LITHOSKOP

Urology of the future available today Data Sheet

Answers for life.

LITHOSKOP
Urology of the future available today

LITHOSKOP, the new multifunctional lithotripter from Siemens, can do much more than just lithotripsy. It also covers a wide range of urological applications. Patient comfort and workflow efficiency reach new heights. Intelligent design, an ergonomic table, a unique, flexible shockwave head, plus a wide variety of sophisticated details all add up to one-time patient positioning. Additionally, LITHOSKOP offers a fully digital imaging system as well as intuitive operation, providing optimum workflow found only in a mature and forward-looking solution. Shockwave technology The new Pulso technology is at the heart of LITHOSKOP. It offers a long service life, and an extremely high degree of efficiency. With a penetration depth of max. 15.7 cm (6.2) and a large shockwave focus, Pulso enables effective treatment even for larger patients. Lithotripsy The shockwave head provides high energy and a wide focus to optimize the stone disintegration. 38 power levels allow for efficient and individualized treatment.

One-time patient positioning LITHOSKOPs most exciting innovation is the unique and flexible positioning of the shockwave head that allows for treatments without patient repositioning. Mounted on an isocentric C-arm, the shockwave head can be moved from an under-left or under-right position to an overtable position by pressing a single button. Thus you can treat the right and left kidney and ureter with your patient always supine. Repositioning is no longer necessary not even for auxiliary procedures. Inline X-ray and ultrasound localization* Excellent inline X-ray and ultrasound imaging simplifies accurate stone localization. The image quality for both localization methods is brilliant, making your work safer and more efficient. You decide which type of imaging you will use. Of course, if you wish, you may also use both imaging methods during a single treatment.

Endourology The adjustable isocentric table tilt of 15 about the perineal end allows for comfortable endourological procedures as well as other necessary auxiliary procedures. LITHOSKOPs exclusive ergonomic table saves you from patient repositioning even when changing from endourology to lithotripsy. Endourological video sequences can be viewed in real time directly on the LITHOSKOP displays (part of the uro configuration). The integrated endoscopic shelf* offers enough space for most of your equipment. Percutaneous interventions and minimally invasive surgery Access from all sides of the ergonomic table makes LITHOSKOP ideally suited for percutaneous and minimally invasive surgical interventions. The one-time patient positioning keeps anesthesia at the same end of the table. Multifunctional LITHOSKOPs multifunctionality offers a system for optimized utilization. With this one system, you can handle virtually all demands of your urological practice without subjecting your patients to risky and time-consuming repositioning.

* Option

System positions for the following indications:

Right kidney stone treatment

Ureteral stone treatment

Left kidney stone treatment

LITHOSKOP
Technical Specification

Basic unit Universal workstation for therapy and diagnosis for extracorporeal shockwave lithotripsy of kidney and ureteral stones and for almost all urological interventions, includes a wide range of accessories The flexible system architecture allows the configuration to be adapted for the two main applications, urological diagnostics and therapy as well as extracorporeal shockwave lithotripsy Combined floor-mounted X-ray, shockwave and patient positioning system The X-ray system for digital acquisition techniques has been designed to meet the requirements of modern urological diagnosis and therapy The flexible shockwave system adapts to the stone location with one-time patient positioning Shockwave system Pulso Electromagnetic principle Energy adjustable in 38 steps (E 0.1 to E 8) Dry coupling Orbital movement Aperture Aperture angle Penetration depth Adjustable shot frequency Operating modes Focal pressure P+ Shockwave energy (E 6 mm) Focal width ( 6 dB) Measured with Light Spot Hydrophone Application All functions required for stone therapy as well as motorized table movements, movements of the X-ray system and ESWL system can be controlled with the menu-guided remote control keypad Extracorporeal shockwave lithotripsy (ESWL) Urological diagnosis and endourology Prostate therapy procedures Percutaneous interventions Cystoscopy 230 ( 180 to + 50) 15.8 cm (6.2) 53 max. 15.7 cm (6.2) 60/90/120 pulses/min or ECG triggering* Standard mode 8.6 MPa to 75.3 MPa 4 mJ to 91 mJ max. 12 mm Soft mode 8.6 MPa to 62.5 MPa 4 mJ to 42 mJ max. 12 mm

