inomed Medizintechnik GmbH of Emmendingen at MEDICA 2021 in Düsseldorf -- COMPAMED Trade Fair
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Manufacturers

inomed Medizintechnik GmbH

Im Hausgrün 29, 79312 Emmendingen
Germany
Telephone +49 7641 941410
Fax +49 7641 941494
info@inomed.com

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Hall map

MEDICA 2021 hall map (Hall 9): stand C66

Fairground map

MEDICA 2021 fairground map: Hall 9

Our range of products

Product categories

Our products

Product category: Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

ISIS Xpert

ISIS Xpert - The new inomed ISIS IOM generation
The key technology for intraoperative neuromonitoring

Measurement modalities from MEP to SEP
  • Individually configurable
  • Easy to handle
  • Complete package for your IOM
With the systems of the ISIS IOM family inomed offers a complete package for multimodal intraoperative neurophysiological monitoring from MEP to SEP. The ISIS IOM systems convince with their high performance, user-friendliness, flexibility and variety of applications.
Three different systems are available for the user - ISIS Xpert, ISIS Xpert plus and ISIS Xpress.

Maximum flexibility for sophisticated neuromonitoring
Flexible configuration of measurement modalities (EMG, MEP, SEP, EEG, AEP und VEP) and the ability to combine a wide variety of applications mean you can individually tailor IOM to your clinical routine and research.
The systems’ modular structure and the ability to flexibly combine different ISIS Headboxes and ISIS neurostimulators mean that the system can be individually configured for specific intraoperative neuromonitoring requirements and optionally also for microelectrode recording for deep-brain stimulation.

Modular structure enables highly configurable systems
  • Neurosurgical tumour resection
  • Spinal surgery (stabilization, decompression, corrective spinal surgery)
  • ENT surgery (parotidectomy, surgery to the inner ear)
  • Pelvic surgery (rectal resection, urological surgeries, gynaecological surgeries)
  • Awake surgery
The powerful and modular ISIS Xpert, ISIS Xpert plus and ISIS Xpress systems are delivered with a broad variety of pre-installed measuring programs, but still allow the user to create their own measuring programs.

New software generation to extend the application fields of neuromonitoring
All ISIS Xpert systems are equipped with the new, particularly powerful NeuroExplorer 2019 software generation. Thanks to its new software modalities, NEX 2019 enables comprehensive IOM complete solutions for a variety of disciplines, for example in the pelvic surgery patented by inomed throughout Germany. In addition, it offers memory space for numerous programs with individual measurement modalities.

Features
  • Individual configuration
  • Choice of three useful systems
  • Integration into hospital network possible (HL7 Ready)
The main areas of application of ISIS Xpert:
  • Neurosurgery, e.g. SEP, MEP, EMG, EEG, AEP, VEP
  • Spine surgery, e.g. SEP, MEP, EMG
  • Orthopaedics, e.g. SEP, MEP, EMG
  • Vascular surgery, e.g. SEP, EEG
  • Cardiothoracic surgery, e.g. SEP, MEP, EEG
  • Rectal surgery, e.g. EMG, pIOM
  • Thyroid surgery, e.g. EMG
  • Ear, nose and throat surgery, e.g. EMG, MEP

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Product category: Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

C2 Xplore

C2 Xplore – One step ahead in IONM

With its powerful new hardware, the C2 Xplore provides the optimum solution for efficient and safe intraoperative neuromonitoring (IONM) . As a further development of our C2 NerveMonitor, the C2 Xplore opens the door to digital transformation.
The digital solutions of the C2 Xplore offer increased comfort during surgery and post-operative evaluation. Data acquisition and analysis is simplified, surgical performance is optimised and treatment results are improved.

The ultimate in usability by digitalisation
Simplification by digitalisation and automation with intuitive & integrated data management:
  • Digital health record: simple and secure documentation during surgery. Supported by simplified data export and an integrated data base
  • Automated and guided applications with an intuitive touch function: gesture-controlled comment function and step-by-step guidance for clarity
  • Maximum user-friendliness with intuitive and clear display
Flexibility for cost-effectiveness – 1 device – 6 applications
  • Application fields: Thyroid Sugery, ENT Surgery, Vascular Surgery, Rectal Surgery, Spine Surgery, Neurosurgery
  • Software flexibility with up to 6 different applications in 1 device
  • Ease-of-use: a range of applications yet just one C2 Xplore
  • New hardware with a sustainable concept, proven and tested for more than 10 years
Maximum interconnection – Facilitated data export
  • Digital integration in the OR
  • Data export by WiFi to the clinic network by HL7, pdf export or postScript printer
  • Presence in the OR: connection to various screens or wireless with every tablet on the market
  • InoView V2 connection to any (Android and iOS) tablet to suit all personal preferences
  • Control comments and settings inside the sterile area with inoView V2
  • LED Scanner for super-fast data acquisition of patient data
  • Reports printed immediately on direct printer or network printer
  • Not only the nerve is safe: no data ever lost thanks to the large internal storage
Connectivity – Inside and outside the OR
  • Join the international network of inomed users to share work and cooperation
  • Evaluate surgery with the C2 Xplore dedicated analysis function
Support at your fingertips
  • Remote support for instant help and diagnosis in the OR
IONM exchange – Broaden your knowledge and connect with international experts
  • Online webinars and training with other users to broaden IONM knowledge
  • OR visits for cutting-edge technology

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

C2 Xplore – Thyroid surgery

C2 Xplore – Maximum reliability in recurrent laryngeal nerve monitoring

Intraoperative neuromonitoring in thyroid surgery explicitly recommended by guidelines
Intraoperative Neuromonitoring (IONM)  is explicitly recommended by the German Society for General and Visceral surgery for redo-operations in thyroid surgery.The correct implementation of recurrent laryngeal nerve monitoring poses several challenges. In order to increase patient safety during these procedures, documenting the monitoring process and implementing it as rapidly and intuitively as possible are particularly important.

C2 Xplore – Digital features for optimised results
The C2 Xplore has a 2D LED scanner to quickly read patient data from barcodes and even QR codes, effortless integration of data into the patient management system, and many other features for easy and rapid reporting. The documentation process is supported by an integrated database, storing all measurement and patient data on a long-term basis. The data can subsequently be retrieved at any time.

Complete solution offering maximum reliability in recurrent laryngeal nerve monitoring
The unique ALM technology combines the synergistic effects of the C2 Xplore software and hardware, its intelligent Channel Select Software and the ALM Tube. These synergies benefit from:
  • the clear signal display on the C2 Xplore’s large-screen display and the accompanying acoustic signals which prevent any signal being missed
  • the ALM Tube with its 8 long measuring contacts, providing 360° surface sensor coverage regardless of tube rotation
  • the intelligent Channel Select Software which always precisely selects and displays the strongest signal.
With the perfectly matching accessories, the versatile C2 Xplore is the perfect partner for safe thyroid surgery.

Features of recurrent laryngeal nerve monitoring
  • Smart trend software
  • Continuous vagus nerve monitoring
  • 2D LED scanner to quickly read patient data from barcodes and QR codes
  • Effortless integration of data in the patient management system
  • Integrated database stores patient data permanently
  • Maximum reliability due to perfectly matched accessories
Main application areas of the C2 Xplore:
  • Thyroid surgery
  • ENT surgery
  • Vascular surgery
  • Rectal surgery
  • Spinal column surgery
  • Neurosurgery

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

C2 Xplore – Facial nerve surgery

C2 Xplore – Iatrogenic injury can be significantly reduced in facial nerve surgery

Operations in the field of facial nerve surgery:
  • are very complex because of the delicate structure and the fan-shaped nerves
  • require high accuracy
  • therefore, represent a particular challenge for surgeons.
For this reason, intraoperative neuromonitoring (IONM) has been established for many years, especially in the field of facial nerve surgery to support surgeons in locating the nerve branches and thus increasing patient safety.

Saving facial nerves – Minimising risks
Neuromonitoring in facial nerve surgery is used in two ways:
  • Signals and spontaneous activities resulting from irritation of the nerve branches by, for example, mechanical manipulation of the nerves are indicated acoustically and visually.
  • Hand-held probes can be used to locate and indicate individual nerve branches within the parotid. These instruments stimulate the nerves electrically. The resulting muscle contractions are reported visually and acoustically.
Where tympanoplasty is performed or a cochlear implant inserted, inomed's neuromonitoring is a useful tool that helps prevent nerve injury during milling near the bony facial canal. During mastoidectomy procedures, neuromonitoring techniques are used to reduce the risk of nerve injury.

