculap Neurosurgery

" The genesis of endoscopic surgery within the


ventricular compartment can be attributed to the
Once fluent with the endoscopic equipment,
more advanced procedures can be performed with
development of small caliber rod lens optics, greater familiarity and experience. It is antici-
fiberoptic light transmission and dedicated pated with future generations of neurosurgeons
instrumentation. Since the advent of intraventri- that the endoscope will be an indispensable part
cular endoscopic surgery, neurosurgeons have of the neurosurgeon's armamentarium given the
applied the technology to treat a number of unmatched image resolution and minimally
disorders. While the enthusiasm has been great invasive qualities.
and the full potential not yet realized, a major
benefit to the patient has been proven for selec- This foreseeable integration will expectantly be
ted conditions. Most notably the treatment of paralleled with continued evolution in compati-
non-communicating hydrocephalus, management ble equipment to suit the needs of an expanding
of patients with pineal region tumors, fenestra- repertoire.
tion of intracranial cysts, and removal of colloid
cysts have all been shown to provide significant Few neurosurgical procedures demand a degree
benefit and reduced morbidity compared with of familiarity with equipment as do neuroendos-
conventional treatment strategies. copic techniques. This feature is somewhat
explained by the recent introduction of the
The benefit in minimally invasive endoscopic neuroendoscope as well as the delicate nature of
procedures is analogous to that of any endosco- the equipment. The basic components of any
pic procedure, namely minimal tissue disruption, neuroendoscopic procedure include the endoscope
enhanced visualization, improved cosmetic results, and trocar, a camera with light source and moni-
shorter hospital stay, and less surgical morbidity.
The surgeon willing to utilize intraventricular
tor, as well as compatible instrumentation.
"
endoscopic surgery is first responsible for attai- Charles Teo
ning a considerable degree of familiarity with the Mark Souweidane
technology, relevant anatomy, and the surgical
procedures. Given the relative nascence of the
field, the discipline is only now being commonly
implemented in training programs. Hence, for
those that have not had the opportunity to have
endoscopic surgery as part of their formal trai-
ning, it is strongly recommended that the surgeon
participates in established practical courses in
endoscopic neurosurgery, such as the courses from
the Aesculap Academy.

Charles Teo Mark Souweidane


Sydney, Australia New York, USA

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MINOP®
Intraventricular Neuroendoscopic System

MINOP® Trocars

Ultra-smooth tip of trocar for atraumatic insertion


into the brain
Single obturator for working channel enables
insertion of the trocar, under visual control, with
the scope
Large MM-length inscription on the outer shaft
of the trocar
Conical entry of working channel for intuitive
insertion of instruments into trocar
Attachment on top of trocar for improved handling
and universal connection of peripheral devices

150 mm, 5 7/8 ”

FF399R

MINOP® Trocar,
Outer diameter 6 mm
working channel 2.2 mm
4 channels:
Scope channel, diam. 2.8 mm irrigation/overflow
channel, 1.4 mm
Working channel, diam. 2.2 mm irrigation/overflow
Irrigation channel, diam. 1.4 mm channel, 1.4 mm

Overflow channel, diam. 1.4 mm


Including 4 obturators
scope channel, 2.8 mm
for all channels

" I had used the Aesculap MINOP system for all intraventricular cases and was mostly
pleased with its versatility and safety. However, I had some concerns regarding its user-friend-
liness and applicability when one needed to be a 2-handed surgeon. Both these issues have been
addressed with the new, improved MINOP trocar and I have been very pleased with its added
safety and practicality. I honestly believe it is quite clearly the best scope on the market for intra-
ventricular endoscopic procedures. I applaud Aesculap for listening to the people who count most...
the surgeons!
"
Charles Teo, Sydney, Australia

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Neuroendoscopy
Intraventricular
Aesculap Neurosurgery

150 mm, 5 7/8 ”


FF398R

MINOP® Trocar,
Outer diameter 4.6 mm

3 channels: scope channel, 2.8 mm

Scope channel, diam. 2.8 mm


Irrigation channel, diam. 0.8 mm
Overflow channel, diam. 0.8 mm
Including one obturator for
scope channel
One sealing cap for pressure
balance in scope channel irrigation/overflow irrigation/overflow
channel, 0.8 mm channel, 0.8 mm

150 mm, 5 7/8 ”


FF397R

MINOP® Trocar,
Outer diameter 3.2 mm
scope channel, 2.8 mm

1 channel:
Single channel for scope
Including one obturator
Optic channel, diam. 2.8 mm
One sealing cap for pressure
balance in scope channel

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MINOP®
Intraventricular Neuroendoscopic System

MINOP® Endoscopes

FULL HD compatible scopes Optimised fibre optics provide more light


Rust-proof steel outer casing for Service-optimised construction reduces
problem-free reprocessing maintenance costs
The external tube is made from a high Highly rectified optical systems
strength special alloy for superior Autoclavable/Steris/Sterrad
breaking resistance

180 mm, 7 1/8 ”


PE184A

MINOP® Endoscope
Direction of view 0°
(green ring)
Shaft diameter, 2.7 mm
Shaft length, 180 mm
Autoclavable

180 mm, 7 1/8 ”


PE204A

MINOP® Endoscope
Direction of view 30°,
upwards (red ring)
Shaft diameter 2.7 mm
Shaft length 180 mm
Autoclavable

" The angled design of the MINOP ventricular endoscope plays a central role in ergonomic and
effective application, allowing the use of rigid instruments through the straight working channel.
In this way, the side-gated camera and light cable do not disturb surgical manipulation. In my
hands, an undisputable advantage!
"
Robert Reisch, Zurich, Switzerland

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Neuroendoscopy
Intraventricular
Aesculap Neurosurgery

MINOP® Rigid Instruments

Instruments Tactile Feedback Rotating Knob


Shaft length 265 mm Integrated tactile feedback By rotating the knob slightly
Diam. 2.0 mm delivers small resistance with index finger, the tip of
indicating that instrument tip instrument turns equally
Fully detachable for
emerges from the trocar No need anymore to turn/
reprocessing
Improves safety and control rotate instrument with the
High precision instrument tip during insertion of instruments entire arm/handle
Improves safety and precision
of neuroendoscopic surgery
Integrated safety mechanism
in instrument shaft

" A very appealing feature of the MINOP tube shaft instruments is a rotational capability of the
instrument tip through a coaxial system thus eliminating the need for hand rotation and reducing
excessive movement of the endoscope. Irrespective of the instrument, graduated markings or
precalibrated indicators on the shaft are important in providing the surgeon knowledge as to when
the instrument will enter the endoscopic field. Even more safety is provided by the new tactile
feedback of the improved MINOP instruments. A small spring delivers a tactile resistance "telling"

"
the surgeon that the instrument tip is exiting the trocar.

Mark Souweidane, New York, USA

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MINOP®
Intraventricular Neuroendoscopic System

MINOP® Rigid Instruments

Ø
2 mm
Instrument complete: Handle · outer tube · jaw part with inner tube

265 mm, 10”

2/1

FF385R
MINOP® micro scissors
sharp / sharp
2/1

2/1

FF386R FF388R
MINOP® micro scissors MINOP® grasping and dissecting forceps
blunt / blunt
2/1

2/1

FF387R FF389R
MINOP biopsy forceps
®
MINOP® surgical micro forceps

The very delicate MINOP® instruments should be carefully detached completely and be pre-cleaned
manually at the end of the operation. Keeping them in dedicated trays for reprocessing and
sterilization protects the super-fine instrument tips. A careful handling by trained operating
& CSSD staff is highly recommended and can eliminate the wear and tear of these sensitive but
highly necessary neuroendoscopic tools.

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Neuroendoscopy
Intraventricular
Aesculap Neurosurgery

MINOP® Rigid Instruments - Spare Parts

Ø
2 mm
Jaw part with inner tube for FF385R - FF389R

FF433R
Outer tube only for FF385R - FF389R

FF432R
Instrument handle only for FF385R - FF389R

2/1

FF435R
MINOP® micro scissors
sharp / sharp

2/1 2/1 Tactile Feedback


If you want to upgrade your
MINOP® system with tactile
FF436R FF438R feedback, simply order a new
outer tube FF433R for all your
MINOP® micro scissors MINOP® grasping and dissecting forceps instruments
blunt / blunt

2/1 2/1

FF437R FF439R
MINOP biopsy forceps
®
MINOP® surgical micro forceps

For disassembly and assembly of MINOP® tube shaft


“Testimonial:At droht Drinstruments,
spe Barden Boy gib ask
please Frl Sonette. Tito
your local fesseln sich
Aesculap salesade Big eng Julis lobe Gas auf
Färberei folgen Extension Brandmal stillte
representative: C. Wartens
Brochure half(English),
C60902 Box umgehauter
C60901 umworbenes
(German). Bruchstücken,
tov Ehe Pokals geh tapsige, segnete sag Einkäufe wer Aas weh einzahlendes Hügeln. Heft abschnürend
Bandit dm dies lügen tankte hat.Abeter teilt geize Bzw turne mystisch Göthes Dorfes, Cha Beo Deute-
rium Alle.“

Charlie Teo
Sydney, Australia

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MINOP®
Intraventricular Neuroendoscopic System

MINOP® – Flexible Instruments

250 mm, 10”

FF373R

Micro scissors

FF374R

Micro grasping and dissecting forceps

FF378R

Micro biopsy forceps

1 mm
Ø 1.0 mm Instruments for bi-instrumental work

Flexible instruments:
For bi-instrumental / bi-manual neuroendoscopic surgery
E.g. grasping and cutting, grasping and coagulating,
grasping and fenestrating
To be used through irrigation or overflow channel of the
MINOP® trocar FF399R
Diam. 1.0 mm, shaft length 250 mm
Non-detachable
With irrigation port for reprocessing/cleaning

" The MINOP® system is providing bi-instrumental endoscopic work. For example in cyst removal or
endoscopic tumor surgery the surgeon has the opportunity to grasp and cut or grasp and coagulate
at the same time. One can utilize flexible instruments or electrodes in one of the side-channels and
rigid tube shaft instruments in the working channel. The design of the side-channels of the MINOP®
trocar makes sure that both instruments do not interfere with each other.
"
Michael Fritsch, Neubrandenburg, Germany

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Neuroendoscopy
Intraventricular
Aesculap Neurosurgery

MINOP® – Electrodes

255 mm, 10”


GK361R 1:1

Blunt electrode, diam. 1.1 mm

GK363R 1:1

Needle electrode, diam. 1.1 mm

GK364R 1:1

Hook electrode, 45°, diam. 2.2 mm

GK365R 1:1

Hook electrode, 70°, diam. 2.2 mm

GK362R 1:1

Hook electrode, 90°, diam. 2.2 mm

GK366R 1:1

Hook electrode,180°, diam. 2.2 mm

GK245
Monopolar cable suitable
for GN300, GN640

BIPOLAR ELECTRODES
255 mm, 10”
GK360R 1:1
Fork electrode, diam. 2.1 mm

GN073
Bipolar cable suitable
for GN060, GN300

“Testimonial:Osen. Funks Freistoss Furchen verleidet zur klatschsüchtigsten Bit Den Landebahn, Dr bare
Gelde zus bei Manierist eingeschrieben Den Alf Amt eingezeichnete zugewandte fals, brüllt Balls Gefie-
dern Emanüla hohlen n.b Brühen zurückgekehrtem Bolzen Bert, spurten Brut flockige Bühnen ade Auf-
gabe zierende. Tangs B. Befolger Memphis aller eng lockerem vollblütiges Rednern ö boxte Kämmerer,
her Bear lau..“

Ronald Young
Indianapolis, USA

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MINOP®
Intraventricular Neuroendoscopic System

MINOP® – Suction Cannula

MINOP® Disposable Suction Cannula


For removal of cystic intraventricular lesions
For puncturing the floor of the 3rd ventricle
With depth marking, interval of 5 mm
Outer diameter of 2.0 mm
Suitable for working channel of MINOP® trocar FF399R
Available with blunt or sharp tip suction cannula
FH606SU FH607SU
Optional control of suction
via thumb plate or Suction cannula, Suction cannula,
via syringe blunt tip 0°, sharp tip 45°,
diam. 2.0 mm diam. 2.0 mm
Single-use, sterile packaging

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Neuroendoscopy
Intraventricular
Aesculap Neurosurgery

MINOP® – Disposable Introducer

MINOP® Disposable Introducer


19 Fr disposable introducer set
including obturator and sheath
Especially for MINOP® trocar FF399R
Introducer sheath protects the brain
while inserting and removing the
endoscope/trocar
Round & blunt obturator tip for FH604SU
atraumatic insertion into the ventricles
Depth scale for precise positioning and Introducer,
perfect control 19 Fr

Easy to peel with side handles

The MINOP® suction cannula and the MINOP® disposable introducer can be used in almost any
intraventricular neuroendoscopic surgery providing more safety and control during the procedure.
The suction cannula can be used for the controlled and fast removal of intraventricular soft tumors
or colloid cysts with its sharp cannula tip or even for the opening of the floor of the 3rd ventricle.
The disposable introducer (also called peel away) is very helpful when several intraparenchymal
in- and out-movements of the trocar are necessary.