* Option

Patient table Tabletop with bilateral cut-out Minimum height for patient entry Table vertical travel range Longitudinal travel Transverse travel Isocentric table tilt Base plate Tabletop extension Max. patient weight Aluminum equivalent value in examination area C-arm X-ray system Orbital movement Source-I.I. distance X-ray generator Microprocessor-controlled high-frequency X-ray generator for radiography and fluoroscopy Automatic X-ray control system for fully automatic calculation and optimization of exposure data based on fluoroscopic values kV display and mAs post-display on the live image monitor Preprogrammed or freely adjustable kV values (64 organ programs) Integrated IONTOMAT automatic exposure control POLYDOROS SX 65 Output Exposure voltage POLYDOROS SX 80* Output Exposure voltage 80 kW (800 mA at 100 kV/80 kW) 40 kV to 150 kV 65 kW (650 mA at 100 kV/65 kW) 40 kV to 150 kV 95 ( 45 to + 50) 125 cm (49.2) 71.5 cm (28.1) 48 cm (18.9) 25 cm (9.8) 15 cm (5.9) 15 (Trendelenburg) 121.5 cm (47.8) x 73 cm (28.7) 95 cm (37.4) x 68 cm (26.8) 205 kg (450 Ibs) 0.9 mm at 100 kV, 2.7 mm Al/HVL according to CFR 1.2 mm at 100 kV, 3.7 mm Al/HVL according to EN 60601-1-3

LITHOSKOP
Technical Specification

X-ray image intensifier Depending on the diagnostic and therapeutic focus, a 33 cm image intensifier with high dynamics is available for superselective and survey images The high contrast and outstanding modulation transfer characteristics enable display of the finest details Cesium-iodide input screen for high quantum absorption producing minimal quantum noise Precision electron optics with minimal image distortion and uniform high resolution across the entire image field Anti-reflective coating at I.I. input and glare trap at I.I. output Four selectable semiconductor measuring fields for dose control (SDM); automatic size correction with format change Collision protection on the I.I. housing DQE SIRECON 33-4 HDR I.I. formats Visual resolution Mean value (LP/mm) Conversion factor Contrast ratio Grid X-ray tube unit OPTITOP 150/40/80 HC-100 Nominal voltage Nominal output Focal spot nominal value Anode heat storage capacity Anode speed Collimator system Multileaf collimator with rectangular and iris diaphragm as well as three motorized Cu prefilters (0.1 mm; 0.2 mm; 0.3 mm) 150 kV 40/80 kW 0.6/1.0 580 000 J (783 000 HU) 150/180 Hz 4.2 5.0 5.6 6.0 26 (cd/m2) (s/Gy) 25:1 at 10% surface area PB 15/80, f0 115 33 cm (13) 22 cm (8.5) 17 cm (6.5) 13 cm (5) 65%

CAREMAX* dose area product measuring device Measuring chamber/Ionization chamber integrated into collimator Measured value displays on the live image monitor Measured values of dose area product in cGycm2

* Option

Display console Two TFT color displays on the console 19 TFT color display Screen size Image matrix Maximum brightness, typical Horizontal/vertical viewing angle Contrast ratio, typical Uro kit* (not retrofittable) Recommended configuration for multifunctional use of LITHOSKOP: Flexible display support arm mounted on the unit column with two 17 TFT color displays Endo/US interface integrated in the unit Ergonomic multifunctional foot switch 17 TFT color display Screen size Image matrix Maximum brightness, typical Horizontal/vertical viewing angle Contrast ratio, typical Alternatively: 19 TFT color display (optional) Screen size Image matrix Maximum brightness, typical Horizontal/vertical viewing angle Contrast ratio, typical 19 (48 cm) 1280 x 1024 300 cd/m2 170/170 300 : 1 17 (43 cm) 1280 x 1024 280 cd/m2 170/170 300 : 1 19 (48 cm) 1280 x 1024 280 cd/m2 170/170 300 : 1 # 144 04 743