Measurement mode in facial nerve surgery
A hand-held stimulation probe locates nerve branches during facial nerve surgery. Every channel and thus every nerve makes a different sound allowing acoustic identification of the nerve by the so-called Channel Ident function.
Bipolar probes are highly selective and can be used to monitor nerve branches and their function in the immediate vicinity, whereas monopolar probes have a wider field of action. Electrodes are placed in the corresponding indicator muscle to record electrophysiological signals. If there is any significant change in the amplitude or latency of the muscle responses during surgery, the surgeon is informed visually and acoustically. This also happens if spontaneous activity should occur. Any spontaneous activity detected is automatically recorded and can be annotated for documentation.

Digital revolution
The C2 Xplore with its wide field of application, provides innovative solutions for optimum surgical performance by its HL7-Ready interface to the hospital network and its intuitive comment function which monitors relevant events at all times.

Features
  • Specially developed software for ENT surgery
  • Channel Ident function to locate nerve branches
  • Detection of spontaneous activities
  • Powerful and quick-to-use systems
  • Smooth interface functions
Applications of facial nerve monitoring
  • Parotid surgery
  • Tympanoplasty
  • Mastoidectomy
  • CI implantation
  • Facial nerve surgery
Main application areas of the C2 Xplore:
  • ENT surgery
  • Thyroid surgery
  • Vascular surgery
  • Rectal surgery
  • Spinal column surgery
  • Neurosurgery

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments, Neurosurgical instruments and equipment

C2 Xplore – Vascular surgery

C2 Xplore – Efficient neuromonitoring in carotid artery surgery

SEP monitoring during carotid artery surgery shows the beginning of cerebral ischaemia
During carotid artery surgery, recording of somatosensory evoked potentials (SEP signals) is recommended for the monitoring of neuronal electrical activity. It helps detect inadequate blood supply to the brain hemispheres. If the SEP amplitude changes while the carotid artery is clamped, it can be an indication of ischaemia. A 50% amplitude reduction in comparison to the baseline amplitude prior to clamping is considered a sign that ischaemia is occurring.

The C2 Xplore’s SEP software preserves vascular function in carotid artery surgery
inomed has provided the C2 Xplore with its special C2 SEP software module for efficient neuromonitoring during carotid artery surgery.
Sensory function is continuously monitored during interventions. Stimulation electrodes are placed on the median nerve, contralaterally to the operation side, while signals are recorded from the sensory cortex on the operation site. A comparison measurement at the level of the cervical vertebrae C7 can also be useful for systemic effect differentiation.
During the entire surgical procedure, the latency and amplitude of the recorded SEP signals are displayed in a trend window. If the measured values reach one out of three adjustable threshold values, the surgeon is notified: yellow, orange and red signals indicate the threshold levels, supported by sounds. The surgeon can then react accordingly, for example by placing a shunt, to prevent irreversible damage.
With the appropriate accessories, the C2 Xplore is the perfect solution for efficient and user-friendly neuromonitoring in vascular (carotid artery) surgery.

Features
  • Specially developed software for SEP testing
  • Clear view of SEP signals
  • Floating averaging process
  • Configurable warning thresholds for latency and amplitude changes
  • Continuous and automated impedance monitoring of the measuring electrodes
  • 2D LED scanner for patient data
Application:
  • Carotidendarectomies
Main application areas of the C2 Xplore:
  • Vascular surgery
  • Thyroid surgery
  • ENT surgery
  • Rectal surgery
  • Spinal column surgery
  • Neurosurgery

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

C2 Xplore – Rectal surgery

C2 Xplore offers improved patient safety thanks to neuromonitoring in colorectal surgery

Colorectal surgery carries an increased risk of post-operative damage
The extremely complex nerve structures of the autonomic nervous system in the minor pelvis pose a considerable risk during interventions in colorectal surgery. Statistics of post-operative anorectal and urogenital disorders indicate that a large proportion of patients suffer from incontinence and sexual dysfunction after minor pelvic surgery.

inomed’s pioneering method for pelvic monitoring
More than 12 years of clinical research have resulted in a novel technology for locating and monitoring the complex autonomic nervous system in the minor pelvis. inomed’s pelvic Intraoperative Neuromonitoring (pIOM), which is patented in Germany, can be used for a variety of interventions in the field of colorectal surgery.
pIOM® technology can help preserve functions
The EMG signals of the internal and external anal sphincter and bladder pressure are monitored intraoperatively by the pIOM® technology. This technology can thus help to preserve the functions of the monitored structures inside the minor pelvis after surgery despite the invasive nature of the therapy. The stimulation sites in the minor pelvis are the hypogastric plexus and the pelvic splanchnic nerves.
The simple application of the procedure supports the surgeon’s workflow without causing any substantial surgical delay.

Measurement mode in colorectal surgery
  • The placement of needles in the internal and external anal sphincter or a rectal electrode in the anal canal allow real-time monitoring of anorectal function
  • Monitoring of the urinary function with the help of a pressure sensor attached to the catheter
  • Specially developed manual probe for stimulation of the pelvic nerves and to locate functional structures during open, laparoscopic and robotic assisted interventions
  • Optical and acoustic notification if activity occurs
  • Recorded signals are processed and displayed in the form of colour bars
  • At the same time, the electrical current flow is continuously indicated acoustically during stimulation
The C2 Xplore is the perfect assistant for neuromonitoring in colorectal surgery with its matching accessories.

Features
  • Smart software, specially developed for rectal surgery
  • Ease-of-use thanks to the guided wizard structure
  • Integrated database stores patient data on a long-term basis
  • Enables a wide range of interventions in the field of colorectal surgery

Main application areas of the C2 Xplore:
  • Rectal surgery
  • Thyroid surgery
  • ENT surgery
  • Vascular surgery
  • Spinal column surgery
  • Neurosurgery

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

C2 Xplore – Spine surgery

C2 Xplore – Optimised results by intuitive guidance in spinal monitoring

Spinal monitoring during pedicle screw placement with the C2 Xplore
The positioning of pedicle screws can lead to perforation of the pedicle wall, jeopardising the integrity of the surrounding spinal nerves.

Spinal monitoring with the C2 Xplore
With its special C2 Spine software, colour-coded accessories and needle-positioning instructions, the C2 Xplore helps to ensure efficient neuromonitoring during spinal column surgery in posterior cervical, lumbar interbody fusions and lateral approaches.
Whether open or minimally invasive procedures, with the C2 Spine system, surgical preparation is quick and easy. The wizard-based Spine software provides intuitive user guidance through the whole procedure.

Neuromonitoring as a standard procedure in spinal column surgery
The software and accessories have consistent colour-coding as well as information for the positioning of the measuring electrodes, facilitating needle positioning and wiring. 
With this needle positioning and wiring assistance, neuromonitoring by pedicle stimulation is a simple standard procedure in spinal column surgery.
To check the pharmacological relaxation status of the patient's muscles, an integrated Twitch Test (TOF test) is included in the software. This ensures that no muscle relaxants remain during spinal surgery and no false-negative results are obtained.
While the software is in measurement mode, pedicle screw stimulation allows the automatic recognition of the relevant stimulation threshold. Here, an EMG signal is measured, providing information about the integrity of the pedicle. This crucial information for spinal column surgery is provided and displayed quickly and easily.

Features of spinal monitoring
  • Clear view of EMG signals
  • Specially developed wizard software for easy-to-use spinal monitoring
  • Automated relaxation monitoring
  • Continuous and automated impedance measurement of recording electrodes
  • 2D LED scanner for patient data
  • Integrated database
  • Colour-coded accessories
Applications in spinal monitoring
  • Posterior cervical interbody fusions
  • Posterior lumbar interbody fusions and lateral approaches
Main application areas of the C2 Xplore:
  • Spinal column surgery
  • ENT surgery
  • Thyroid surgery
  • Vascular surgery
  • Rectal surgery
  • Neurosurgery

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments, Neurosurgical instruments and equipment

C2 Xplore – Neurosurgery

C2 Xplore – Advanced brain mapping for safe tumor resection

Preventing neurological deficits by intraoperative neuromonitoring
The localisation of functional areas – known as mapping – plays an extremely important role in the surgical resection of brain tumors. Tumors can shift the normal anatomy, which complicates orientation in the tissue for the surgeon. Mapping helps the surgeon locate language-relevant and motor regions and then gently resect the tumor with continuous monitoring.
Intraoperative neuromonitoring (IONM) is an important part of brain mapping. The continuous monitoring of eloquent functions of the nervous system during a neurosurgical operation reduces the patient´s risk of postoperative impairment. Simultaneously, neuromonitoring allows the function-controlled resection of a tumor during surgical procedures, making it possible to preserve the function of brain areas, connected nerve pathways, the spinal cord and peripheral nerve structures.