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MINOP®
Intraventricular Neuroendoscopic System

MINOP® – Storage

FF358R

For MINOP® trocars and scopes


Storage rack with silicone
protection cushioning
Bottom and lid
Only for reprocessing, not for
transportation/shipment
(L/W/H 489 x 257 x 63 mm)

FF359R

For MINOP® instruments and


electrodes
Storage rack with silicone
protection cushioning
Bottom only, lid not necessary
Only for reprocessing, not for
transportation/shipment
(L/W/H 485 x 253 x 120 mm)

JK440 JK444 JK486

Container body 1/1 Container body 1/1 Container lid 1/1


for FF358R for FF359R blue
without base perforation without base perforation
(L/W/H 592 x 274 x 187 mm)

Dedicated storage racks for cleaning and reprocessing are highly


recommended for your neuroendoscopic equipment. A safe and
special-designed storage concept is keeping the scopes and instruments
safely stored and protected.

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Neuroendoscopy
Intraventricular
Aesculap Neurosurgery

For more information about sterile container systems and accessories,


please ask your local Aesculap sales representative: Brochure C40402
(English), C40401 (German).

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Paediscope
Paediatric Intraventricular Neuroendoscopic System

Paediscope

150 mm, 5 ⁄ ”
7
8

PF010A

Endoscope shaft
with integrated optical fibres

30.000 pixel fiber optic


Fibres integrated in rigid shaft for high
precision and control
3.0 mm outer diameter for minimally PF011A
invasive pediatric surgery
Light-weight and ergonomic design Ocular with focus
Black handle can be held like a pencil * for complete Paediscope,
please order both PF010A
Weight of camera ocular is away
and PF011A
from the operating site

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Neuroendoscopy
Intraventricular
Aesculap Neurosurgery

250 mm, 10”

Flexible instruments:
Diam. 1.0 mm, shaft length 250 mm, non-detachable

FF373R FF374R

Micro scissors Micro grasping 2:1


2:1
and dissecting
forceps

FF378R
2:1
Micro biopsy forceps

FH603SU

Paediscope Disposable Introducer

10 Fr disposable introducer set including Round & blunt obturator tip for atraumatic
obturator and sheath insertion into the ventricles
Especially made for Paediscope PF010A Depth scale for precise positioning and
Introducer sheath protects the brain while perfect control
inserting and removing the endoscope/trocar Easy to peel with side handles

" The peel away sheath protects the brain while inserting and removing the pediatric endoscope.
Because of its small outer diameter, the Paediscope does not have a dedicated trocar. The blunt
obturator tip of the sheath allows atraumatic insertion into the ventricles. The sheath has a depth
scale for precise positioning and is easy to peel back the side handles. Using a peel away sheath is
especially helpful, if repeated in and out movements of the scope are necessary or different

"
instruments or catheters (e.g. for aqueductoplasty) have to be utilized in addition to the scope.

Michael Fritsch, Neubrandenburg, Germany

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Paediscope
Paediatric Intraventricular Neuroendoscopic System

Paediscope

GK363R
255 mm, 10”
Needle electrode 1:1

GK361R

Blunt electrode 1:1

GK245 1:1

Monopolar cable
suitable for GN300, GN640

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Neuroendoscopy
Intraventricular
Aesculap Neurosurgery

FF379R

For Paediscope shaft,


instruments and electrodes
Storage rack with silicone
protection cushioning
Bottom and lid
Only for reprocessing, not
for transportation/shipment

JK440

Container basis 1/1


without base perforation
(L/W/H 592/274/90)

JK486

Container basis 1/1 lid


blue

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Endoscope-Assisted
Microneurosurgery
Endoscope-Assisted Microneurosurgery

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MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

26
Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
The aim of minimally invasive neurosurgery is is especially ideal for obtaining a detailed view
"
to avoid approach-related traumatization of the of structures in the shadow of the microscope's
patient by creating a tailor-made limited cranio- light beam. Thus, in situations during micro-
tomy based on skilled preoperative planning. surgical dissection where additional visual
information of the target area is desired or
Using modern diagnostic tools, surgical instru- when avoidance of retraction of superficial
ments and visual equipment, the specific anato- structures is recommended, an endoscope may be
my and pathology of the individual patient can be introduced into the surgical site.
precisely visualized and anatomical pathways and
surgical corridors determined for the surgical The use of dedicated microneurosurgical instru-
approach. According to the predefined access, ments is obligatory in transcranial endoscope-
surgical dissection can be subsequently performed assisted microneurosurgery. Highly sophisticated
creating a much less traumatic cranial opening. instrumentation including microdrills, Kerrison
The aim is not the limited cranial opening, but the micropunches, self-retaining retractors, suction
limited approach associated injury with less brain tubes, fine bipolar forceps, microscissors, diamond
exploration and retraction. The craniotomy should knives, microforceps, microdissectors, micro-
be as small as possible for minimally invasive curettes, and clip appliers are mandatory for
exposure, but as large as necessary for achieving microsurgical dissection.
maximal surgical effect. In this way, limited
exposure is not the primary goal but the result of All before mentioned surgical tools - the
the keyhole concept with the main and most microscope, endoscope and dedicated surgical
important goal being to avoid surgery-related instruments - complement each other and
complications. contribute in a TEAM-work manner to the goal of
the keyhole concept: the achievement of the
The intraoperative use of microscopes is manda- smallest iatrogenic trauma with the highest
tory in keyhole neurosurgery. The operating
microscope provides both stereoscopic magnifi-
therapeutic effect for the patients.
"
cation and illumination of the surgical field. Peter Nakaji
However, the loss of light intensity in the depth Nikolai Hopf
of the surgical field is a fundamental problem in
keyhole approaches. For the purpose of bringing
light into the site, operating microscopes can
effectively be combined with the intraoperative
use of modern endoscopes. The advantages of
the endoscopic image are increased light,
extended viewing angle and a better depiction
of anatomical details in close-up. The endoscope

Peter Nakaji Nikolai Hopf


Phoenix, USA Stuttgart, Germany

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MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

Angled “Perneczky” Scopes

FULL HD ready scopes, diam. 4.0 mm


Brilliant image, rod lens system and different
viewing directions (0°, 30°, 70°)
Angled endoscope design and lateral connection
for camera and light source
Ergonomic handling by centered balance of weight
Permits parallel microscope image
Free area around the scope shaft for parallel
use of micro instruments
Autoclavable/Steris®/Sterrad®
Robust and rigid scope sheath enables the
scope to be used as dissector, manipulating
delicate structures without bending the scope.

150 mm, 6”

PE486A

Angled neuroscope
Direction of view: 0°
Shaft diameter: 4 mm
Shaft length: 150 mm, 6“

" I have been using the Aesculap angled Perneczky scopes since the mid nineties and in over
1000 cases. I have trialed many different scopes for endoscope-assisted surgery but the Perneczky
scopes have the versatility that I need when removing tumors from many different cranial
locations. The main advantage of the angled scopes is the unique design that allows simultaneous
use of endoscope and microscope. Other important qualities that are met by this system are
robustness, ability to use it to retract if necessary and clarity of image. I believe these scopes are
an essential tool in the neurosurgeon’s armamentarium.
"
Charles Teo, Sydney, Australia

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Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
150 mm, 6”

PE506A

Angled neuroscope
Direction of view: 30°, upwards
Shaft diameter: 4 mm
Shaft length: 150 mm, 6“

150 mm, 6”
PE526A

Angled neuroscope
Direction of view: 70°, upwards
Shaft diameter: 4 mm
Shaft length: 150 mm, 6“

JF324R

Storage tray
with silicone cushioning racks and lid
for 2 angled neuroscopes (not included)

" During microneurosurgical skull base approaches for either vascular lesions or tumors,
there is often a difficulty of visualizing important neurovascular structures around and be-
hind the lesion. In such a situation, the use of endoscopes has greatly advanced my surgical
possibilities. The additional view through the endoscopes, which is complementary to what
can be seen through the operating microscope, facilitates the handling of the lesion, be it
aneurysm clipping or tumor removal, while at the same time there is no need for extensive
retraction or bone removal.
"
André Grotenhuis, Nijmegen, Netherlands

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MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

XS Tube Shaft Micro Instruments

" Performing limited keyhole approaches, the application of conventional microsurgical instruments
becomes limited in several cases. Slender keyhole microinstruments have been specially created to
overcome this problem allowing unhindered introduction of the tool through the limited craniotomy.
These XS tube-shaft designed instruments can be used in very small operating corridor enabling safe

"
manipulation within the narrow surgical passage and obvious visualisation of the surgical field.

Robert Reisch, Zurich, Switzerland

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Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
ngth
ing le
Work

Working length 70 mm 100 mm 130 mm


2 3/4” 4” 5 1/8”

Total length 200 mm 230 mm 260 mm


8” 9” 10 1/4”

XS Micro Scissors, straight, sharp / sharp FM670R FM671R FM672R

XS Micro Scissors, straight, blunt / blunt FM690R FM691R FM692R

XS Micro Scissors, curved, sharp / sharp FM680R FM681R FM682R

XS Micro Scissors, curved, blunt / blunt FM700R FM701R FM702R

XS Micro Forceps, Jaw 0.9 mm FM710R FM711R FM712R

XS Micro Tumor Grasping Forceps, Jaw 3 mm, sharp FM720R FM721R FM722R

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MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

XS Tube Shaft Aneurysm Clip Applying Forceps

360° rotation
suitable for narrow approach

1 /2"
m ,3
9 0m
220 mm, 8 3/4"

Titanium FT495T FT490T

Phynox FE495K FE490K

3 /8"
,4
mm
110

240 mm, 9 1/2"

Titanium FT496T FT491T

Phynox FE496K FE491K

" The cause for the significant superiority of the endovascular treatment of aneurysms compared
with the surgical therapy in the ISAT study was the surgical morbidity and mortality of large sized
standard approaches. In my opinion, surgical clipping will play an important role in the treatment of
intracranial aneurysms in the future only, if it will be able to reduce approach related complications
using limited craniotomies. The use of endoscope-assisted techniques and tube-shaft clip appliers
offer increased safety in keyhole vascular neurosurgery, thus achieving the basic goal with minimally
invasive and maximal effective aneurysm closure.
"
Robert Reisch, Zurich, Switzerland

32
Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
SENSATION Micro Instruments

The well known Aesculap NOIR® - coating offers the


advantage that irritating reflections can be strongly reduced.
NOIR® – No Irritating Reflections.

Noir Scissors,
upwards curved

120 m
m 43/4
90 mm
70 mm


31 /2”
60 mm

23 /4”
21 /3”

1/1

1/2

sharp/sharp FM146B FM147B FM148B FM149B

Working length 60 mm 2 1/3“ 70 mm 2 3/4“ 90 mm 3 1/2“ 120 mm 4 3/4“


Total length 185 mm 7 1/3“ 195 mm 7 3/4“ 215 mm 8 1/2“ 245 mm 9 3/4“

Angled bayonet shape Serrated blades


For enhanced sight lines and easier prevent the tissue
handling. It removes the surgeons from slipping
hand out of the view while out of the jaws.
working under the microscope.