* Option

LITHOSKOP
Technical Specification

FLUOROSPOT Compact (FLC) digital fluoro radiography system Remote service function (integrated service software, Magic Watch) Storage of all examination data in a patient folder in the FLC (including ultrasound images) Integrated help function Display of X-ray, endoscopic and ultrasound images on the reference monitor Automatic stone positioning in the therapy focus (AutoPos*) Integrated statistics tool for statistical analysis of therapy data Integrated image quality tool Image acquisition system Intel-compatible microprocessor with PCI bus architecture, min. 2 GHz, 768 MB RAM, SCSI drive and interface cards for the camera/X-ray system, based on Windows 2000 operating system Continuous with 30 f/s (VIDEOMED), 1024 x 512/10 bit matrix and digital filtration, storage of fluoroscopic images, sliding weighted averaging CAREVISION* Pulsed fluoroscopy (1024 x 1024/10 bit matrix) Dose saving of up to 90% Pulse rates: 15; 7.5 or 3 p/s Digital radiography Automatic measuring field display Image storage Image display Digital spotfilm technique with 1024 x 1024/10 bit matrix, digital filtration, single image acquisition Predisplay of the selected measuring fields on the last fluoroscopic image (LIH) 10,000 images on hard disk in 1024 x 1024 matrix (optionally 15,000 images or 20,000 images) 5:4 aspect ratio corresponding to 1280 x 1024 matrix, 1024 x 1024 image content, flicker-free freeze frame with progressive scanning 72 Hz (TFT)

Digital fluoroscopy

* Option

FLUOROSPOT Compact digital fluoro radiography system Patient directory Input of patient name, patient ID, date of birth, study number, accession number, physician, etc. Input can be made via keyboard or directly via DICOM Worklist* Integrated system operation User programs with predefined parameter sets for radiography and fluoroscopy (organ programs) Monitor display for live and reference images Endo/ultrasound* interface for displaying endoscopy or ultrasound images on the reference color display Image display DICOM Send Organ programs X-ray/endoscopic/ultrasound images incl. DICOM Storage Commitment The following can be configured: X-ray parameters kV automatic or fixed, dose, adjustable frame rate, pulsed fluoroscopy (CAREVISION*), tube focus, automatic prefiltration, fluoro program, ADC field position (SDM) Image processing parameters Window values, edge enhancement, black/white image inversion, harmonization factor* Automatic functions Auto shutter, auto Cu-filter Image postprocessing Setting for contrast/brightness, edge enhancement, 2-fold zoom, 2-fold electronic magnifying glass (EMG), split screen (4, 9, 16-on-1), angle measurement, black/white image inversion (grayscale inversion), electronic shuttering, roaming, vertical and horizontal image reversal, R/L marking, harmonization (DDO)* Marking, annotation, image comment, R/L marking, quantification with angle/length measurement Automatic recording of all ESWL parameters from the lithotripter Documentation of the therapy progress and outcome Tool for selective statistical evaluations of all ESWL treatments Background functionality Image processing functions such as DICOM Send, DICOM Print, CD ROM writing etc. are performed in background mode

Text/graphic functions LithoReport

* Option

LITHOSKOP
Technical Specification

Options for FLUOROSPOT Compact Reference image display Fluoro loop In 1024 x 1024 matrix: storage and direct access to up to 16 reference images on the second monitor Storage and review of dynamic fluoro sequences The maximum storable fluoro time depends on the pulse rate selected, e.g. 30 and 15 f/s approx. 17 s; 7.5 f/s approx. 34 s and 3 f/s approx. 85 s Harmonization Digital Density Optimization (DDO) preprogrammed and/or postprocessed to compensate for undesirable density differences in the exposure Degree of harmonization configurable in the organ program, also including online DDO for fluoroscopy Security package (HIPAA) Advanced security functions including user management and data access protection

VIDEOMED DH TV system VIDEOMED DH Dynamics TV matrix TV frame rate TV standard Ultrasound localization* Allows precise inline localization and continuous follow-up of the stone treatment with ultrasound imaging Software-controlled display of the cross hair for precise stone localization ECG triggering*1) Physiological measuring device with screen for monitoring the patient and for ECG triggering of shock waves High-resolution TV camera with maintenance-free 1K CCD sensor for digital fluoroscopy, fluoro radiography Max. 69 dB 1024 x 1024 matrix Max. 30 f/s; with CAREVISION* 15; 7.5; 3 pulses/s 72 Hz, progressive sampling independently of line frequency