Functional preservation of important areas of the brain with the C2 Xplore
During surgery, functionally important areas of the brain are located using hand-held stimulation probes and their integrity can be monitored throughout the entire operation with, for example, strip electrodes. Up to 8 EMG channels are available for motor cortex mapping. Standard programs are available for this purpose: if required, settings can be changed, or individual programs can be created at any time.
  • Cortical Mapping: continuous stimulation, monophasic positive pulse, up to 2 Hz
  • Subcortical Mapping: continuous stimulation, monophasic negative pulse, up to 2 Hz
A further feature is dynamic continuous subcortical mapping. It simplifies safe tumor resection.

Speech mapping is performed in awake craniotomies in Broca’s and Wernicke’s areas to evaluate language function.
The C2 Xplore has a special stimulation program for speech mapping and meets all the requirements of a standalone stimulator. Biphasic stimulation and the Penfield technique (50 Hz or 60 Hz) are possible.

In addition, the program has two standard stimulation configurations:
  • Speech Mapping: continuous stimulation, biphasic pulse, 50 or 60 Hz
  • Speech Mapping 4s: time-limited stimulation of 4 seconds, biphasic pulse, 50 or 60 Hz
The set stimulation pulse with all its settings, and the visual and acoustic stimulation confirmation are available at any time including during brain mapping.

In addition to its matching accessories, the C2 Xplore offers a wide range of application possibilities in neurosurgery:
  • Direct cortical stimulation
  • Speech mapping
  • Motor mapping
  • Mapping of the cranial nerves
Features
  • Specially developed software for cortical mapping
  • Easy and intuitive procedure in accordance with the proven C2 software concept
  • Clear view of EMG signals
  • Continuous and automated impedance measurement of the recording electrodes
  • Integrated database stores patient data on a long-term basis
Main application areas of the C2 Xplore:
  • Neurosurgery
  • Thyroid surgery
  • ENT surgery
  • Vascular surgery
  • Rectal surgery
  • Spinal column surgery

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Product category: Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

C2 NerveMonitor

C2 NerveMonitor – Specialist for versatile use in the OR

The C2 NerveMonitor from inomed was developed for daily use and is considered as a specialist for a versatile application in the OR.
The intelligent technology offers reliable signal stability in the monitoring of motor and sensory nerves and with an additional simple and intuitive user interface. The C2 combines all the functions of the current purely acoustic nerve monitors, and combines their simplicity with precise visual display and comprehensive documentation. All components of the device are optimized for precise and reliable neuromonitoring in order to achieve the highest signal quality and reliability. With its versatile applications, the C2 NerveMonitor is therefore a true all-rounder which impresses with its uncomplicated handling.

Specially developed software modules extend applications
The C2 NerveMonitor specially developed for thyroid surgery was expanded with new C2 software modules. This substantially extends its range of applications and the C2 is now also available as a reliable partner for efficient neuromonitoring to surgeons in spinal, vascular, facial nerve, rectal and neurosurgery. The perfectly matched accessories allow intermittent and continuous neuromonitoring.

Features
  • Intuitive user interface
  • Barcode scanner for patient ID input
  • High quality loudspeakers
  • Integration into hospital network possible (HL7 Ready)
  • Integrated patient database
  • USB interface for easy data export
The main application areas of the C2 NerveMonitor are:
  • Thyroid surgery
  • Ear, nose and throat surgery / facial surgery
  • Vascular surgery
  • Rectal surgery
  • Spine surgery
  • Neurosurgery (C2 Xtend) 

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Product category: Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

NeuroExplorer 2019

For demanding monitoring - The neuromonitoring software NEX2019

  • Best signal stability due to optimized signal processing
  • Sets new standards in user-friendliness
  • Complete documentation of all procedures

The neuromonitoring software NEX2019 is available for all ISIS IOM systems: ISIS Xpert, ISIS Xpert plus and ISIS Xpress. 
The modular structure offers maximum flexibility and can be expanded accordingly to individual requirements.

New software modalities of NeuroExplorer 2019 extend the application fields of neuromonitoring:

pIOM® (pelvic intraoperative neuromonitoring)
The use of the pIOM® software modality allows vegetative nerve monitoring in the small pelvis.
This new technology has been patented by inomed throughout Germany.

Spine - Spinal Neuromonitoring
The Spine Software Modality of NeuroExplorer 2019 offers automated stimulation and display functions in intuitively designed setup and measurement windows.
These are especially suitable for EMG monitoring during placement of pedicle screws and lateral accesses to the lumbar spine.

Automated control of the degree of relaxation via TOF
The TOF (Train-of-four) measurement enables a clear, color-coded representation of the TOF index during the procedure showing the level of muscle relaxation.

Channel Select function for monitoring thyroid interventions
The Channel Select function enables reliable recognition of muscle responses even with the smallest signals. The ALM (Advanced Laryngeal Monitoring) technology  provides the highest security.

Multi-channel video
The NEX2019's multi-channel video module enables simultaneous display from up to four different video sources.

HL7 Ready
The HL7 interface offers optimized documentation by automatic transmission of patient data to the hospital network (not included in the standard package).

Proven technologies with new features for improved user guidance
With the development of the powerful NEX2019 software, reliable and efficient monitoring for optimum measurement results in operating theatres has been perfected.
The latest generation convinces with tried and tested features and impresses with new features in an improved, intuitive user guidance, ensuring a short period of training in the often stressful operating environment.

Features of NeuroExplorer 2019
  • Meets the latest GDPR requirements
  • New application-oriented software modalities
  • Intuitive operation
  • Optimized signal processing
Applications
  • Monitoring in neurosurgery
  • General & visceral surgery, e.g. EMG and pIOM®
  • Monitoring during thyroid gland surgery
  • Vascular surgery, e.g. SEP monitoring for carotid stenosis, monitoring during aortic aneurysm surgery
  • Orthopaedics and spine surgery, e.g. SEP and MEP
  • Cardiothoracic surgery, e.g. SEP and MEP

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Product category: Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

ISIS Neurostimulator

New possibilities in IOM: The ISIS neurostimulator with stimulation artifact suppression

The ISIS Neurostimulator's flexible, unique and US patented technology has been specifically designed to meet the most demanding requirements of intraoperative neuromonitoring. 
  • High current and direct nerve stimulation with monophasic, biphasic and alternating pulse forms
  • Use as a single device or as part of the ISIS IOM system via the integrated NeuroExplorer software
  • Continuous impedance control of the stimulation electrodes during the operation
Stimulation artifact suppression
With the newly developed and German patented technology for the suppression of the stimulation artifact, signals with short latency and low amplitude can be displayed more clearly. Whether D-wave or corticobulbar MEPs, less superimposition makes it easier to identify the signals.

Maximum flexibility with the ISIS neurostimulator
The 12 channels for high current stimulation (max. 250 mA) and one channel for direct nerve stimulation (max. 25 mA) allow the use of different neurophysiological measurement methods in neurosurgery, epilepsy surgery, general and visceral surgery as well as otorhinolaryngology.

Easy and safe to handle
Stimulation and discharge adaptor for electrode connection:
  • The adaptor boxes connecting the electrodes to the ISIS neurostimulator for neurostimulation are simple and safe to use - thanks to color-coded slots, plug connections and cables.
  • A clear and distinct marking speeds up the connection of the electrode.
  • If required the connection to a neurodiagnostic system is possible. The results of neurostimulation can be displayed and documented in the form of EMG or iEEG signals.
Attributes
  • Stimulation artifact suppression
  • Constant current stimulator with 12+1 flexible outputs for direct nerval, cortical, muscular, transcutaneous and transcranial electrical neurostimulation
  • Stimulation current adjustable from 0.01mA to 250mA in individually definable steps
  • Impedance measurement and current flow control display
  • Simple programming of an unlimited number of application-specific stimulation programs
  • Patient database for documentation
Application Fields of Neurostimulation
  • Transcranial electrical neurostimulation for motor evoked potentials
  • Direct cortical and subcortical neurostimulation of the speech and motor cortex
  • Direct intracerebral neurostimulation for localization of functional disorders in pre-surgical epilepsy diagnostics
  • Direct nerve stimulation for monitoring of cranial and peripheral nerves including nerve action potential measurements
  • Nerve and muscle stimulation for pelvic and anal atresia surgery

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Product category: Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

FLUOBEAM® LX

FLUOBEAM® LX - The ultimate camera for monitoring in parathyroid surgery

The FLUOBEAM® LX from FLUOPTICS® is a world novelty for fluorescence imaging in thyroid and parathyroid surgery.
To minimize the risk of parathyroid injury during thyroid surgery, the identification of the parathyroid glands is essential. With the FLUOBEAM® LX (dedicated for thyroid and parathyroid surgery) the surgeon has a precise instrument with optimal comfort in use.
The FLUOBEAM® LX is the first FDA-approved and CE certified imaging system for parathyroid autofluorescence in parathyroid surgery.