33
MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

SENSATION Micro Instruments

Scissors, Scissors, angled


downwards curved

90 mm

1/1 1/1 1/1 1/1

90 mm
90 mm
90 mm
45° angled 45° angled 125° angled
31/2”

31/2”
31/2”
31/2”
one blade
probe pointed

1/2 1/2 1/2 1/2

sharp/sharp FM163R

blunt/blunt FM164R FM167R FM168R FM169R

Working length 90 mm 3 1/2“ 90 mm 3 1/2“ 90 mm 3 1/2“ 90 mm 3 1/2“


Total length 215 mm 8 1/2“ 215 mm 8 1/2“ 215 mm 8 1/2“ 215 mm 8 1/2“

upwards curved downwards curved 45° angled 45° angled 125° angled
with knob

34
Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
e x t
Scissors,
upwards curved

r a5 mm 5 / ”
13
120 m

13
m 4 /4
90 mm

l o n
3 ”
70 mm

31/2”
23/4”

1/1

g
1/2 1/2 1/2 1/2

sharp/sharp FM121R FM123R FM125R FM161R

sharp/blunt FM131R FM133R FM135R

blunt/blunt FM141R FM143R FM145R FM162R

Working length 70 mm 2 3/4“ 90 mm 3 1/2“ 120 mm 4 3/4“ 135 mm 5 1/3“


Total length 195 mm 7 3/4“ 215 mm 8 1/2“ 245 mm 9 3/4“ 260 mm 10 1/2“

35
MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

SENSATION Micro Instruments

1/1

120 mm 4 /4”
1/1 1/1

90 mm 3

3
90 mm 3 /2
1/2”

1 ”

1/2 1/2 1/2

Tissue forceps 1 x 2 teeth FM174R

Tumor grasping forceps 2.5 mm FM176R FM178R

Tumor grasping forceps 3.5 mm FM177R FM179R

Working length 90 mm 3 1/2“ 90 mm 3 1/2“ 120 mm 4 3/4“


Total length 210 mm 8“ 210 mm 8“ 240 mm 9 3/4“

Forceps with teeth for Serrated ring tip


safe grasping and for quick and safe
holding of tissue. tumor removal
Ideal for soft lifting of
fine structures.

36
Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
120 mm
90 mm

43/4”
31/2”
70 mm
2
3/4”

1/2 1/2 1/2

0.5 mm FM150R FM153R FM156R

0.9 mm FM151R FM154R FM157R

Working length 70 mm 2 3/4“ 90 mm 3 1/2“ 120 mm 4 3/4“


Total length 190 mm 7 3/4“ 210 mm 8 1/2“ 245 mm 9 3/4“

Grasping of fine Pin prevents


structures scissoring

37
MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

TREND Curettes and Dissectors

TREND instruments
Bayonet instruments for
pituitary and skull base
1/8

NICOLA NICOLA HARDY HARDY


FA041R-FA068R FA041R FA042R FA043R FA044R
Working length: Curette Curette Enucleator Enucleator
130 mm, 5 1⁄8” diam. 6.5 mm diam. 6.5 mm left cutting right cutting
45° vertical 45° horizontal
Total length: angled short
angled long
280 mm, 11” neck neck

1/1

HARDY HARDY HARDY HARDY


FA045R FA046R FA047R FA060R
Curette Curette Curette Curette
diam. 4.0 mm diam. 4.0 mm diam. 4.0 mm diam. 4.0 mm
90° left angled 90° left angled 90° right angled 90° right angled
long neck short neck long neck short neck

" Compared to a classical curette instrument, the TREND curettes provide highly ergonomic
grasping with a well-balanced weight distribution and a perfect grip. This significantly supports the
curette movements when the instrument is inserted vertically into smaller craniotomies, e.g.
keyhole approaches. As the TREND instruments come in bayonet and straight design, I use them for
both microscopic minimally invasive keyhole surgery and endoscope-assisted approaches.
"
Nikolai Hopf, Stuttgart, Germany

38
Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
HARDY HARDY HARDY HARDY
FA061R FA062R FA063R FA064R
Curette Curette Curette Curette
diam. 4.0 mm diam. 4.0 mm diam 6.0 mm diam. 6.0 mm
45° left 45° right 90° left angled 90° left angled
horizontal angled horizontal angled long neck short neck
short neck short neck

1/1

REULEN- REULEN-
HARDY HARDY LANDOLT LANDOLT
FA065R FA066R FA067R FA068R
Curette Curette Micro Hook Dissector
diam. 6.0 mm diam. 6.0 mm diam. 1.7 mm diam. 2.0 mm
90° right angled 90° right angled blunt
long neck short neck

39
MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

Bipolar Yasargil Forceps

Bipolar Yasargil forceps:


extra-small bipolar forceps for
keyhole approaches

135 mm, 5 1⁄4“

95 mm, 3 3⁄4“

95 mm, 3 3⁄4“
Special pin between the branches
opens the tip of the forceps by
additional compression of the
handle – allowing secure coagula-
tion in narrow and deep seated
surgical field.

1/2

0.4 mm GK780R

0.7 mm GK777R

GK801R 0.7 mm GK781R

Total length 255 mm, 10” 215 mm, 8 1/2” 215 mm, 8 1/2”

" The black "pivot" bipolar forceps are a great advance. The bipolar is as essential a tool as the
neurosurgeon's own fingers. As we go more and more minimally invasive, the need for a very
slim, responsive bipolar that will work under tight conditions is essential. The tips can be
precisely separated even when the shafts are together in a tiny space. This is a must-have
instrument, especially for transphenoidal and keyhole approaches.
"
Peter Nakaji, Phoenix, USA

40
Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
Atraumatic Micro Suction Instruments

Micro Suction Cannulas:


Atraumatic and rigid suction cannluas

Color code Working length Working length Working length Working length
80 mm 100 mm 120 mm 140 mm

yellow, 1.4 mm 4 Fr ⁄1
1 GF470R GF473R GF476R GF479R

blue, 2.0 mm 6 Fr ⁄1
1
GF471R GF474R GF477R GF480R

green, 2.7 mm 8 Fr ⁄1
1
GF472R GF475R GF478R GF481R
3 Fr = 1 mm

In endoscope-assisted approaches to complex structures


like fine vessels or aneurysms, Micro-Cannulas are
reassuringly safe due to the delicate instrument tip.
During preparations in conjunction with a bipolar
forceps the Micro-Cannula offers a safe and stable
retraction.
The ball tip at the end of Colour coding for rapid identification
the instrument allows gentle of all three diameters. Black Rings as
preparation and stable indicators to identify the instrument
atraumatic retraction. length.

41
MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

Curved Micro Suction Instruments

Suction cannulas
Curved suction instruments
FUKUSHIMA DESIGN


5
m m,
h 135
lengt
ing 8”
Wo
rk
00 mm,
g th 2
l len
Tota

Working length 135 mm, 5 1/4” 135 mm, 5 1/4”


Total length 200 mm, 8” 200 mm, 8”
Outer diameter 2.7 mm 2.7 mm
Inner diameter 2.0 mm 2.0 mm
Angled tip Right angled tip Left angled tip

GF431R GF432R

42
Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
Micro Suction Instruments - Fukushima Design

Suction Cannulas
Bendable suction cannulas
FUKUSHIMA DESIGN
S
0 mm
gth 10
kin g len
Wor lengt
h
Total

M
m
115 m

L
mm
140

LL
mm
165 Suction cannulae, tapered teardrop

S M L LL
Working length 100 mm, 4“ 115 mm, 4 1/2“ 140 mm, 5 1/2“ 165 mm, 6 1/2“
Total length 165 mm, 6 1/2” 180 mm, 7” 205 mm, 8” 230 mm, 9”
Outer diameter

3 Fr 1.0 mm GF401R GF391R GF411R GF421R

4 Fr 1.4 mm GF402R GF392R GF412R GF422R

5 Fr 1.7 mm GF403R GF393R GF413R GF423R

6 Fr 2.0 mm GF404R GF394R GF414R GF424R

7 Fr 2.3 mm GF405R GF395R GF415R GF425R

8 Fr 2.7 mm GF406R GF396R GF416R GF426R

9 Fr 3.0 mm GF407R GF397R GF417R GF427R

10 Fr 3.3 mm GF408R GF398R GF418R GF428R

12 Fr 4.0 mm GF409R GF399R GF419R GF429R

Tear drop shaped thumb control for very precise suction regulation
Malleable material for individual forming the suction hose
Conical tube design prevents plugging
Large, clear labeling of outer diameter and length on the thumb control
for easy and fast identification

43
MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

Diamond Knives

Diamond knives
Blade made of natural diamond
Superior mechanical stability
& elasticity of the blade
Sustained sharpness
Excellently clean, precise
and force-free incisions
Protection mechanism for
safe storage of the blade
inside the handle
Color coded Titanium handles

1
⁄1 ⁄1
1 1
⁄1 ⁄1
1

FD113D FD114D FD115D FD116D

Round blade, Retro blade, Wedge blade, Lancet blade,


gold-colored copper-colored black-colored bronze-colored
7 facets 60° 45° 60°
Length Length Length Length
205 mm, 8” 205 mm, 8” 205 mm, 8” 205 mm, 8”

SEM view of a diamond knife blade SEM view of a common scalpel blade

44
Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
NOIR® Brain Spatulas

NOIR® Brain Spatulas


NOIR® (NO Irritating Reflections)
Less light reflections under the
endoscope light
Length 200 mm, 8”

FF456B FF457B FF458B FF459B

S M L XL
8/4 mm 13/6 mm 17/9 mm 21/11 mm

" Important goal in minimally invasive keyhole approaches is to avoid unnecessary brain exploration
and retraction. With accurately tailored limited craniotomy and patients adequate positioning this
ambition can be achieved in most cases. Nevertheless, if retraction cannot be avoided or brain sur-
face must be protected, the use of a sensitive brain spatula is obligatory. With their conical shape,
the NOIR® spatulas avoid extensive deep tissue retraction and provide excellent visualization of the
field. In addition, the black coating avoids disturbing reflections using endoscope-assisted TEAM
technique.
"
Robert Reisch, Zurich, Switzerland

45
MINOP® TEAM
Transcranial Endoscope Assisted Microneurosurgery

NOIR® KERRISON Bone Punches – NOIR® (NO Irritating Reflections)

Jaw position 130°, upward opening

Shaft length Width Footplate Article No. Ejector Jaw opening

180 mm, 7” 1.0 mm standard FK900B - 8 mm

1.5 mm standard FK911B - 9 mm

2.0 mm standard FK901B  9 mm

2.5 mm standard FK912B  10 mm

3.0 mm standard FK902B  10 mm

200 mm, 7 3/4” 4.0 mm standard FK966B - 9 mm

2.0 mm standard FK913B  9 mm

2.5 mm standard FK967B  10 mm

3.0 mm standard FK914B  10 mm

At a glance, large numbered jaw Ejector - for the easy removal of Numerical code – for reliable identification
identification punched-out material. when assembling the two punch components.