* Option

10

1)

Mandatory for the US

DICOM 3.0 functions* DICOM Print For connection to a DICOM-compatible camera or a DICOM-compatible printer Sending and receiving of images DICOM Worklist / MPPS DICOM Worklist Management For importing patient /examination data from an independent HIS/RIS system, incl. HIS/RIS queries via special search criteria MPPS (Modality Performed Procedure Step) For importing/exporting examination data from/to an independent HIS/RIS system DICOM Query/Retrieve Retrieval of studies and images created with Fluorospot Compact from a digital image archive (PACS) or from a workstation

Documentation CD/DVD writer* Interface for paper printer* (local connection or in network) Documentation of images in DICOM format on CD/DVD (multisession) Suitable for image and report documentation on paper Prerequisite: PostScript Level 2, formats: DIN A 4, US letter or US tabloid For connection within network: Network-compatible printer required (not suitable for diagnostic purposes, only in connection with additional documentation device) Suitable for printing image information on film

Interface for laser camera* Operating data Power requirements

3/PE ~ 400 V ( 10%) with 50 Hz or 60 Hz; 440/480 V ( 10%) via optional line-matching transformer; internal line resistance according to Planning Guide

Environmental conditions (operation) Temperature range Relative humidity Barometric pressure + 10C to + 30C 30% to 75%, non-condensing 700 hPa to 1060 hPa

* Option

11

LITHOSKOP
Technical Specification

Options Shockwave system Imaging system and display AutoPos Fluoro loop Harmonization CAREVISION Memory extension 15,000 images or 20,000 images HIPAA Security package (Health Insurance Portability and Accountability Act) Data transfer and documentation DICOM Print DICOM Worklist DICOM Query/Retrieve CD/DVD writer Printer interface Dose measurement Patient monitoring Generator/unit Table CAREMAX integrated dose measuring chamber ECG monitoring1) and triggering POLYDOROS SX 80 Endoscopy shelf Coxafix leg supports Pediatric leg supports (Coxafix) Amatech foot supports Amatech knee crutch stirrups Patient arm rest (rigid) Shoulder supports Wrist restraints Elbow supports Multifunctional foot switch Drain pan Holder for plastic drain bag Anesthesia screen holder Infusion bottle holder Paper roll holder

12

1)

Mandatory for the US

Standard accessories

Head wedge Head wedge for comfortable positioning of the patient.

Compression belt For reducing stone excursion caused by respiration and for patient immobilization.

13

LITHOSKOP
Accessories

Accessories (optional)

Coxafix leg supports

# 144 00 922

The leg supports can be attached anywhere along the lateral OR rails with a quick-action lock. Continuous, gas spring assisted height adjustment with self-locking spindle, padded leg rests, lockable and swivelable in 3 directions for pressure-free positioning of the legs in the knee joint. Leg rest quickaction lock, suitable for use of the special pediatric leg rest.

Pediatric leg supports (Coxafix)

# 144 00 923

For examinations of children, the adult leg rests of the Coxafix leg supports can be replaced by pediatric leg rests.

Amatech foot supports Amatech adjustable gas spring loaded foot supports. Attached with low profile siderail clamps. Boot stirrups, Siemens customization, including clamps and boot pads. Adjusts at side rail socket from low to high lithotomy. The telescoping bar permits simple length adjustment while eliminating any protrusions beyond the boot. An offset support creates unrestricted access for the operative team. A limited motion ball socket at the base of the boot prevents unsafe inversion or eversion when the socket is loosened. It may be left loosened to self-align during position changes and then locked in final position.