Camera for parathyroid detection by autofluorescence
The precise camera solution for parathyroid surgery allows identification of the parathyroid glands based on their autofluorescence: The camera head of the FLUOBEAM® LX contains a laser that emits light in the NIR (near infrared) range. At the same time the operating area is captured by the camera head of FLUOBEAM® LX and the light fluoresced by the parathyroid gland is displayed. This allows the parathyroid gland to be precisely located in the surgical area.

Easy handling and compatibility with ambient light in the operating room
Easy handling and optimized ergonomics in the form of a joystick make it easier for the surgeon to navigate and select software functions. The FLUOBEAM® LX also demonstrates reduced sensitivity to disturbing light from the light sources in the OR during its use. As a result, real-time visualization of the parathyroid glands is possible even without switching off the OR light completely. The operating flow remains unaffected to a large extent.

Imaging system with highest quality
Thanks to the hardware with a high refresh rate (25 FPS) for real-time display and a high depth of field (>5 cm) resulting from the powerful imaging software FLUOSOFT™ LX, the FLUOBEAM® LX provides optimal working conditions for the surgeon in the field of parathyroid surgery and enables easy interpretation of the images.
The FLUOBEAM® LX for localization as well as vascularization of the parathyroid glands in parathyroid surgery offers in combination with the C2 Xplore an innovative complete solution for highest reliability and safety in thyroid surgery.

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Product category: Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

inomed Planning Software - iPS

Target point planning, biopsy and DBS

Accurate and precise planning is essential for all forms of neurosurgery that require targeting structures in the brain. For example, targeting the STN for DBS procedures requires that the target is identified and a precise and accurate trajectory is defined for use with stereotactic devices. In order to achieve this, it is essential that a high-precision and easy-to-use planning tool is employed. The inomed iPS software is such a tool, enabling the clinician to easily assemble all of the necessary imaging modalities and create an optimum set of planning coordinates to target the area of interest.
State-of-the-art imaging techniques in combination with developments in the field of IT have led to breakthroughs in stereotactic and functional neurosurgery. These technologies have enabled accurate and tissue-sparing interventions in the human brain.  All the planning tasks are carried out by the inomed iPS planning system.

Safe intervention during DBS requires precise planning
Before any surgical intervention, surgeons use the iPS from inomed to plan their access and target point coordinates for specific surgical interventions in the brain. The target defined may be verified prior to surgery using the inomed target point simulator.
What sets the IPS planning software apart is the high quality of its image manipulation tools and the methods and algorithms used to merge images together. If required, anatomical atlases can be projected onto the patient's own data. In turn, this allows verification based on anatomical principles and provides for safe intervention.  

Seamless connection to IT systems
Interfacing with hospital imaging tools is a prerequisite for successful and effective operation in planning and stereotactic interventions. The inomed iPS software connects seamlessly to hospital-specific imaging equipment and IT structures. In addition, the iPS software supports a variety of different image formats, allowing for a wide range of applications. Once planning is complete, the resulting data is transferred to the stereotactic system, paving the way for an accurate and safe surgical intervention.
There is currently no other stereotactic planning software besides iPS that supports the wide range of different stereotactic systems on the market. Whether carried as a laptop or in stationary mode with a network connection, iPS provides reliable coordinates and helps ensure successful interventions.

Supporting all planning approaches
iPS supports all planning approaches, whether free-hand, functional, atlas-based or metabolically-oriented. In each case, various options are available that can complement each other to provide greater safety in interventions, such as DBS.
A powerful multi-level fusion algorithm allows the merging of digital and digitized image information, always preserving the exact patient geometry in the foreground, with simultaneous optimization of anatomical visibility and image quality. This forms the basis for a secure, high-risk intervention, such as DBS.
Additionally, post-operative imaging can, after an intervention such as DBS, be combined with pre-operative information so that complications can be excluded and the accuracy of the procedure verified.

Features
  • PACS connectivity
  • DICOM import and export
  • Automatic image fusion
  • 3D simulation
  • Visualization of electrodes
  • Anatomical atlases
  • Supports all imaging systems
  • Post-operative checks
Applications
  • Stereotactic target planning
  • Biopsy planning
  • Deep Brain Stimulation (DBS)
  • SEEG planning

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Product category: Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

Stereotactic systems

Stereotactic systems from inomed
inomed continues the tradition of uncompromising precision in stereotactic tools

Modern functional neurosurgery procedures are now so minimally invasive that they have to be planned and performed with the highest degree of precision. The inomed stereotactic systems are defined by their reliability, precision and stability in their overall function. The fact that the work of the surgeon and the OR team is so simplified - because inomed’s systems are so easy to operate - is one of the qualities of inomed’s stereotactic systems that our customers appreciate most.
To date, there are no other systems on the market that are more convenient or have higher precision than the stereotactic systems created by inomed. The following reasons will help to explain why.

High stability for stereotactic interventions
The ring-based stereotactic system used by inomed provides the highest level of stability. The basic physical properties of a ring are superior to all other basic geometric shapes in terms of strength and tolerance. This basic design element of the system and structure avoids common sources of error.
inomed stereotactic systems are the only systems worldwide with an advanced target point simulator. With the inomed target point simulator, theoretical planning from the planning software tools can be measured and verified according to the real-world geometric environment. There is no better way to ensure maximum patient safety combined with optimum precision. In addition, the use of inomed target point simulator results is a second and clear practical advantage. This means that when using the planning software, stereotactic frame and MicroDrive system, it is easy to check that the instruments used are functioning properly and within tolerances prior to surgical intervention. No other system on the market is more capable of providing this level of safety and design. inomed stereotactic systems set the absolute benchmark in terms of accuracy.

Choose the right system for optimal patient treatment
inomed offers a choice of stereotactic systems to suit customer-specific requirements our customers are able to choose between the Riechert-Mundinger system (RM) and the Zamorano-Duchovny (ZD ) system. Both systems were developed by fellow neurosurgeons. Both systems are also an indelible part of the history of stereotactic neurosurgery. This is a further reason why inomed enjoys an international reputation for providing the highest precision and is respected for continuing the tradition of the application-driven and patient-oriented development of stereotactic devices.
Verification of the stereotactic planning coordinates is performed by the inomed target point simulator, also known as a phantom. All the systems combine methods of traditional stereotactics with the modern requirements of stereotactically-guided microsurgery, deep brain stimulation, thalamotomy/pallidotomy, and stereotactic biopsies.
Using inomed products for stereotaxic surgery means you will be benefiting from the reliability of a system where the functioning of all individual components is perfectly coordinated into one complete system.
  • RM-System
  • ZD-System
  • Target point simulator

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Product category: Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

ISIS MER

The inomed ISIS Microelectrode Recording (MER) system
inomed ISIS MER - The most compact and intuitive MER system available

Deep brain recording and stimulation or extracellular recording in other regions of the brain is potentially a high-risk intervention requiring a precise and systematic approach. The ISIS MER system is a self-contained, microelectrode recording system that provides all of the hardware and software elements necessary for targeted measurement in MER and neuromodulation  techniques. The ISIS MER system can be configured for a wide range of applications and is designed to be easy and intuitive to use.

ISIS MER System: Modularity in neurosurgery
The portable ISIS MER system comprises all the equipment the neurosurgeon will need in one box: ISIS MER USB Headbox module for microelectrode recording and ISIS EMG USB Headbox module for electromyography. The system includes a high specification Notebook computer and medical grade power supply. The MER system carry case includes space for the high-precision inomed MicroDrive and sterilization box. The ISIS MER system also includes a small yet powerful and portable workstation for the OR.
Within the cart configuration, the system also includes a wide-screen monitor with an easy-to-clean surface and optional touchscreen operation. A high-performance speaker system and laser printer complete the cart configuration. The cart also benefits from additional space for accessories.
The intuitive interface of the ISIS MER Headbox ensures that both the surgeon and the operator of the MER system can see the electrode depth at all times throughout the procedure. This is critical to target localization during deep brain stimulation or when measuring local field potentials. Easy access to this information is also vital to ensuring accurate and safe procedures.

Hightech Systems combine to deliver the ultimate MER
The ISIS MER system has an intuitive and easy-to-use user interface. This means that the surgeon and the MER operator can focus on the procedure and patient during the critical recording and stimulation phases of the procedure.
System integration with the inomed MicroDrive and the micro-macro electrodes delivers seamless performance. The design is stunningly simple. This means that only one plug-in connection is required per electrode. Switching between recoding and stimulation for a given electrode/channel is very simple – internal computer-controlled switching means there is no need to swap cables from recording to stimulation. All raw signal information is recorded for each channel used and signal filtering is an online function of the software. This results in the complete signal spectrum being recorded and available for post-operative investigation and intra-operative display.