46
Aesculap Neurosurgery

Endoscope-Assisted
Microneurosurgery
KERRISON Bayonet Bone Punches

Jaw position 130°, upward opening

Length Width Working length Article No. Jaw width

240 mm, 7” 2.0 mm 170 mm FF496R 10 mm

3.0 mm 170 mm FK497R 10 mm

4.0 mm 170 mm FK498R 10 mm

5.0 mm 170 mm FK499R 10 mm

47
48
Transnasal Neuroendoscopy

Neuroendoscopy
Transnasal

49
MINOP® TREND
TRansnasal ENDoscopic System

50
Aesculap Neurosurgery

When looking at recent publications on trans- rhinoseptal submucosal dissection providing a


"
sphenoidal surgery, it will be clear that TRans- direct and quicker approach to the sphenoid sinus.
sphenoidal ENDoscopy is TREND-setting! How- This method avoids the need for postoperative na-
ever, this endoscopic technique is not in routine sal packing, thus causing less pain and discomfort
use everywhere and neurosurgeons are often after surgery, providing better nasal airflow and a
reluctant to use it: One is often cautious about an shorter hospital stay.
endoscopic endonasal dissection because the
permanent contamination of the endoscope with Pre-conditions of transsphenoidal endoscopy
blood and nasal secretions hinders orientation. In are the basic endoscopic experience and anato-

Neuroendoscopy
addition, the para-endoscopic and biportal mical studies in the laboratory; however, it is

Transnasal
dissection is very unfamiliar requiring an un- indispensable to use a dedicated endoscopic
acceptably steep learning curve. system to further shorten the learning phase. The
endoscope for transsphenoidal skull base surgery
Nevertheless, endoscopic visualization and must provide a brilliant image quality with true
para-endoscopic dissection without using the colors, high contrast and highly realistic images.
surgical microscope offers several undisputable This simplifies the differentiation between
advantages. Advantages in visualization increa- healthy or pathological structures. It is essential
ses light intensity in the deep-seated surgical field to have an effective cleaning function in order to
and clearly displays patho-anatomical details. In free the endoscope lens from fog, blood or muco-
addition, the extended viewing angle of endosco- sal secretions. The endoscope must offer a high-
pes enables surgeons to observe hidden parts of ly ergonomic design and sufficient working length
the surgical field. The major benefit in surgical for extended approaches. For selected cases, it is
dissection is the unhindered approach to these also necessary to connect the endoscope to
clearly visible structures: Without using a nasal
speculum, surgical manipulation is not impeded
a navigation system or a holding device.
"
and the instruments are freely mobile. In addition, André Grotenhuis , Robert Reisch
a pure endoscopic technique avoids the need for

André Grotenhuis Robert Reisch


Nijmegen, Netherlands Zurich, Switzerland

51
MINOP® TREND
TRansnasal ENDoscopic System

MINOP® TREND

FH615 RT099R

Handle with irrigation button Adapter for Aesculap


for FH610R and FH611R holding arm
Ergonomic grasping part

FH605SU

Suction and irrigation tube,


sterile, 4.5 m, 2 puncture needles,
for MINOP® TREND handle FH615
and FH610R/FH611R,
Package of 10 tubes

FF357R

Storage tray with silicone


padding and lid for all
MINOP® TREND components

JK740

container body 3/4


with base perforation
(L/W/H 470/274/90)

JK789
container lid 3/4
blue

" The view through the operating microscope allows a purely coaxial visualisation in transsphenoidal
surgery: laterally located structures are concealed behind the nasal speculum. Blind tumor removal
involves a higher risk of iatrogenic damage to neurovascular structures and a possible increase in tumor
remnants. With the use of the MINOP TREND endoscope for transnasal procedures, these laterally
located parts of the field are directly visible and therefore surgically better approachable. In the past 15
years of endoscopic transnasal surgery, the use of endoscopes has proven to be not only indispensable
but rather mandatory for a safe and effective transnasal surgery in de sellar and parasellar region.
"
André Grotenhuis, Nijmegen, Netherlands

52
Aesculap Neurosurgery

FH610R

Neuroendoscopy
Transnasal
Suction and irrigation trocar
for 0° endoscope PE487A
Diameter: 4.5 / 6.0 mm
Working length: 120 mm

FH611R

Suction and irrigation trocar


for 30° endoscope PE507A
Diameter: 4.5 / 6.0 mm
Working length: 120 mm

PE487A

Endoscope
0° viewing angle,
shaft diameter 4.0 mm

PE507A

Endoscope
30° viewing angle,
shaft diameter 4.0 mm

" No other system that I have used combines as many helpful features in a single 'instrument'.
The lens cleaning is rapid and conveniently controlled with a button, instead of a pedal. The suction
is effective. The ability to rotate the scope easily and quickly within the handle improves angled
viewing. Overall, these features make the MINOP TREND an asset for endonasal surgery.
"
Jeremy Greenlee, Iowa City, USA

53
MINOP® TREND
TRansnasal ENDoscopic System

TREND – Curettes and Dissectors

1/8

NICOLA NICOLA HARDY HARDY


FA041R-FA068R FA041R FA042R FA043R FA044R
Working length Curette Curette Enucleator Enucleator
130 mm, 5 1⁄8” diam. 6.5 mm diam. 6.5 mm left cutting right cutting
45° vertical angled 45° horizontal
Total length angled, short
long neck
280 mm, 11” neck

1/1

HARDY HARDY HARDY HARDY


FA045R FA046R FA047R FA060R
Curette Curette Curette Curette
diam. 4.0 mm diam. 4.0 mm diam. 4.0 mm diam. 4.0 mm
90° left angled 90° left angled 90° right angled 90° right angled
long neck short neck long neck short neck

Difficulties in the learning curve of transsphenoidal endoscopy are often caused by handicaps of
"
endoscope systems. The TREND endoscope clearly compensates this drawback with a human-
engineered grasping part. The surgeon holds the TREND endoscope as a fine microinstrument allowing
precise manipulation; the unique construction and perfect balance provide a less tiring tool for the
neurosurgeon. The efficient suction/irrigation device is also incorporated within the grasping part
where the valve is controlled simply with the index finger. Moreover the grasping part offers a quick
connection of the endoscope to a holding arm and easy application with several navigation systems.
"
Robert Reisch, Zurich, Switzerland

54
Aesculap Neurosurgery

Neuroendoscopy
Transnasal
HARDY HARDY HARDY HARDY
FA061R FA062R FA063R FA064R
Curette Curette Curette Curette
diam. 4.0 mm diam. 4.0 mm diam 6.0 mm diam. 6.0 mm
45° left 45° right 90° left angled 90° left angled
horizontal angled horizontal angled long neck short neck
short neck short neck

1/1

REULEN- REULEN-
HARDY HARDY LANDOLT LANDOLT
For more information about
FA065R FA066R FA067R FA068R Minop® Trend instruments please
Curette Curette Micro Hook Dissector see our brochure no. C26402.
diam. 6.0 mm diam. 6.0 mm diam. 1.7 mm diam. 2.0 mm
90° right angled 90° right angled blunt
long neck short neck

55
MINOP® TREND
TRansnasal ENDoscopic System

TREND – Curettes and Dissectors

1/1

NICOLA NICOLA HARDY HARDY HARDY HARDY


FA030R FA031R FA032R FA033R FA034R FA035R
Curette Curette Enucleator Enucleator Curette Curette
diam. 6.5 mm diam. 6.5 mm diam. 4.0 mm diam. 4.0 mm
45° vertical 45° horizontal left cutting right cutting 90° angled 90° angled
angled, long neck angled, short neck long neck short neck

FA030R-FA040R

Working length:
140 mm, 5 1⁄2”

Total length:
265 mm, 10 1⁄2”
1/1
Straight design with
ergonomic grasping
LANDOLT- LANDOLT-
part and semi-sharp
tips HARDY HARDY HARDY REULEN REULEN
FA036R FA037R FA038R FA039R FA040R
Curette Curette Curette Micro Hook Dissector
diam. 4.0 mm diam. 6.0 mm diam. 6.0 mm diam. 1.7 mm diam. 2.0 mm
45° angled 90° angled 90° angled blunt
short neck long neck short neck

56
Aesculap Neurosurgery

Nasal Specula

OK090R
90 x 7 mm

Neuroendoscopy
Nasal specula for

Transnasal
protective
mobilization
of the turbinates

1/2

" Operating with surgical miroscope, the use of a nasal speculum is mandatory in transnasal surgery.
However, the narrow space between the blades of the speculum causes an almost coaxial view of the
instruments and very little free movement within the deep-seated field. The main advantage of the
pure endoscopic approach is not only the superior visualisation, but also the lack of restrictions is
surgical dissection. Therefore, I use the nasal specula only by initiation of the operation, for gentle
mobilisation on the nasal turbinates and optimal placement of patties for nasal deflammation.
"
Robert Reisch, Zurich, Switzerland

57
MINOP® TREND
TRansnasal ENDoscopic System

Pituitary Instruments

FA076R

Backwards cutting
antrum punch,
Rotating sheath 360°,
1/1
Working length: 120 mm, 4 3⁄4“

For removal of posterior


nasal septum
1/2

LANDOLT
205 mm, 8”
FF345R

Tumor grasping forceps,


blunt
Diam. 9.0 mm

1/1

1/1

1/2

58
Aesculap Neurosurgery

GK801R Special pin between the branches opens the tip of


the forceps by additional compression of the
Bipolar coagulation forceps handle – allowing secure coagulation in narrow

Neuroendoscopy
with slender jaws and higher and deep seated surgical field.

Transnasal
spring tension
Total length 255 mm, 10”
Working length 135 mm, 5 1⁄4“ 135 mm, 5 1⁄4“

1/2

GK800R

T-coagulation forceps
135 mm, 5 1⁄4“
with blunt, t-shaped tips
1/1
Total length 255 mm, 10” 1/2
Working length 135 mm, 5 1⁄4“

FM158R
3/4“
120 mm, 4
Bayonet grasping forceps
straight tip
Total length 240 mm, 9 1⁄2”
Working length 120 mm, 4 3⁄4 ” 1/2

FM156R Jaw 0.5 mm


FM157R Jaw 0.9 mm
, 4 3/4“
120 mm
Bayonet micro grasping
forceps straight tip
Working length 120 mm, 4 3⁄4”
Total length 245 mm, 9 3⁄4” 1/2

59
MINOP® TREND
TRansnasal ENDoscopic System

Pituitary Scissors

165 mm, 6 1⁄2”

FAHLBUSCH
FD220R
1/1
Micro scissors, extra delicate pattern,
curved on flat, horizontal cutting 1/2

NICOLA
FD222R FD220R-FD226R
1/1
Forceps, scoop-shaped, diam. 2.5 mm extra delicate tubular shaft
scissors and grasping instruments
YASARGIL-NICOLA
for pituitary & skull base surgery
FD224R
1/1
Grasping forceps with long conical jaw

NICOLA
FD226R
1/1
Micro scissors, straight, diam. 2.5 mm

115 mm, 4 1/2”

CASPAR
FD228R
1/1
Micro scissors, curved
rotatable sheath 360°
1/2

" Essential part of the endoscopic transnasal surgery is the nasal dissection, using special pituitary in-
struments. Goal is the maximum exploration of the target area, but also minimally invasive nasal trau-
matisation, thus avoiding mucosal lacerations and unnecessary bony fractures. This influences patients
postoperative quality of life enormously.
"
André Grotenhuis, Nijmegen, Netherlands

60
Aesculap Neurosurgery

180 mm, 7”

Neuroendoscopy
Transnasal
FA072R
straight
1/1

1/2
FA073R

1/1
left curved

FA074R FA072R-FA075R
right curved Micro Scissors
1/1

FA075R

1/1
angular

180 mm, 7”

FA069R
1/1 straight

1/2
FA070R

1/1
right curved
FA069R-FA071R
FA071R
Micro Forceps
1/1
left curved

61
MINOP® TREND
TRansnasal ENDoscopic System

Curved Micro Suction Instruments

Suction cannulas
Curved suction instruments
FUKUSHIMA DESIGN


5
m m,
h 135
lengt
ing 8”
Wo
rk
00 mm,
g th 2
l len
Tota

Working length 135 mm, 5 1/4” 135 mm, 5 1/4”


Total length 200 mm, 8” 200 mm, 8”
Outer diameter 2.7 mm 2.7 mm
Inner diameter 2.0 mm 2.0 mm
Angled tip Right angled tip Left angled tip

GF431R GF432R

62
Aesculap Neurosurgery

Micro Suction Instruments

Suction Cannulas
Bendable suction cannulas
FUKUSHIMA DESIGN

Neuroendoscopy
S
0 mm

Transnasal
gth 10
kin g len
Wor lengt
h
Total

M
m
115 m

L
mm
140

LL
mm
165 Suction cannulae, tapered teardrop

S M L LL
Working length 100 mm, 4“ 115 mm, 4 1/2“ 140 mm, 5 1/2“ 165 mm, 6 1/2“
Total length 165 mm, 6 1/2” 180 mm, 7” 205 mm, 8” 230 mm, 9”
Outer diameter