Amatech knee crutch stirrups For easy attachment to the table rails. The Lift Assist neutralizes leg weight, allowing easy handling and adjustment of the leg position. Knee crutch stirrups, Siemens customization, including clamps and crutch pads. Stirrups attach to the lateral OR rails. Provides excellent patient comfort and precise surgical positioning for short duration procedures. Doughty soft pad reduces popliteral pressure. One easy to use handle provides vertical adjustment from 40 cm (16) to 52 cm (21) and 360 horizontal rotation. Velcro strap for security. 14

Accessories (optional)

Patient arm rest (rigid)

# 144 00 929

The padded arm rest allows safe and comfortable positioning of the patients left or right forearm. It can be locked in place anywhere along the lateral OR rails.

Shoulder supports

# 144 00 931

The shoulder supports allow safe and comfortable positioning of the patient in Trendelenburg positions. The padding can be adapted to the patients anatomy. The shoulder supports attach anywhere along the lateral OR rails.

Wrist restraints

# 144 00 934

The wrist restraints are attached to the OR rails and are used to restrain the patients hands during an examination.

Elbow supports

# 144 00 919

Swiveling elbow supports at the perineal end of the tabletop, supporting the examiners elbows during transuretheral procedures.

15

LITHOSKOP
Accessories

Accessories (optional)

Endoscopy shelf

# 144 00 921

Compact storage rack mounted on the unit base with integrated power supply for ergonomic positioning of endoscopy modules such as endo light source, endo camera, HF generator, video recorder or video printer. Max. load capacity 50 kg (110 lbs) with limited mounting height of the modules.

Multifunctional foot switch (fluoroscopy/radiography/endoscopy/table movements)

# 144 00 918

Ergonomic foot control for lift, tilt, longitudinal/transverse table movement, switchover between X-ray/endoscopic/ultrasonic images, image storage and rocker switch for fluoroscopy/radiography, rocker switch for C-arm orbital movement.

Drain pan

# 144 00 927

Stainless-steel drain pan which can be hooked in at the perineal table end and moved laterally, with water supply and drain hose, including a park position holder.

16

Accessories (optional) Holder for plastic drain bag # 144 00 924

Flexible, tiltable spring band frame for use at the perineal table end, allowing easy attachment of a plastic drain bag with drain hose.

Urological PE drain bag (box of 20)

# 144 00 925

Preassembled plastic drain bags with apron, removable filter screen and expandable drain hose.

Anesthesia screen holder

# 144 00 933

The telescopic height-adjustable anesthesia screen holder allows the attachment of a sterile cover and mounts anywhere along the OR rails.

Infusion bottle holder

# 144 00 932

The telescopic extendable infusion bottle holder can hold up to 4 infusion bottles and attaches anywhere along the OR rails of the table.

Paper roll holder

# 144 00 930

Attaches to the examination table for holding medical crepe paper. Medical crepe paper # 144 04 755

Medical crepe paper is placed between the patient and the examination table. 17

LITHOSKOP
Technical Specification

Dimensions in cm (inches)

18

Dimensions in cm (inches)

Room layout

19

The information in this document contains general descriptions of the technical options available and may not always apply in individual cases. The required features should therefore be specified in each individual case at completion of contract. Siemens reserves the right to modify the design and specifications contained herein without prior notice. Please contact your local Siemens sales representative for the most current information. Original images always lose a certain amount of detail when reproduced. In the interest of complying with legal requirements concerning the environmental compatibility of our products (protection of natural resources, waste conservation), we recycle certain components. Using the same extensive quality assurance measures as for new components, we guarantee the quality of these recycled components. 02.2008 Siemens AG Order No. A91001-M1530-G945-4-4A00 Printed in Germany SP PLM DA 02082

Contact addresses: In the USA Siemens Medical Solutions USA, Inc. 51 Valley Stream Parkway Malvern, PA 19355 Telephone: +01 610 448 4500 Telefax: +01 610 448 1620 In Germany Siemens AG, Medical Solutions Special Systems Allee am Rthelheimpark 2 D-91052 Erlangen Germany Telephone ++49 9131 84-0

Siemens AG Wittelsbacherplatz 2 D-80333 Muenchen Germany

Headquarters Siemens AG, Medical Solutions Henkestr. 127, D-91052 Erlangen Germany Telephone ++49 9131 84-0

www.siemens.com/healthcare