Features
  • 5 MER channels for recording and stimulation
  • Up to 16 EMG channels
  • Intuitive and easy to use
  • Upgradeable with additional functions and additional ISIS USB headboxes
  • High-quality loudspeakers
  • Online analysis functions
  • Depth sensor for electrode position display
Applications
  • Target localization for extracellular recording and deep brain stimulation
  • Recording and localization of the core area in case of lesions

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Product category: Microsurgical instruments, Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS)

MSV – MicroDrive

MSV – MicroDrive for deep brain recording and stimulation
A mechanical masterpiece

This is the fourth generation of the sophisticated high-precision instrument used by surgeons and medical professionals around the world to position electrodes during stereotactic interventions and in deep brain stimulation.
The inomed MicroDrive was developed in cooperation with leading international practitioners and experts. The resulting standards and specifications set by the experts were extremely high. inomed has delivered on the specifications required and achieved mechanical precision delivering unique performance. The inomed MicroDrive is known to most specialists in the field and the device is favored for deep brain recording and stimulation applications.
Professionals and subject matter experts use the MicroDrive routinely. Using the inomed MicroDrive delivers the best possible neurophysiologically targeted diagnostics (deep brain recording and stimulation).

Modern imaging technology can identify physical structures of the brain, however, imaging modalities alone are not able to clearly and finitely identify target areas. In addition to this, target location can be affected by brain shift or indeed the functional target point may differ from the imaging results. For all of these reasons, microelectrode recording is used to further improve target point localization and precision. Precise localization, recording and stimulation are particularly important for DBS and neurmodulation procedures. For this entire spectrum of uses, the inomed MicroDrive is an indispensable tool. Correct application of the MicroDrive enables users to determine the optimum target point, for optimal treatment outcome in deep brain stimulation (DBS).
The universal nature of the MicroDrive design means that the inomed MicroDrive can be used with other Stereotactic systems and a wider range of users are able to benefit from the technology. With the addition of a suitable adaptor available from inomed, the MicroDrive can be used on all currently available stereotactic systems.

Functional neurosurgery requires more than just manual dexterity
Surgeon’s tools become an extension of his hands. The tools and technology used in the OR must work in perfect synchronization with the surgeon and be entirely reliable too. This is especially the case when positioning electrodes during a stereotactic procedure, such as deep brain stimulation (DBS).
The depth stops on the inomed MicroDrive ensure that fitting the electrodes and guide tubes incorrectly is not possible. The tactile feedback (‘click’) allows the neurosurgeon to ‘feel’ when a full turn of the MicroDrive spindle has been completed.
The inomed MicroDrive is able to position and deliver up to five electrodes for recording and stimulation for deep brain stimulation (DBS) procedures. The inomed MicroDrive has a resolution of 50 µm per division and allows the surgeon to position the electrodes accurately, with tactile feedback after each full turn.
With the addition of the optional depth sensor to the MicroDrive, the stereotactic position of the electrodes is automatically transferred to the ISIS MER system and is indicated on the screen and recorded as part of the patient recording process.

Features
  • Implanting of DBS electrodes from Medtronic® , St. Jude® and Boston Scientific®
  • Positioning resolution of 50 µm
  • Tactile feedback after one complete turn (0.5mm)
  • Optional depth sensor available
  • Autoclavable
Applications
  • Deep Brain Stimulation
  • Recording and localization of the core area in the case of lesions
  • Micropositioning of other probes and electrodes

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Product category: Microsurgical instruments, Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS)

Stereotactic biopsy instruments

Stereotactic biopsy for the brain

inomed delivers the best instrument for every biopsy requirements
When the diagnosis of a brain tumor is uncertain, a stereotactic biopsy can provide clarity and confidence. To ensure that such clarity and confidence is delivered during a biopsy, inomed offers a sophisticated set of biopsy instruments for intra-operative stereotactic surgery.
From an evidence-based perspective, histopathological diagnosis of a brain tumor is the method with the highest accuracy rate for classifying a tumor. In this sense, stereotactic biopsy is the best method of treatment, especially for smaller and more deeply-seated lesions. This is considered to be the best way to classify a lesion accurately, and only this way can each and every patient receive the optimal treatment for their specific disease.

Working lengths for every application
Depending on the application and the requirements of its intended use, inomed biopsy sets offer a range of working lengths. Biopsy sets are selected to suit the stereotactic system that is being used. This means all systems with internationally established stereotactic working lengths, i.e. both 190 mm and 280 mm, can use inomed stereotactic instruments.
Planning a stereotactic biopsy can be performed with the inomed planning software (iPS): inomed's software supports current methods for target point definition, visually, functionally and metabolically. Due to the high quality of inomed’s biopsy instruments, users are able to work precisely at the point from where tissue is to be removed. The inomed target point simulator helps to validate the design and verify the exact calibration of the instruments used.

Safety and precision during the biopsy
inomed provides a safe process within the framework of planning and implementing a stereotactic biopsy for the brain. Using the unique inomed target point simulator, inomed is uniquely positioned to offer the highest levels of precision in the field of stereotactic biopsy. inomed continues to set standards for accuracy and precision.
The inomed portfolio comprises all current types of biopsy instruments, including forceps and probes (Sedan-type and Backlund).
Depending on personal preference or clinical requirements, disposable products and reusable products are also available. The sets include guide tubes and, if necessary, Mandarin and sterilization boxes.
  • Zamorano-Duchovny (ZD) 
  • Riechert-Mundinger (RM) 
  • Leksell
  • Micromar
  • CRW Radionics
Features
  • Available as single-use or reusable instruments
  • Available as forceps, probe or needle
  • Working length 190 mm or 280 mm
Applications
  • Controlled removal of tissue in the brain (biopsy)

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments, Neurosurgical instruments and equipment

ZD stereotactic system

The ZD stereotactic system – for neurosurgery and neuromodulation

Aiming arm system for frame-based stereotactic neurosurgery
The inomed ZD frame derives its name from partners who developed it, Prof. L. Zamorano and Prof. M. Dujovny. This ZD localization system is most often used for neurosurgery and neuromodulation surgery applications.
The ZD system is an unparalleled combination of classical stereotaxy methods with the modern requirements of stereotactically-guided microsurgery. The procedures include stereotactic endoscopy, laser therapy and other cutting-edge applications, including neuromodulation and stereotactic biopsy.
The design of the ZD frame combines precision engineering and manufacturing with easy and intuitive operation. The ZD system therefore provides an important tool for the modern neurosurgeon. The minimally invasive neurosurgery techniques undertaken using the ZD frame offer patient-friendly and life-sustaining treatment options for disorders of the brain.

Almost unlimited access to all intracranial regions
The ZD system is based on the center-of-arc principle, which allows almost unlimited access to all intracranial regions, with a free choice of trepanation point. The surgeon is able to select the access point, offering the greatest safety to the patient and ensuring that all the settings for neuromodulation are configured on the ZD system with the highest level of mechanical precision.
The ZD system is compatible with all imaging procedures used with advanced therapy requirements, including DBS. The ZD head ring unit is made of titanium and guarantees artefact-free CT and MR images. The head ring is also transparent for X-rays. By design, the modular nature of the ZD system makes it possible to quickly and easily pick up whilst accurately and safely performing a number of diagnostic and therapeutic stereotactic procedures and neurosurgery. This is true for DBS procedures in the field of neuromodulation and also for stereotactic biopsy performed on the brain.

Variety of accessories for neuromodulation
When using the ZD system in neurosurgery and neuromodulation procedures, the surgeon is advised to take into consideration all indications and contraindications that generally apply to frame-based stereotaxis.
The ZD system can be used together with all inomed stereotactic rings. There are a variety of accessories and tools available for use with the ZD system. Using the inomed planning system (iPS), surgery can be planned and mapped on to the ZD frame. This includes all steps leading to a neuromodulation (DBS) implantation.

Features
  • Center-of-arc principle, target point remains the same from different trepanation points
  • 6 possible mounting positions for best possible access
  • Single-point fixing for easy and flexible mounting
  • MicroDrive with depth sensor for micro-electrode recording
  • Target point verification using target point simulator
  • Compatible with inomed IPS planning software
Applications
  • Deep Brain Stimulation
  • Pallidotomy
  • Thalamotomy
  • Stereotactic biopsy
  • SEEG depth electrodes

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments, Neurosurgical instruments and equipment

RM stereotactic system

RM – the most accurate stereotactic system in the world

High-precision from Germany: The inomed RM system
The Riechert Mundinger (RM) system is the only stereotactic system on the market with three fixation points. This gives the device a very high level of stability and precision. The RM is regarded to be the most precise stereotactic system in the world and, with its unique design, provides uncompromised accuracy in stereotactic surgery.
The RM system from inomed is based on the polar coordinate principle. This concept was developed by the two well-known stereotactic experts, Prof. Traugott Riechert and Prof. Fritz Mundinger. The RM aiming arm with its probe mount delivers a high level of mechanical precision. A wide range of accessories ensure that the RM system delivers universal application for the modern stereotaxy service.