3 Fr 1.0 mm GF401R GF391R GF411R GF421R

4 Fr 1.4 mm GF402R GF392R GF412R GF422R

5 Fr 1.7 mm GF403R GF393R GF413R GF423R

6 Fr 2.0 mm GF404R GF394R GF414R GF424R

7 Fr 2.3 mm GF405R GF395R GF415R GF425R

8 Fr 2.7 mm GF406R GF396R GF416R GF426R

9 Fr 3.0 mm GF407R GF397R GF417R GF427R

10 Fr 3.3 mm GF408R GF398R GF418R GF428R

12 Fr 4.0 mm GF409R GF399R GF419R GF429R

63
MINOP® TREND
TRansnasal ENDoscopic System

KERRISON Bone Punches

Jaw position 130°, upward opening

Shaft length Width Footplate Non detachable, Detachable Ejector NOIR®, Ejector Jaw opening
without ejector detachable

180 mm, 7” 1.0 mm thin FF771R FK906R - FK906B - 8 mm

1.5 mm thin FF645R FK923R - FK923B - 9 mm

2.0 mm thin FF772R FK907R  FK907B  9 mm

2.5 mm thin FF646R FK924R  FK924B  10 mm

3.0 mm thin FF773R FK908R  FK908B  10 mm

4.0 mm thin FF769R FK909R  FK909B  12 mm

Jaw position 130°, downward opening

Shaft length Width Footplate Non detachable, Detachable Ejector Jaw opening
without ejector

180 mm, 7” 1.0 mm thin FF781R FK936R - 8 mm

2.0 mm thin FF782R FK937R  9 mm

3.0 mm thin FF783R FK938R  10 mm

64
Aesculap Neurosurgery

KERRISON Bayonet Bone Punches

Jaw position 130°, upward opening

Neuroendoscopy
Transnasal
Length Width Working length Article No. Jaw width

240 mm, 7” 2.0 mm 170 mm FF496R 10 mm

3.0 mm 170 mm FK497R 10 mm

4.0 mm 170 mm FK498R 10 mm

5.0 mm 170 mm FK499R 10 mm

65
Aesculap Neurosurgery
Holding Devices

M-TRAC – Mechanical Holding Arm

FF168R

M-TRAC
Flexible holding device with mechanical fixation
Assembly: flexible holding arm with integrated
fixation bar
Total length: 107 cm
Length of fixation bar: 46 cm
Diameter of fixation bar: 20 mm
Total weight: 0,7 kg
Holding force: 4 kg
Easy mechanical fixation by clamping handle
Small, flexible joints for fine positioning
Autoclavable 134°C, 5 minutes
Full range of accessories/adapters for connecting
Aesculap endoscopes, trocars and instruments
Holding Arm fits into regular
Standard 1/1 Container

FF280R RT090R FF151R

Flexible fixing element with Flexible fixing element with Rigid fixation element suitable
ball joint suitable for RT040R and sprocket suitable for RT040R and for RT040R and FF168R
FF168R FF168R

66
Aesculap Neurosurgery

UNITRAC – Pneumatic Holding Arm

RT040R

UNITRAC®
Single handed use
Fast sterile set-up in the OR
Universal retraction and holding system with
special accessories for neuroendoscopy
Simple to assemble onto the OR table railing
Integrated safety systems prevent collapse
of holding arm if OR compressed air supply

Holding Devices
is interrupted
Direct connection to OR compressed air supply
Diameter of fixation bar: 20 mm
To be used with JG901

JG901 RT020R

Sterile drape for coverage of the Quick connect adapter for use with
Unitrac® arms, single-use product, sterile drape JG901allows the change
package of 50 pcs. of instruments after draping with JG901

" Bimanual, two-handed dissection forms the foundation of microneurosurgery and is also an
essential precondition for transsphenoidal endoneurosurgery. For this reason, the TREND endoscope
can be easily fixed in a special holding arm: the endoscope placed through nostril does not disturb
surgical dissection, especially by using biportal – binostril approaches. The pneumatic and mechani-
cal devices can be also used effectively in transcranial endoscope-controlled and intraventricular
pure endoscopic neurosurgery.
"
Nikolai Hopf, Stuttgart, Germany

67
Aesculap Neurosurgery
Holding Devices

Adapters for UNITRAC® and M-TRAC

RT046P RT099R

Universal Holder Adapter


for Endoscopes diam. 3.0-7.5 mm for fixation of MINOP® TREND
consisting of: RT081R and RT055P handle, FH615

RT081R RT079R

Adapter Adapter
for universal insert RT055P for fixation of angled
neuroscopes PE486A, PE506A,
PE526A

RT055P RT079205

Universal Insert (Spare Part) Silicone insert for RT079R


for Endoscopes diam. 3.0-7.5 mm

68
Aesculap Neurosurgery

Angled Angled Angled MINOP®


MINOP® MINOP® MINOP® Paediscope MINOP® TR
scopes scopes scopes TREND
FF397R FF398R FF399R PA010A FH601R
PE486A PE506A PE526A FH615

RT046P

RT099R

Holding Devices
RT079R

69
Aesculap Neurosurgery
Holding Devices

Neuropilot® – Fine-positioning for UNITRAC® and M-TRAC

NeuroPilot® for IntraVentricular


and Endoscope-Assisted
indications with all Aesculap
neuroendoscopes. NeuroPilot® is a
new, unique steering device for
neuroendoscopes. After positioning
the neuroendoscope in situ, finest
corrections or adjustments are
necessary, to receive the optimal
endoscopic image. With traditio-
nal holding devices, only rough
positioning is possible; a precise
and fine steering of the neuro-
endoscope can be compromised.
NeuroPilot® offers a number of
unique advantages:
Optimal fixation of the neuro-
endoscope in the NeuroPilot®
and the holding device UNITRAC®
Precise steering of the neuro-
endoscope by three screws in
the three-dimensional space
Safe manoeuvring of the neuro-
endoscope by defined move-
ments in the sub-millimeter area
Optimal positioning of the
neuro-endoscope in situ

" In pure intraventricular neuroendoscopy, a micro-steering device can be extremely useful. If the
precision and adjustment of a holding arm is not enough, the Neuropilot closes this gap. Additionally,
in cases where both hands are needed for instrumentation the Neuropilot is of great help.
The Aesculap Neuropilot is the only system on the market providing finest correction of your endos-
cope in a three-dimensional space inside the ventricular compartments.
"
Peter Nakaji, Phoenix, USA

70
Aesculap Neurosurgery

RT060R

NeuroPilot ®
for intraventricular and endoscope-assisted
indications with all Aesculap neuroendoscopes

Holding Devices
RT061R RT064R

Insert for angled neuroscopes Insert for MINOP ® trocars FF398R


PE486A - PE526A with diam. 4 mm and FH601R with diam. 4.6 mm

RT062R RT065R

Insert for short ventriculoscope Insert for MINOP ® trocar FF399R


FF372R with diam. 6.2 mm with diam. 6 mm

RT063R RT066R

Insert for MINOP ® trocar FF397R Insert for PaediScope® PF010A


with diam. 3.2 mm with diam. 3 mm

71
Aesculap Neurosurgery
Holding Devices

Neuropilot® – Fine-positioning for UNITRAC® and M-TRAC

Angled Angled Angled MINOP®


MINOP® MINOP® MINOP® Paediscope MINOP® TR
scopes scopes scopes TREND
FF397R FF398R FF399R PA010A FH601R
PE486A PE506A PE526A FH615

RT060R

RT061R

RT062P

RT063P

RT064P

RT065P

RT066P

72
Aesculap Neurosurgery

Holding Devices

73
Aesculap Neurosurgery
Visual Equipment

Neuroendoscopy Tower with FULL HD Camera and Touch Screen

PV875

Extension arm for flat panel display


VESA 100 Fixation

PV946

24” Full HD flat panel

PV909
PV941 Monitor stand
for PV946
15“ Flat panel display “Touch Screen”
for EDDY PV820
PV440

Full HD Camera system


PV820 consisting of CCU, 3 chip
camera head, zoomcoupler
EDDY DVD PV126S, to be ordered
Digital Documentation System separately

OP930
PV880
Xenon light source
“Metro Junior” Endoscopy cart
835 x 1580 x 750 mm (w x h x d)

PV881

“Metro Classic” Endoscopy cart


with integrated Isolation Transformer
835 x 1580 x 750 mm (w x h x d)

Recently, the intraoperative use of full high definition (HD) image quality offers a new area in endoscopic neurosurgery
"
with an increased range of indications in minimally invasive neurosurgery. The image quality of the full-HD system is
markedly superior to that of a standard one- or three-chip camera unit providing a five times higher optical resolution.
This superior quality is particularly important in delicate situations, namely the differentiation of subtle structures and in
the case of blurred scope vision. A recording system is also an important part of the equipment for documentation of
the procedure and is useful for scientific evaluation and teaching purposes. An ideal solution is a digital video system
with user friendly and rapid recording, e.g. with a touch screen.
"
Nikolai Hopf, Stuttgart, Germany

74
Aesculap Neurosurgery

OP923

Full HD Light cable,


autoclavable, diam. 4.8 mm,
length 250 cm

JG904

Sterile Camera drape,


disposable, ring design,
package of 25

JG908SU

Visual Equipment
Closed sterile Camera drape,
15 cm diam. the optic can
be changed under sterile
conditions during surgery,
package of 10

For more information see brochure C46702

for more information about


visual equipment and
accessories, please ask your
local Aesculap sales
representative:
Brochure C46702 (English),
C46701 (German).

75
Aesculap Neurosurgery
Power Systems

microspeed uni – Electric High Speed Motor System

System components:

GD670
For more information about
microspeed uni equipment and
microspeed uni control unit
accessories, please ask your local
Aesculap sales representative or
see brochure no. O28302

GD675

microspeed uni XS high speed motor

GD685

microspeed uni perforator driver

GD672

motor cable

GD668

foot control – single pedal

76
Aesculap Neurosurgery

HiLAN® XS – Pneumatic High Speed Motor System

System components:

GA740R
For more information about
Hilan XS equipment and accessories,
HiLAN XS
please ask your local Aesculap sales
high speed motor representative or see brochure no.
O26002

GA742R

HiLAN
perforator driver

GA521

Foot Pedal

GA513R Motor hose (3 m)

GA464R Supply hose (3 m)

Power Systems
wall connection Aesculap Dräger

GA468R Supply hose (3 m)


wall connection Schrader

GA461R Supply hose (3 m)


wall connection DIN

77
Aesculap Neurosurgery
Power Systems

Highspeed Tools – for microspeed uni and HiLAN XS

GB740R Dura guard Craniotome cutters


Fixed Steerable
Spiral Straight

GB741R GB746R GE420R GE429SU

Fixed Steerable

Spiral Straight

GB742R GB747R GE520R GE529SU

Fixed Steerable

Spiral Straight

GB743R GB748R GE620R GE629SU

78
Aesculap Neurosurgery

Drill depth guard Twist drills

Ø 1.0 Ø 1.1 Ø 1.2 Ø 1.5

GB744R GE390R GE391R GE389R GE395R


2 – 8 mm

Holding sleeve Diamond burrs


Coarse Extra coarse

Ø 3.1 Ø 5.0 Ø 6.0 Ø 4.0 Ø 5.0

GB745R GE394R GE398R GE399R GE386SU GE387SU

Twin-cut burrs Pin cutter

Ø 1.0

Power Systems
Ø 5.0 Ø 6.0

GE396R GE397R GE392R

79
Aesculap Neurosurgery
Power Systems

Highspeed Tools – for microspeed uni and HiLAN XS

GB751R GB756R Rosen burrs


Ø 1.0 Ø 1.4 Ø 1.8 Ø 2.3 Ø 2.7
mm
40
ca.
ca. 40 mm

GE401R GE402R GE403R GE404R GE405R

Diamond burrs
Ø 1.0 Ø 1.4 Ø 1.8 Ø 2.3 Ø 2.7

GE411R GE412R GE413R GE414R GE415R

Diamond burrs coarse Extra coarse


Ø 2.3 Ø 3.1 Ø 4.0 Ø 5.0

GE424R GE425R GE456SU GE457SU

Acorn burr Twist drills


Ø 6.0 Ø 1.5 Ø 2.0

GE437R GE432R GE433R

80
Aesculap Neurosurgery

Ø 3.1 Ø 4.0 Ø 5.0 Ø 6.0

GE406R GE407R GE408R GE409R

Ø 3.1 Ø 4.0 Ø 5.0 Ø 6.0

GE416R GE417R GE418R GE419R

Neuro cutters
Ø 1.8 Ø 2.3 Ø 3.1

GE431R GE434R GE435R

TUNGSTEN CARBIDE
Rosen burrs Neuro

Power Systems
cutter
Ø 3.1 Ø 4.0 Ø 5.0 Ø 3.1

GE406TC-SU GE407TC-SU GE408TC-SU GE435TC-SU

81
Aesculap Neurosurgery
Power Systems

Highspeed Tools – for microspeed uni and HiLAN XS

Rosen burrs
Ø 1.0 Ø 1.4 Ø 1.8 Ø 2.3 Ø 2.7
GB752R GB757R
mm

GE501R GE502R GE503R GE504R GE505R


70
ca. 70 mm

ca.

Diamond burrs

Ø 1.0 Ø 1.4 Ø 1.8 Ø 2.3 Ø 2.7

GE511R GE512R GE513R GE514R GE515R

Neuro cutters
Ø 3.1

Ø 1.8 Ø 2.3 Ø 3.1

GE531R GE534R GE535R GE553R

Cone burrs Acorn burr Twist drills


Ø 1.5 Ø 2.0

Ø 4.0 Ø 6.0 Ø 6.0

GE540R GE542R GE546R GE532R GE533R

82
Aesculap Neurosurgery

Ø 3.1 Ø 4.0 Ø 5.0 Ø 6.0

GE506R GE507R GE508R GE509R

Diamond burrs coarse Extra coarse

Ø 3.1 Ø 4.0 Ø 5.0 Ø 6.0 Ø 2.3 Ø 3.1 Ø 4.0 Ø 5.0 Ø 6.0

GE516R GE517R GE518R GE519R GE524R GE525R GE556SU GE557SU GE558SU

Diamond coarse Reverse Taper Barrel burrs Barrel burrs Oval burr
Ø 3.1 Ø 3.1 burr Diamond soft cut standard
coarse Ø 4.0 Ø 5.0 Ø 6.0 Ø 4.0 Ø 6.0 Ø 4.0
Ø 4.0

GE554R GE555R GE539R GE548R GE549R GE550R GE544R GE546R GE536R

Pin cutter Lindemann Tungsten carbide


Ø 1.0 Ø 1.4 Ø 1.4
Rosen burrs Neuro cutter

Power Systems
Ø 4.0 Ø 5.0 Ø 3.1
20 mm
12 mm

GE533R GE522R GE523R GE507TC-SU GE508TC-SU GE535TC-SU

83
Aesculap Neurosurgery
Power Systems

Highspeed Tools – for microspeed uni and HiLAN XS

Rosen burrs
Ø 1.8 Ø 2.3 Ø 2.7 Ø 3.1 Ø 4.0
GB753R GB758R

GE603R GE604R GE605R GE606R GE607R


mm

Diamond burrs
100
ca. 100 mm

Ø 1.8 Ø 2.3 Ø 2.7 Ø 3.1 Ø 4.0


ca.

GE613R GE614R GE615R GE616R GE617R

Diamond burrs coarse Extra coarse

Ø 2.3 Ø 3.1 Ø 4.0 Ø 5.0 Ø 6.0

GE624R GE625R GE656SU GE657SU GE658SU

Barrel burrs
soft cut
Ø 4.0
Ø 4.0 Ø 5.0 Ø 6.0

GE648R GE649R GE650R GE645R

84
Aesculap Neurosurgery

Ø 5.0 Ø 6.0

GE608R GE609R

Ø 5.0 Ø 6.0

GE618R GE619R Neuro cutters Reverse Taper


Diamond coarse burr
Neuro cutters Ø 3.1 Ø 3.1 Diamond coarse
Ø 3.1
Ø 4.0
Ø 1.8 Ø 2.3 Ø 3.1

GE631R GE634R GE635R GE653R GE654R GE655R GE639R

Barrel burrs Tungsten carbide


standard Rosen burrs Neuro cutter

Power Systems
Ø 4.0 Ø 6.0 Ø 4.0 Ø 5.0 Ø 3.1

GE644R GE646R GE607TC-SU GE608TC-SU GE635TC-SU

85
Aesculap Neurosurgery
Power Systems

Highspeed Tools – for microspeed uni and HiLAN XS

Rosen burrs
Ø 2.3 Ø 3.1 Ø 4.0 Ø 5.0 Ø 6.0
GB771R XLI

GE704R GE706R GE707R GE708R GE709R


mm
130

Diamond burrs
ca.

XLI
Ø 2.3 Ø 3.1 Ø 4.0 Ø 5.0 Ø 6.0

GE714R GE716R GE717R GE718R GE719R

Neuro Barrel burrs Twist drill


cutter soft cut Ø 1.5
Ø 3.1 Ø 4.0 Ø 5.0 Ø 6.0

GE702R GE711R GE729R GE712R GE700SU

86
Aesculap Neurosurgery

Power Systems

87
Aesculap Academy
Neuroendoscopy Courses

Horizons of Knowledge. Competence to Master the Future.

Innovative developments in the field of medical technology, sophisticated new treatment


methods, increasingly more stringent requirements for hospital and quality management
and, last but not least, a healthy interest in acquiring new knowledge have given rise to
an enormous and ever-increasing demand for further and advanced training.

The Aesculap Academy enjoys a world-wide reputation as a leading forum for medical
training and answers the demands of physicians and medical staff in OR, anaesthesia,
ward, outpatient care and hospital management. The course program comprises a wide
range of hands-on workshops, management seminars and international symposia.
www.aesculap-neuro.com or Aesculap Academy courses are of premium quality and are accredited by the respective
www.aesculap-academy.com medical societies and international medical organizations. A scientific advisory board
guarantees the perfect selection of speakers and topics.

All of our courses are conducted by pioneering neurosurgeons who will address the
theoretical knowledge of neuroendoscopy, cranial endoscopic anatomy, and clinical
applications of neuroendoscopy. Each course includes extensive hands-on sessions or pos-
sibly live surgeries. Course attendees will benefit from discussions and analysis of real
cases together with expert colleagues from all over the world. The training facilities of the
Aesculap Academy in Berlin and Tuttlingen are traditional and spectacular locations
for “sharing expertise”.

Competence to master the future – keep yourself fit for the future and ask for the latest
course programme offerings, e.g.

“Basic” Neuroendoscopy Course


“Advanced” Neuroendoscopy Course
“Applied” Neuroendoscopy Course

Visit our website and register for one of the next neuroendoscopy courses -
www.aesculap-neuro.com or www.aesculap-academy.com
or contact your local B. Braun Aesculap representative.

" Pre-requisites of intracranial neuroendoscopy are valuable and user-friendly endoscopic equipment. However, despite of
availability of dedicated systems, the endoscopic technique is not in routine use everywhere and neurosurgeons are often
hesitant to use it. The cause of the aversion is often the steep learning curve. The goal of our Neuroendoscopy Courses is to
facilitate the initial steps, thus giving a comprehensive overview in contemporary endoscopic techniques, including intraventri-
cular, transcranial and transnasal applications. Didactic lectures by international experts give the necessary theoretical basis.
Extensive hands-on laboratory allow basic anatomical studies and offer practical experience with endoscopes. Illustrative live
surgeries show clinical application, giving advantageous tips in the every-day application of neuroendoscopy.
"

88
Aesculap Neurosurgery

“Basic” Neuroendoscopy Course “Advanced” Neuroendoscopy Course “Applied” Neuroendoscopy Course

The objective of the course ”Basic Intra- “Advanced Intracranial Neuroendos- The course ”Applied Intracranial Neu-
cranial Neuroendoscopy“ is to offer a copy” is designed for neurosurgeons with roendoscopy“ offers a clinically oriented
comprehensive overview on endoscopic basic experience in neuroendoscopic comprehensive overview on contempo-
techniques in intracranial neurosurgery. techniques. The didactic lectures address rary techniques in cranial endoscopic
Didactic lectures, extensive hands-on the preoperative surgical planning as well neurosurgery. Dedicated lectures, exten-
laboratory and illustrative live-surgeries as distinguished endoscopic techniques sive case discussions and live surgeries
are especially designed for newcomers in for cranial neurosurgery. Extended hands- will offer important tips and tricks
the field of neuroendoscopy, giving ex- on dissections and illustrative live sur- providing valuable instructions for your
cellent theoretical and practical basis. geries demonstrate clinical applications everyday use. This event is a well recom-
Manuals and digital documentation of in the daily routine offering important mended adjunct to the hands-on courses
your own laboratory exercise provide an tips and tricks as well as valuable in- on ”Basic Intracranial Neuroendoscopy“
additional positive impact on your lear- structions for everyday use. The course and ”Advanced Intracranial Neuroendo-
ning. is offered in two complementary parts. scopy“ in Berlin and Tuttlingen. In addi-
However, please note, that the both parts tion, you will have the opportunity to look
can be booked separately as well as in behind the scenes of the headquarters
combination. and manufacturing plant of B. Braun
Part I (Endoscope-assisted Neurosurge- Aesculap in Tuttlingen. Forming aneurysm
ry) concentrates on minimally invasive clips yourself, experiencing how micro in-
transcranial keyhole approaches and struments are manually fabricated and
endoscope–assisted techniques dealing visiting the famous Surgery Museum
in a comprehensive way with the supra- Asclepios are impressive parts of the
orbital, subtemporal and retrosigmoidal course.
exposure.
Part II (Endoscopic Transsphenoidal
Surgery) deals with endoscopic techni-
ques to treat sellar and parasellar lesions
via the transsphenoidal route. Special
attention will be given to extended skull
base surgery.
Aesculap Academy

André Grotenhuis Nikolai Hopf Peter Nakaji Robert Reisch Mark Souweidane
Nijmegen, Netherlands Stuttgart, Germany Phoenix, USA Zurich, Switzerland New York, USA

89
Aesculap Neurosurgery
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Endoscopic Third Ventriculostomy in Patients with a Diminished Surgical Management of Bilateral Middle Cerebral
Prepontine Interval Artery Aneurysms via a Unilateral Supraorbital Key-Hole
Journal of Neurosurgery: Pediatrics, Vol. 5, 250-254, March 2010 Craniotomy
Minimally Invasive Neurosurgery, Vol. 52, 126-131, 2009

O. Sacko, S. Boetto, V. Lauwers-Cances, et al.


Endoscopic Third Ventriculostomy: Outcome Analysis in R. Reisch, A. Stadie, R. Kockro, et al.
368 Procedures The Minimally Invasive Supraorbital Subfrontal
Journal of Neurosurgery: Pediatrics, Vol. 5, 68-74, January 2010 Key-Hole Approach for Surgical Treatment of
Temporomesial Lesions of the Dominant Hemisphere
Minimally Invasive Neurosurgery, Vol. 52, 163-169, 2009
N. Luther, W. R. Stetler Jr., Ira. J. Dunkel, et al.
Subarachnoid Dissemination of Intraventricular
Tumors Following Simultaneous Endoscopic Biopsy J. Leonardo, R. A. Hanel, W. Grand
and Third Ventriculostomy Endoscopic Tracking of a Ventricular Catheter for Entry into the
Journal of Neurosurgery: Pediatrics, Vol. 5, 61-67, January 2010 Lateral Ventricle: Technical Note
Minimally Invasive Neurosurgery, Vol. 52, 287-289, 2009