Stereotactic system offering the highest precision
The high precision of the inomed RM system was specifically developed for stereotactic interventions in functional neurosurgery. The configuration can be easily adapted for stereotactic brachytherapy. The precision and stability of the RM stereotactic system means that it is the frame of choice, particularly for interventions in functional neurosurgery.
The RM stereotactic system consists of an RM stereotactic base ring and an RM aiming arm unit. The application of the stereotactic base ring and the use of localizers for imaging are described in separate manuals (patient immobilization, localization systems). The RM target device allows the attending neurosurgeon to reach every point in the brain precisely. In order to achieve optimum results, it is a requirement that the patient's head, the position of the target and the trepanation point are taken into consideration when mounting the ring. Different mounting options can be applied both positively and negatively. The standard mount method is used for all acquisitions in the frontal and occipital region of the skull. With negative mounting of the RM, the posterior fossa and pituitary gland can be reached.

Vernier scale for accurate setting
To ensure the settings are as accurate as possible, Vernier scales are attached to the corresponding scales on the RM system. The Vernier scale allows surgeons to define small measurement units that can no longer be read on the main scale. A Vernier scale line corresponds to 1/10 of a degree. In the Vernier scale, 9° are divided into 10 equal sections. Using the Vernier scale in this way, the RM coordinate values can be adjusted precisely to decimal points (1 -, 1 -, 3, etc.). The digits after the decimal point are read from the scale line on the Vernier.
Components of the inomed stereotactic product can be adapted as part of a modular system directly on the aiming arm carriage of the RM system. Other components can also be used separately, and provide further helpful tools for the attending neurosurgeon.

Features
  • Polar coordinate system, with 5 setting parameters allowing for extremely high precision
  • Three fixation points for unmatched stability
  • Trepanation in the target direction
  • MicroDrive with depth sensor for micro-electrode recording (MER)
  • Target point verification using target point simulator
  • Artifact-free, optimized for medical imaging
  • Compatible with inomed iPS planning software
Applications
  • Deep Brain Stimulation
  • Pallidotomy
  • Thalamotomy
  • Brachytherapy
  • Stereotactic biopsy
  • SEEG depth electrodes

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments, Neurosurgical instruments and equipment

Phantom - Target point simulator

The inomed target point simulator – Stereotaxic Phantom

Recommended by leading neurosurgeons – inomed target point simulator (Phantom)
The stereotactic target point simulator from inomed, also referred to as a phantom, is a unique product and only available from inomed. Professors Riechert and Mundinger, globally recognized pioneers in neurosurgery, have developed the Phantom alongside the development of the RM stereotactic system. The target point simulator has become internationally established and is regarded by leading neurosurgeons to be an essential and recommended tool for planning and conducting complex operations on the brain. The use of the Phantom becomes especially significant for the highly complex neuromodulation (DBS) techniques.
The target point simulator (phantom) is used primarily to translate the coordinates from the planning software and mechanically setting the target point in real-space prior to surgery. A steel target point rod is moved with three movable thumb screws in the X-, Y-, and Z-axis (coordinates from the planning software). The tip of the rod forms the target point, in accordance with the planning software. A base ring is attached to the target point simulator and the aiming arm unit can be placed on this ring. The Phantom consequently simulates the respective target point for the patient.

There are two options for setting the target direction on a phantom:

a) Mechanical adjustment on the Phantom:
The desired stereotactic coordinates are set on the Phantom. The trepanation marker is brought and fixed to the patient's head in the position of the desired trepanation gap. This is transferred to the base ring on the target point simulator by loosening the retaining screw and attaching in the same place (number of degrees on the ring).
After attaching the aiming arm to the base ring on the Phantom, a puncture probe is directed through the opening of the trepanation marker directly to the target point. In order to do this, all screws on the aiming arm and carriage are loosened. This enables the assembly to be moved in all directions. By looking through the depth gauge, with the instrument holder and the trepanation marker, it is relatively easy to slide the assembly in all directions and move until the tip of the aiming point marking rod is visible. Once the best possible setting is reached on a phantom, all fixing screws are locked and secured and the entire aiming arm is attached to the base ring.

b) Mathematical adjustment on the Phantom:
Using X-ray, CT and MRI scans with the inomed planning software (iPS),  the target and trepanation point coordinates are calculated and converted to stereotactic angles. The coordinates calculated by the iPS can be set directly on the aiming arm carriage of the RM or ZD stereotactic system. The aiming arm is then mounted on the Phantom for verification.
Despite this rather simple target setting, an additional check on the phantom is always recommended. Any errors in adjusting the angle on the aiming arm or curved/bent instruments are detected immediately with the phantom. The phantom is therefore the final authority for preventing stereotactic errors. Only the use of a phantom can ensure the highest level of safety for patients during neurosurgery and neuromodulation.

Features
  • Patient-customized checking of target points
  • The setting of the stereotactic system in relation to the patient's target point is guaranteed to be accurate and correct for the given coordinates
  • Faulty instruments are detected before being used
  • Perfect for training beginners
  • X, Y and Z axes can be set for the patient-specific target point
  • Autoclavable
Applications
  • Target point verification for the stereotactic system and instruments

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments, Neurosurgical instruments and equipment

Mapping Suction Probe

Surgical suction device and monopolar probe in one instrument
One product – A wide range of applications

The mapping suction probe is a real all-round talent and is used in a wide variety of applications:
  • Neurosurgery
  • ENT
  • Vascular Surgery
  • Plastic Surgery
  • Maxillofacial and Facial Surgery
Two instruments combined in one – Surgical suction device and monopolar probe at the same time  
Electrical stimulation needs no change of instruments: do intraoperative mapping without delay with our combination of surgical suction device and monopolar probe. Flexible application while always at the scene: synchronous fluid and tissue suction and mapping of neuronal structures e.g. peripheral nerves in the vicinity. Developed by surgeons for surgeons: swift surgery due to acoustic feedback and no restraints by additional instruments. Focus on patient security for best results.

Product features:
  • Sterile single-use product. Reference electrode included: always ready to use
  • Ergonomic form, light-weight material, insulated up to the tip
  • Universal use because of standard connections for suction and stimulation as well as easy handling of the suction power due to a suction control hole
  • Surgical suction device and monopolar probe in one single instrument

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Product category: Instruments for the minimal-invasive surgery (MIS), Neurosurgical instruments and equipment, Microsurgical instruments

IOM Accessories

A complete connection concept from needle electrodes to adapter box

inomed stimulation and recording accessories have been specifically developed to meet intraoperative applications.
Our accessories portfolio includes stimulation probes and electrodes (e.g. subdermal needle electrodes) for stimulation and recording. These are complimented by color-coded adapter boxes and connecting cables in a wide range of lengths.

Electrodes for stimulation and recording
In addition to their use in relation to signal recording, electrodes, including needle electrodes, can also be used for stimulating nerve and muscle tissue. Application-specific electrodes with a range of different geometries have been optimized for use with a range of multimodality applications (surface and needle electrodes). All electrodes, including needle electrodes, can be used for all measurement modalities (AEP, EEG, EMG, MEP, SEP, VEP) in a multimodal neuromonitoring application. All electrodes also feature a 1.5 mm safety connector and are compatible with a variety of connection schemes on other manufacturer systems.

Subdermal needle electrodes (SDN electrodes)
The subdermal needle electrodes available from inomed provide an easy and reliable patient connection to enable the high-quality recording of electrophysiological signals. These electrodes can also be used for the electrical stimulation of nerve and muscle tissue. Subdermal needle electrodes are also available in the form of corkscrew electrodes, hookwire electrodes, hook electrodes and short needle electrodes for pediatric applications. In addition, the range offers various bipolar needle electrodes, including electrodes for vocalis and oculomotor nerve recording.
The Trigon SDN electrode is a special form factor subdermal needle electrode. As a result of its extremely thin geometry and 30° angle to the needle, the special hand-piece on the Trigon enables an easy to manipulate atraumatic fixation. All needle electrodes are available with different needle and cable lengths, as well as different color combinations.

D-wave electrode
The inomed D-wave electrode is a bipolar flexible drainage and stimulation electrode. It can be used for recording both D- and I-waves. The D-wave electrode can also be used to stimulate the spinal cord and enables electrical intraoperative functional testing during the procedure. In addition, this flexible electrode is also used in the postoperative prognosis of spinal cord function in neurosurgery, spinal surgery and vascular surgery.

Strip and grid electrodes (including needle electrodes)
inomed strip and grid electrodes are typically used for reverse-phase SEPs, direct cortical stimulation – bipolar or monopolar against a counter electrode (e.g. needle electrodes). In addition, these electrodes can also be used for epilepsy surgery. The electrodes are available in a range of designs with 4, 6 or 8 contacts per strip. The strips are combined in a range of configurations to deliver grinds of differing numbers of electrodes.