G. P. Lekovic, J. F. Kerrigan, S. Wait, et al.


In Situ Single-Unit Recording of Hypothalamic A. T. Stadie, R. Reisch, R. A. Kockro, et al.
Hamartomas Under Endoscopic Direct Visualization Minimally Invasive Cerebral Cavernoma Surgery Using Keyhole
Neurosurgery, Vol. 65, Nr. 6, E1195-E1196, December 2009 Approaches – Solutions for Technique-Related Limitations
Minimally Invasive Neurosurgery, Vol. 52, 9-16, 2009

B. D. Kollroy, F. A. Ponce, Scott D. Wait, et al.


Endoscopic Intraventricular Biopsy of Infundibular Langerhana Cell P. Pillai, M. Lubow, A. Ortega, et al.
Histiocytosis: Case Report Endoscopic Transconjunctival Surgical Approach
Neurosurgery, Vol. 65, Nr. 1, E214-E215, July 2009 to the Optic Nerve and Medial Intraconal Space:
A Cadaver Study
Neurosurgery, Operative Neurosurgery 2, Vol. 63, OBS204-ONS209,
P. Pillai, M. N. Baig, Ch. S. Karas, et al. October 2008
Endoscopic Image-Guided Transoral Approach to the Cranioverte-
bral Junction: An Anatomic Study Comparing Surgical Exposure
and Surgical Freedom Obtained with the Endoscope and the S. C. Froelich, K. M. Abdel Aziz, P. D. Cohen, et al.
Operating Microscope Microsurgical and Endoscopic Anatomy of Liliequist’s Membrane:
Neurosurgery, Operative Neurosurgery 2, Vol. 64, ONS437-ONS444, A Complex and Variable Structure of the Basal Cisterns
May 2009 Neurosurgery, Operative Neurosurgery 1, Vol. 63, ONS1-ONS9, July 2008

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Aesculap Neurosurgery

B. C. Ong, P. A. Gore, M. B. Donnellan, et al. B. Depreitere, N. Dasi, J. Rutka, et al.


Endoscopic Sublabial Transmaxillary Approach to the Rostral Endoscopic Biopsy for Intraventricular Tumors in Children
Middle Fossa
Journal of Neurosurgery: Pediatrics, Vol. 106, 340-346, May 2007
Neurosurgery, Operative Neurosurgery 1, Vol. 62, 30-37, March 2008

M. Gangemi, F. Maiuri, G. Colella, et al.


J. D. W. Greenlee, C. Teo, A. Ghahreman, et al.
Is Endoscopic Third Ventriculostomy an Internal Shunt Alone?
Purely Endoscopic Resection of Colloid Cysts
Minimally Invasive Neurosurgery, Vol. 50, 47-50, 2007
Neurosurgery, Operative Neurosurgery 1, Vol. 62, ONS51-ONS56,
March 2008
M. Husain, M. Rastogi, B. K. Ojha, et al.
Endoscopic Transoral Surgery for Craniovertebral Junction Anomalies
P. A. Gore, L. F. Gonzalez, H. L. Rekate, et al.
Journal of Neurosurgery: Spine, Vol. 5, 367-373, October 2006
Endoscopic Supracerebellar Infratentorial Approach for Pineal Cyst
Resection: Technical Case Report
Neurosurgery, Operative Neurosurgery 1, Vol. 62, March 2008 C. Teo, P. Nakaji, R. J. Mobbs
Endoscope-Assisted Microvascular Decompression for Trigeminal Neu-
ralgia: Technical Case Report
P. Cappabianca, G. Cinalli, M. Gangemi, et al.
Neurosurgery, Operative Neurosurgery 4, Vol. 59, October 2006
Application of Neuroendoscopy to Intraventricular Lesions
Neurosurgery, Supplement, Vol. 62, No. 2, SHC575-SHC598, February
2008 A. Weyerbrock, T. Mainprize, J. T. Rutka
Endoscopic Fenestration of a Symptomatic Cavum Septum Pellucidum:
Technical Case Report
J. P. Greenfield, L. Z. Leng, U. Chaudhry, et al.
Neurosurgery, Operative Neurosurgery 4, Vol. 59, October 2006
Combined Simultaneous Endoscopic Transsphenoidal and Endosco-
pic Transventricular Resection of a Giant Pituitary Macroadenoma
Minimally Invasive Neurosurgery, Vol. 51, 306-309, 2008 R. Moftakhar, M. S. Salamat, S. Sahin, et al.
Endoscopically-Assisted Resection of a Choroid Plexus Vascular
Malformation Traversing the Cerebral
P. Y. Hwang, C. Long Ho
Aqueduct: Technical Case Report
Neuronavigation Using an Image-Guided Endoscopic
Neurosurgery, Operative Neurosurgery 1, Vol. 59, July 2006
Transnasal-Sphenoethmoidal Approach to Clival
Chordomas
Neurosurgery, Operative Neurosurgery 2, Vol. 61, ONS212-ONS218, J. van Beijnum, P. W. Hanlo, K. Sen Han, et al.
November 2007 Navigated Laser-Assisted Endoscopic Fenestration of a Suprasellar
Arachnoid Cyst in a 2-Year-Old Child with Bobble-Head Doll
Syndrome
Journal of Neurosurgery: Pediatrics, Vol. 104, 348-351, May 2006
Literature

91
Aesculap Neurosurgery
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F. T. Mangano, D. D. Limbrick, J. R. Leonard, et al. Y. Arakawa, K. Nakazawa, H. Kataoka, et al.


Simultaneous Image-Guided and Endoscopic Navigation without Microfiberscope Coaxial Technique in
Rigid Cranial Fixation: Application in Infants: Technical Case Report Neuroendoscopic Surgery
Neurosurgery, Operative Neurosurgery 2, Vol. 58, ONS-377-ONS-378, Minimally Invasive Neurosurgery, Vol. 49, 380-383, 2006
April 2006

I. Gawish, R. Reisch, A. Perneczky


G. P. Lekovic, L. F. Gonzalez, I. Feiz-Erfan, et al. Endoscopic Aqueductoplasty through a Tailored
Endoscopic Resection of Hypothalamic Hamartoma using a Novel Craniocervical Approach
Variable Aspiration Tissue Resector Journal of Neurosurgery, Vol. 103, 778-782, November 2005
Neurosurgery, Operative Neurosurgery 1, vol. 58, ONS166-ONS169, Fe-
bruary 2006
R. Reisch, A. Perneczky
Ten-Year Experience with the Supraorbital Subfrontal Approach
A. Morita, M. Shin, L. N. Sekhar, et al. through an Eyebrow Skin Incision
Endoscopic Microneurosurgery: Usefulness and Cost-Effectiveness in Neurosurgery, Operative Neurosurgery 4, Vol. 57, ONS242-ONS255,
the Consecutive Experience of 210 Patients October 2005
Neurosurgery, Vol. 58, No. 2, 315-321, February 2006

M. M. Souweidane
A. A. Figaji, A. G. Fieggen, P. L. Semple, et al. Endoscopic Surgery for Intraventricular Brain Tumors in Patients
Intracranial Endoscopy without Hydrocephalus
Samj Forum, Vol. 96, No. 1, 32-37, January 2006 Neurosurgery, Operative Neurosurgery 4, Vol. 57, ONS312-ONS318,
A. Bussarsky, M. Marinov, V. Bussarsky, et al. October 2005

Virtual Simulation of Neuroendoscopic Procedures: Early Clinical K. Schmidt, C. Coimbra


Experience with Ventricular Lesions Endoscopic Treatment of Thalamic Neuroepithelial Cysts
Central European Neurosurgery, Vol. 67, 129-136, 2006 Journal of Neurosurgery, Vol. 103, 342-346, August 2005

J. Zhao, Y. Wang, Y. Zhao, et al. N. Luther, A. Cohen, M. M. Souweidane


Neuroendoscope-Assisted Minimally Invasive Hemorrhagic Sequelae from Intracranial Neuroendoscopic Proce-
Microsurgery for Clipping Intracranial Aneurysms dures for Intraventricular Tumors
Minimally Invasive Neurosurgery, Vol. 49, 335-341, 2006 Neurosurgical Focus, Vol. 19 (1), E9, 1-4, July 2005

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P. D. Purdy, T. Fujimoto, R. E. Replogle, et al. M.J. Fritsch, S. Kienke, T. Ankermann, et al.


Percutaneous Intraspinal Navigation for Access to the Subarachnoid Endoscopic Third Ventriculostomy (ETV) in infants
Space: Use of Another Natural Conduit for Neurosurgical Procedures Journal of Neurosurgery: Pediatrics, Vol. 103: 50-53, 2005
Neurosurgical Focus, Vol. 19 (1), E11, 1-5, July 2005

M. Taniguchi, A. Kato, T. Taki, et al.


M. M. Souweidane Endoscope Assisted Removal of Jugular Foramen Schwannoma;
Endoscopic Management of Pediatric Brain Tumors Report of 3 Cases
Neurosurgical Focus, Vol. 18 (6a), E1, June 2005 Minimally Invasive Neurosurgery, Vol. 48, 365-368, 2005

N. Luther, M. M. Souweidane H. Kinouchi, T. Yanagisawa, A. Suzuki, et al.


Neuroendoscopic Resection of Posterior Third Ventricular Simultaneous Microscopic and Endoscopic Monitoring During
Ependymoma Surgery for Internal Carotid Artery Aneurysms
Neurosurgical Focus, Vol. 18 (6a), E3, 1-2, June 2005 Journal of Neurosurgery, Vol. 101, 989-995, December 2004

E. Nathal, J. L. Gomez-Amador J. C. Wang, L. Heier, M. M. Souweidane


Anatomic and Surgical Basis of the Sphenoid Ridge Keyhole Advances in the Endoscopic Management of
Approach for Cerebral Aneurysms Suprasellar Arachnoid Cysts in Children
Neurosurgery, Operative Neurosurgery 1, Vol. 56, ONS178-ONS185, Journal of Neurosurgery: Pediatrics, Vol. 100, 418-426, May 2004
January 2005

M.J. Fritsch, S. Kienke, H.M. Mehdorn


J. Martin, C. Neal, I. Moores, et al. Endoscopic aqueductoplasty: stent or not to stent?
Use of a Nitrogen Arm-Stabilized Endoscopic Childs Nerv System, Vol. 20, 137-142, 2004
Microdriver in Neuroendoscopic Surgery
Minimally Invasive Neurosurgery, Vol. 48, 63-65, 2005
M.J. Fritsch, K.H. Manwaring, S. Kienke, et al.
Endoscopic treatment of isolated 4th ventricle in children
M.J. Fritsch, L. Dörner, S. Kienke, et al.
Neurosurgery, Vol. 55, 372-379, 2004
Hydrocephalus in children with posterior fossa tumors:
The role of Endoscopic Third Ventriculostomy (ETV)
Journal of Neurosurgery: Pediatrics, Vol. 103: 40-42, 2005 C. Trantakis, J. Helm, M. Keller, et al.
Third Ventriculostomy in Communicating Hydrocephalus in Adult
Patients – The Role of Lumbar and Cranial Cerebrospinal Fluid
Outflow Measurement
Minimally Invasive Neurosurgery, Vol. 48, 140-144, 2004
Literature

93
Aesculap Neurosurgery
Literature

S. Wolfsberger, M.-T. Forster, M. Donat, et al. V. Rohde, J. M. Gilsbach


Virtual Endoscopy is a Useful Device for Training and Preoperative Anomalies and Variants of the Endoscopic Anatomy for Third
Planning of Transsphenoidal Endoscopic Pituitary Surgery Ventriculostomy
Minimally Invasive Neurosurgery, Vol. 47, 214-220, 2004 Minimally Invasive Neurosurgery, Vol. 43, 111-117, 2000

Y. Lin, Y. Qiu J. Paladino K. Rotim, D. Štimac, et al.


Microanatomy of Endoscope-Assisted Glabellar Nasal Keyhole Endoscopic Third Ventriculostomy with Ultrasonic Contact
Approach Microprobe
Minimally Invasive Neurosurgery, Vol. 46, 155-160, 2003 Minimally Invasive Neurosurgery, Vol. 43, 132-134, 2000

T. G. Psarros, J. Krumerman, C. Coimbra T. Menovsky, J. A. Grotenhuis, J. de Vries, et al.


Endoscopic Management of Supratentorial Ventricular Endoscope-Assisted Supraorbital Craniotomy for Lesions of the
Neurocysticercosis: Case Series and Review of the Literature Interpeduncular Fossa Technique and Application
Minimally Invasive Neurosurgery, Vol. 46, 331-334, 2003 Neurosurgery, Vol. 44, No. 1, 106-112, January 1999

M. A. Barajas, G. Ramirez-Guzmán, C. Rodríguez-Vazquez, et al. P. Wieneke, T. Lutze


Multimodal Management of Craniopharyngiomas: Technologies for Microendoscopes of the Future:
Neuroendoscopy, Microsurgery, and Radiosurgery The MINOP Project
Journal of Neurosurgery (Supplement 5), Vol. 97, 607-609, December Minimally Invasive Therapy & Allied Technology, Vol. 7/3, 233-239,
2002 1998

Z. Horváth, F. Vetö, I. Balás, et al. E. van Lindert, N. Hopf, A. Perneczky


Biportal Endoscopic Removal of a Primary Intraventricular Endoscopic Treatment of Mesencephalic Ependymal Cysts:
Hematoma: Case Report Technical Case Report
Minimally Invasive Neurosurgery, Vol. 43, 4-8, 2000 Neurosurgery, Vol. 43, No. 5, November 1998

A. Rieger, N. G. Rainov, M. Brucke, et al. F. Vetõ, Z. Horváth, T. Dóczi


Endoscopic Third Ventriculostomy is the Treatment of Choice for Biportal Endoscopic Management of Third Ventricle Tumors in
Obstructive Hydrocephalus due to Pediatric Tumors Patients with Occlusive Hydrocephalus: Technical Note
Minimally Invasive Neurosurgery, Vol. 43. 83-86, 2000 Neurosurgery, Vol. 40, No. 4, 871-877, April 1997

94
Aesculap Neurosurgery

J. A. Grotenhuis
Endoscope-Assisted Craniotomy
Techniques in Neurosurgery, Vol. 1, No. 3, 201-212, 1996

G. Fries, R. Reisch
Biportal Neuroendoscopic Microsurgical Approaches to the
Subarachnoid Cisterns: A Cadaver Study
Minimally Invasive Neurosurgery, Vol. 39, 99-104, 1996

A. Perneczky
Planning Strategies for the Suprasellar Region
Neurosurgeons 11, 343-348, 1992

Literature

95
Aesculap Neurosurgery
Numerical Index

FM157R 59 FD220R 60 FF645R 64


FA030R 56 FD222R 60 FF646R 64
FA031R 56 FD224R 60 FF769R 64
FA032R 56 FD226R 60 FF771R 64
FA033R 56 FD228R 60 FF772R 64
FA034R 56 FE490K 32 FF773R 64
FA035R 56 FE491K 32 FF781R 64
FA036R 56 FE495K 32 FF782R 64
FA037R 56 FE496K 32 FF783R 64
FA038R 56 FF151R 66 FH603SU 21
FA039R 56 FF168R 66 FH604SU 17
FA040R 56 FF280R 66 FH605SU 52
FA041R 38, 54 FF345R 58 FH606SU 16
FA042R 38, 54 FF357R 52 FH607SU 16
FA043R 38, 54 FF358R 18 FH610R 53
FA044R 38, 54 FF359R 18 FH611R 53
FA045R 38, 54 FF373R 14, 21 FH615 52
FA046R 38, 54 FF374R 14, 21 FK497R 47, 65
FA047R 38, 54 FF378R 14, 21 FK498R 47, 65
FA060R 38, 54 FF379R 23 FK499R 47, 65
FA061R 39, 55 FF385R 12 FK900B 46
FA062R 39, 55 FF386R 12 FK901B 46
FA063R 39, 55 FF387R 12 FK902B 46
FA064R 39, 55 FF388R 12 FK906B 64
FA065R 39, 55 FF389R 12 FK906R 64
FA066R 39, 55 FF397R 9 FK907B 64
FA067R 39, 55 FF398R 9 FK907R 64
FA068R 39, 55 FF399R 8 FK908B 64
FA069R 61 FF432R 13 FK908R 64
FA070R 61 FF433R 13 FK909B 64
FA071R 61 FF435R 13 FK909R 64
FA072R 61 FF436R 13 FK911B 46
FA073R 61 FF437R 13 FK912B 46
FA074R 61 FF438R 13 FK913B 46
FA075R 61 FF439R 13 FK914B 46
FA076R 58 FF456B 45 FK923B 64
FD113D 44 FF457B 45 FK923R 64
FD114D 44 FF458B 45 FK924B 64
FD115D 44 FF459B 45 FK924R 64
FD116D 44 FF496R 47, 65 FK936R 64

96
Aesculap Neurosurgery

FK937R 64 FM681R 31 GB758R 84


FK938R 64 FM682R 31 GB771R 86
FK966B 46 FM690R 31 GD668 76
FK967B 46 FM691R 31 GD670 76
FM121R 35 FM692R 31 GD672 76
FM123R 35 FM700R 31 GD675 76
FM125R 35 FM701R 31 GD685 76
FM131R 35 FM702R 31 GE389SU 79
FM133R 35 FM710R 31 GE390SU 79
FM135R 35 FM711R 31 GE391SU 79
FM141R 35 FM712R 31 GE392SU 79
FM143R 35 FM720R 31 GE394SU 79
FM145R 35 FM721R 31 GE395SU 79
FM146B 33 FM722R 31 GE396SU 79
FM147B 33 FT490T 32 GE397SU 79
FM148B 33 FT491T 32 GE398SU 79
FM149B 33 FT495T 32 GE399SU 79
FM150R 37 FT496T 32 GE401SU 80
FM151R 37 GE402SU 80
FM153R 37 GA461R 77 GE403SU 80
FM154R 37 GA464R 77 GE404SU 80
FM156R 37, 59 GA468R 77 GE405SU 80
FM157R 37 GA513R 77 GE406SU 81
FM158R 59 GA521 77 GE406TC-SU 81
FM161R 35 GA740R 77 GE407SU 81
FM162R 35 GA742R 77 GE407TC-SU 81
FM163R 34 GB740R 78 GE408SU 81
FM164R 34 GB741R 78 GE408TC-SU 81
FM167R 34 GB742R 78 GE409SU 81
FM168R 34 GB743R 78 GE411SU 80, 81
FM169R 34 GB744R 79 GE412SU 80
FM174R 36 GB745R 79 GE413SU 80
FM176R 36 GB746R 78 GE414SU 80
FM177R 36 GB747R 78 GE415SU 80
FM178R 36 GB748R 78 GE416SU 81
FM179R 36 GB751R 80 GE417SU 81
FM670R 31 GB752R 82 GE418SU 81
FM671R 31 GB753R 84 GE420SU 78
Numerical Index

FM672R 31 GB756R 80 GE424SU 80


FM680R 31 GB757R 82 GE425SU 80

97
Aesculap Neurosurgery
Numerical Index

GE426SU 80 GE533R 82, 83 GE644R 85


GE427SU 80 GE534R 82 GE645R 84
GE429SU 78 GE535R 82 GE646R 85
GE431SU 81 GE535TC-SU 83 GE648R 84
GE432R 80 GE537R 83 GE649R 84
GE433R 80 GE540R 82 GE650R 84
GE434SU 81 GE542R 82 GE653R 85
GE435SU 81 GE544R 83 GE700SU 86
GE435TC-SU 81 GE546R 82, 83 GE702R 86
GE437R 80 GE548R 83 GE704R 86
GE501R 82 GE549R 83 GE706R 86
GE502R 82 GE550R 83 GE707R 86
GE503R 82 GE555R 82 GE708R 86
GE504R 82 GE603R 84 GE709R 86
GE505R 82 GE604R 84 GE711R 86
GE506R 83 GE605R 84 GE712R 86
GE507R 83 GE606R 84 GE714R 86
GE507TC-SU 83 GE607R 84 GE716R 86
GE508R 83 GE607TC-SU 85 GE717R 86
GE508TC-SU 83 GE608R 85 GE718R 86
GE509R 83 GE608TC-SU 85 GE719R 86
GE511R 82 GE609R 85 GE729R 86
GE512R 82 GE613R 84 GF391R 43, 63
GE513R 82 GE614R 84 GF392R 43, 63
GE514R 82 GE615R 84 GF393R 43, 63
GE515R 82 GE616R 84 GF394R 43, 63
GE516R 83 GE617R 84 GF395R 43, 63
GE517R 83 GE618R 85 GF396R 43, 63
GE518R 83 GE619R 85 GF397R 43, 63
GE519R 83 GE620SU 78 GF398R 43, 63
GE520SU 78 GE624R 84 GF399R 43, 63
GE522R 83 GE625R 84 GF401R 43, 63
GE523R 83 GE626R 84 GF402R 43, 63
GE524R 83 GE627R 84 GF403R 43, 63
GE525R 83 GE629SU 78 GF404R 43, 63
GE526R 83 GE631R 85 GF405R 43, 63
GE527R 83 GE634R 85 GF406R 43, 63
GE529SU 78 GE635R 85 GF407R 43, 63
GE531R 82 GE635TC-SU 85 GF408R 43, 63
GE532R 82 GE637R 85 GF409R 43, 63

98
Aesculap Neurosurgery

GF411R 43, 63 GK777R 40 RT040R 67


GF412R 43, 63 GK780R 40 RT046P 68, 69
GF413R 43, 63 GK781R 40 RT055P 68
GF414R 43, 63 GK800R 59 RT060R 71, 72
GF415R 43, 63 GK801R 40, 59 RT061R 71, 72
GF416R 43, 63 GN073 15 RT062P 72
GF417R 43, 63 RT062R 71
GF418R 43, 63 JF324R 29 RT063P 72
GF419R 43, 63 JG901 67 RT063R 71
GF421R 43, 63 JG904 75 RT064P 72
GF422R 43, 63 JG908SU 75 RT064R 71
GF423R 43, 63 JK440 23 RT065P 72
GF424R 43, 63 JK444 18 RT065R 71
GF425R 43, 63 JK486 18, 23 RT066P 72
GF426R 43, 63 JK740 52 RT066R 71
GF427R 43, 63 JK789 52 RT079205 68
GF428R 43, 63 RT079R 68, 69
GF429R 43, 63 OK090R 57 RT081R 68
GF431R 42, 62 OP923 75 RT090R 66
GF432R 42, 62 OP930 74 RT099R 52, 68, 69
GF470R 41
GF471R 41 PE184A 10
GF472R 41 PE204A 10
GF473R 41 PE486A 28
GF474R 41 PE487A 53
GF475R 41 PE506A 29
GF476R 41 PE507A 53
GF477R 41 PE526A 29
GF478R 41 PF010A 20
GF479R 41 PF011A 20
GF480R 41 PV440 74
GF481R 41 PV820 74
GK245 15, 22 PV875 74
GK360R 15 PV880 74
GK361R 15, 22 PV881 74
GK362R 15 PV909 74
GK363R 15, 22 PV941 74
GK364R 15 PV946 74
Numerical Index

GK365R 15
GK366R 15 RT020R 67

99
The main product mark ’Aesculap’ is a
registered mark of Aesculap AG.

Subject to technical changes. All rights reserved.


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Aesculap AG | Am Aesculap-Platz | 78532 Tuttlingen | Germany purpose of obtaining information about our
products. Reproduction in any form partial or
Phone +49 0 74 61 95-0 | Fax +49 0 74 61 95-26 00 | www.aesculap.com otherwise is not permitted.

Aesculap – a B. Braun company Brochure No. C35502 0611/2.0/14

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