Stimulation probes (including needle electrodes)
Hand-held stimulation probes are used for electrical stimulation of nerves and neural structures. When used in conjunction with needle electrodes, probes and electrodes can be used to record electrophysiological signals. A wide variety of bayonet-shaped probes are available from our product range. These products help ensure that working under the microscope remains unobstructed and easier for the surgeon. The probes are sterilized with ETO and have a cable with length of 3 m, leading to a standard safety plug for connection to a full range of stimulation outputs and headboxes. All monopolar probe packages include a needle electrode used as a ground electrode. Reusable probes are connected to the systems via a 4-meter probe cable.

Bipolar stimulation probes
Bipolar probes are available in the following form factors; bipolar concentric probes, fork sensors and hook probes. In order to accommodate the various application requirements from direct cortical stimulation to stimulation and recording of direct nerve action potentials (NAPs), bipolar probes can be delivered in a variety of geometries.

Monopolar stimulation probes
Monopolar stimulation probes are primarily used for motor mapping and muscle stimulation in spinal surgery and pedicle screw stimulation. The probes have an active electrode (the probe) and a return electrode (ground), which is placed outside the stimulation region. The electrode used for ground can be in the form of a needle electrode or stick-on pad electrodes.

VEP goggles
inomed offers a range of a VEP stimulators that can be used for intraoperative stimulation of the visual pathways. With two independent LED pads, disturbing immobilizing elements are not necessary. The recording of electro-physiological signals takes place on the primary visual cortex and can be carried out using surface electrodes, as well as subdermal needle electrodes.

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments, Neurosurgical instruments and equipment

Delta electrode

Delta electrode – Continuous monitoring of the recurrent laryngeal nerve during thyroidectomy

Improved information on nerve state using continuous neuromonitoring of the recurrent laryngeal nerve
Thyroid disorders affect millions of people worldwide. In many cases, surgical treatment is necessary and often the only solution. For example, where a goitre, an enlargement of the thyroid gland, has formed, or if malignant changes are found, surgical intervention is recommended.

Perfect fit on the nerve
In continuous recurrent laryngeal nerve monitoring, the vagus nerve is stimulated so as to monitor and protect the recurrent laryngeal nerve in the surgical area.
The delta-electrode is placed around the vagus nerve and thus always keeps contact with the nerve and delivers stimulation pulses at the defined rate and threshold.
The distinct advantage of the electrode is its delta-like shape and form factor. The shape enables the electrode to be positioned optimally on the nerve and prevents the electrode from slipping or sliding off. As a result of the constant contact with the vagus nerve, technically-induced signal attenuation and even signal loss can be avoided. The surgeon can thus immediately see if the recurrent laryngeal nerve is at risk and can act before a reduction in nerve conductivity becomes an irreversible vocal cord paralysis.
The ALM Tube is ideally suited for obtaining the best possible EMG signal recording from the vocal cords. Its multifunctional combination of a clear PVC ET tube and a surface electrode with eight long recording contacts offers the ultimate signal stability. Due to its all-around 360° surface sensor coverage and the extended length of the 8 sensor pads, the ALM Tube provides reliable signal recordings independent from tube shift or rotation. The surgeon benefits from easy placement of the recording electrode. Thanks to the flat surface and smooth bevelled tube tip, trachea injuries can be avoided.
Using intraoperative nerve monitoring, and depending on nerve performance during the procedure, the surgeon has the option of ending the procedure after a unilateral thyroidectomy if the results from nerve monitoring are inconclusive or sub-optimal. After successfully maintaining the ipsilateral function of the recurrent laryngeal nerve, the surgeon is able to continue operating contra laterally with a higher degree of confidence. This method helps to identify nerve impairment at an early stage and therefore avoid bilateral vocal cord paralysis.

Improved patient safety using continuous neuromonitoring of the recurrent laryngeal nerve
In the case of surgical intervention where partial removal of the thyroid gland (subtotal thyroidectomy) or its complete removal (total thyroidectomy) is required, these procedures carry a risk of damage to the vocal cord nerve, the recurrent laryngeal nerve. If the recurrent laryngeal nerve is impaired or damaged, this can have serious consequences for the patient. Impairment or damage to the recurrent laryngeal nerve can result in short-term hoarseness after surgery or even lead to permanent bilateral vocal cord paralysis.

Avoiding bilateral vocal cord paralysis
Intraoperative neuromonitoring  during thyroid surgery enables the function of the recurrent laryngeal nerve to be monitored throughout. The continuous monitoring process enables the surgeon to make informed decisions during surgery. Following surgery, a definitive statement can be made as to nerve function. The ultimate goal of recurrent laryngeal nerve monitoring is to minimize nerve impairment and to avoid bilateral vocal cord paralysis.
During the procedure, the surgeon is able to use a hand probe to locate the recurrent laryngeal nerve, map it and check its function. Nerve function is therefore recorded both at the beginning and at the end of the operation. In addition, continuous neuromonitoring allows for both audible and visual feedback of the nerve function in real time and enables the surgeon to react quickly to avoid vocal cord paralysis.

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments, Neurosurgical instruments and equipment

pIOM accessories

pIOM accessories – For professional pelvic monitoring

The pIOM technique enables the intraoperative monitoring of autonomic nerves in the small pelvis. The nerve structures can be monitored and nerve impairment avoided, thereby enabling the patient to maintain quality of life. The pIOM accessories developed by inomed for this specific procedure form an important part of the success of surgical interventions in the pelvis.

Methodology for pelvic monitoring
The world's newest methodology for pelvic monitoring is based on proven neuromonitoring techniques and technologies developed by inomed. The techniques and technologies have been developed following many years of clinical research in the processes of monitoring autonomic nerves in the pelvis. Following exhaustive testing and validation processes, the pIOM technique is now available for pelvic monitoring during intraoperative procedures.
Pelvic intraoperative monitoring helps surgeons to protect the anorectal and urogenital functions, and thus helps to maintain the patient's quality of life following surgery. As a result, pelvic monitoring can reduce postoperative follow-up costs and contribute to the delivery of state-of-the-art medicine.
pIOM technical applications currently include pelvic neuromonitoring and are especially useful for  total mesorectal excision. The technology has other applications, for example, in small pelvis interventions nerve impairment may be prevented by the use of pelvic monitoring. Other surgical indications include proctology, gynecology and urology.

pIOM accessories for professional pelvic monitoring
In order to use the pIOM technique for pelvic monitoring during surgery on a colorectal carcinoma, a range of pIOM accessories are required. Monitoring the anorectal function requires that electrodes are placed on the anal sphincter to conduct the EMG muscle response. The function of the bladder is monitored via bladder pressure measurement. Neuromodulation is performed by stimulating the corresponding nerve structures using a bipolar handheld probe. With an intact nerve function, a response signal is recorded from the anal sphincter electrodes and, depending on the nerve structure stimulated, a corresponding pressure measurement is performed and then made available. These responses are presented on screen, with an audio signal output being optional. With pelvic monitoring, the surgeon is able to localize nerve structures and test their function. The results are stored with the patient records and can be documented in accordance with procedure. 

Nerve impairment and physiological dysfunction can be avoided
The monitoring of nerves and nerve structures is an important tool for surgical procedures in the small pelvis. The anorectal and urogenital functions can be monitored with accessories specially designed for pelvic monitoring. In this way, nerve impairment and any resulting dysfunctions can be avoided, while the quality of life for patients can be maintained postoperatively. Standardized implementation of pelvic monitoring can result in an improvement in patient care and a reduction in complication rates.

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Product category: Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments, Neurosurgical instruments and equipment

Accessories for stereotaxy and functional neurosurgery

inomed offers a wide range of accessories and instruments for stereotactic and functional neurosurgery

inomed micro-macro electrodes (MiMa):
Ideal for neurosurgery requiring electrophysiological identification of anatomic target points for stereotactic-functional interventions, including deep brain stimulation (DBS). The patented bipolar architecture allows for both recording and test stimulation to be carried out. The low capacitance of the electrodes enables the maximum spike amplitude to be measured. This results in an excellent signal-to-noise ratio for this type of brain surgery.

inomed MicroMove electrodes (IMM):
A combined electrode for the precise electrophysiological localization of anatomical target points in the human brain. The impedance of the MicroMove electrode is 1 MOhm, which means the electrode can be used with most commercially available recording systems.

inomed macro electrodes:
This electrode can be used to identify an anatomical target point by selective test stimulation during brain surgery. The electrode has a monopolar architecture and therefore it does not allow signal recording.

Biopsy Instruments
To enable precise removal of tissue during a stereotactic biopsy, inomed is the single source for all the latest biopsy instruments for brain surgery – these include forceps and probes (Sedan-type and Backlund). Single-use products and reusable versions are available. 
  • Disposable biopsy probes (Sedan-type)
  • Reusable biopsy forceps (also pediatric)
  • Reusable spiral probes (Backlund-type)
We support the following stereotactic systems for brain surgery (the choice of system determines the working length of the biopsy instruments):
  • Zamorano Duchovny (ZD) 
  • Riechert-Mundinger (RM) 
  • Leksell
  • Micromar
  • Radionics
Open stereotactic system (OSS) by inomed
The open stereotactic system (OSS) is a system for frame-based stereotaxy in brain surgery. The open ceramic ring is fixed rigidly to the patient's head and remains in place throughout the entire procedure. The stereotactic coordinates from the tomographic images can be transferred to the ceramic ring-mounted stereotactic systems and allow for a targeted intervention.
For neurosurgical and radiosurgical procedures and treatments, the goal is to achieve - as closely as possible - a preoperatively planned target point for brain surgery. Imaging procedures, such as computer tomography or magnetic resonance imaging, can provide images of the patient during brain surgery. With the help of modern computer software, such as inomed iPS planning software, it is possible to view this tomogram either individually or as a three-dimensional image and to analyze the target for brain surgery.
The inomed open ceramic ring ensures minimum interference and maximum artefact reduction when imaging is used, and this is particularly the case with MRI. The semi-open architecture means a part of the patient’s face is not covered. This increases patient comfort, especially during brain surgery while awake.

Indications
Suitable for all types of neuro- or radiosurgical brain surgery that requires a stereotactic procedure.
The open ceramic ring has been specially designed for use with imaging in modern MRI scanners. Often used in compact head coils for brain surgery (e.g. Siemens Vision), it limits the size to an outer diameter of 260 mm. The concept of the open ring still allows access to the ENT region of the patient. In order to achieve the best possible MR imaging and correct for artefacts during brain surgery, a ceramic material is used. This is a high-performance ceramic material. It is characterized by its high resistance to mechanical loads during normal hospital operation and is largely resistant to the effects of daily steam sterilization.

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Product category: Neurosurgical instruments and equipment, Instruments for the minimal-invasive surgery (MIS), Microsurgical instruments

LG2 Lesion generator

RF Thermolesion with the LG2 Lesion generator
Modern device for pain treatment and brain lesion

The LG2 is the new, portable radiofrequency (RF) lesion generator from inomed with attractive design, graphical touchscreen user interface, remote control, and a lot more.
The two-channel RF lesion generator supports a large variety of instruments for pain and brain applications. Suitable TC-Electrodes and cannulas complement the product range of inomed for pain treatment. TC Brain-Electrodes round off the product range for the application in functional neurosurgery.

Lesion generator with comprehensive features for precise thermolesion
The LG2 lesion generator is a modern and portable lesion generator for all common lesion techniques (continuous RF and pulsed RF with different control modes) in pain treatment and functional neurosurgery. All critical application parameters are permanently monitored by the device, thereby providing maximum safety and comfort for both the user and patient during thermolesioning.
All inomed mono- and bipolar TC electrodes can be used with the LG2 lesion generator. The LG2 includes two independent RF channels, which can be used at the same time. The combination of two monopolar electrodes for a bipolar application is possible.
The temperature control of the LG2 lesion generator allows to perform controlled thermal lesions. The volume of the thermolesion will be determined by the cannula diameter, the size of the active tip, and the target temperature and therefore becomes reproducible. An integrated temperature sensor in the tip of the TC electrode is used to monitor the temperature in the tissue. The LG2 lesion generator features continuous RF application with temperature control and temperature step profile or pulsed RF application with control of temperature, pulse duration or voltage.

Integrated electrical stimulation and impedance
In addition to RF application, localisation and differentiation of sensory and motor nerves with electrical stimulation, for even more precise electrode positioning is possible. With the LG2 lesion generator, thermolesion, electric stimulation, and impedances can be performed quickly, precisely and safely.

RF Thermolesion for reduction of chronic pain
Interventional pain therapy uses minimally invasive procedures such as thermolesion or cryotherapy with the aim of achieving a prolonged reduction of chronic pain through selective disruption or modification of the pain pathways of the affected nerves. This is carried out either by targeted drug injections or the interruption of pain transmission by minimally invasive neurodestructive procedures (e.g. thermolesion).
As an example, chronic pain within facet joint syndrome can be treated accurately, effectively, and safely with the proper indications using radiofrequency thermolesion.

Features of LG2 Lesion generator
  • Continuous RF in two different modes: Temperature or Preset Temperature-Profile
  • Pulsed RF in three different modes: Temperature, Pulse Duration, or Voltage
  • Direct Nerve Stimulation for the localisation of motor and sensory nerves
  • Continuous Temperature and Impedance Monitoring
  • Neutral Electrode Contact Quality Monitoring (NEM)
  • Saving of up to 25 pre-set programs
  • Touchscreen monitor to manage the intuitive workflow
  • Digital display of all relevant application parameters
  • Remote control to operate the device from sterile field
  • Compact and light-weight system design
  • Compatible with all inomed TC electrodes for pain and brain application
Application fields of RF Thermolesion
  • Facet denervation of lumbar, thoracic and cervical spine
  • Sacroiliac joint
  • Trigeminal neuralgia (Thermolesion of Ganglion Gasseri)

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Product category: Instruments for the minimal-invasive surgery (MIS), Neurosurgical instruments and equipment

ALM – Advanced Laryngeal Monitoring

High-tech technology for advanced signal recording in thyroid surgery

C2 Channel Select Software for ultimate reliability
The innovative and user-friendly Channel Select Software, especially developed for the C2 Xplore and application in thyroid surgery, automatically selects the optimal trace from the 4 channels of the ALM Tube and displays the strongest signal. This allows a seamless and reliable detection of muscle responses even under poor signal conditions.

8 contacts – 4 channels – 1 best signal
The ALM Tube (IOM accessories for thyroid surgery) is a multifunctional combination of a clear PVC ET tube and a surface electrode, together providing the best possible EMG signal recording from the vocal cords. Thanks to the easy placement of the recording electrode at the vocal cords and the extended length of the 8 sensor pads, the ALM Tube offers optimal signal recording of the M. vocalis during intraoperative neuromonitoring in thyroid surgery. The 360° surface sensor coverage with 8 long electrode contacts ensures ultimate signal stability, even if the tube is rotated or vertically shifted.
All signals are displayed acoustically and visually via the C2 Xplore (IOM system for thyroid surgery). The C2 Xplore is known as a smart specialist for various surgical applications, and is the result of inomed‘s several years of experience and intensive research in the field of intraoperative neuromonitoring.

Synergistic effects combined to one high-tech technology
Using the ALM technology, the users benefit from the synergistic effects of individual key technologies. The ALM Tube, C2 Xplore, and the C2 Channel Select Software build an intelligent end-to-end solution, ensuring efficient application in thyroid surgery, especially during RLN monitoring.
Together with more than 25 years of expertise, ALM represents the most innovative cutting-edge technology for advanced signal recording and ultimate reliability in thyroid surgery to date.

Features
  • Efficient end-to-end solution for ultimate reliability in IOM for thyroid surgery
  • ALM Tube – tube for EMG signal recording with 360° surface sensor coverage and 8 long recording electrodes
  • C2 Channel Select - software module for C2 Xplore for automatic selection of the optimal signal
  • C2 Xplore - available as four or eight channel EMG monitor
Application
  • Thyroid surgery

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About us

Company portrait

inomed - innovative by tradition

Ever since inomed was founded in 1991, the requirements of our customers for our systems and the associated safety of their patients have been the focus of our activities. We have made it our goal to offer our customers today what they will need in the future.

With this service-oriented guiding principle and our claim to unique quality and innovation, inomed Medizintechnik GmbH develops, produces and sells medical technology systems for all surgical areas for the protection and therapy of neurological functions
In addition to these tailor-made solutions, inomed offers comprehensive service and training for the optimal use of our systems.

Partner at the side of our customers
We have always seen ourselves as a reliable partner at our customers' side - before, during and after the sale. Short paths and quick decision making for the best possible customer service characterize the structure of success at inomed.

In order to be able to specifically optimize our applications to the requirements of a dynamic market and everyday medical life, our inomed specialists work closely with users from clinics, practices and research. The roots of inomed lie in the intraoperative monitoring of neurological functions, where we pioneered medical technology.
This is confirmed by numerous new patents - inomed's award as one of the most innovative companies in the German SME sector in 2013 - as well as considerable investments in research and development.

In the meantime, we reach customers of our medical technology company all over the world from our main location in Emmendingen and our two international subsidiaries (Great Britain and Poland) as well as five sales territories worldwide.

Innovation is our daily routine - perfection is our ambition
With our currently 250 inomed employees we implement the high quality in the development, production and marketing of our products. In terms of service, installation and support of our systems, we convince with our partnership-based professionalism and fast flexible services.

Our imaginative mentality results in trend-setting solutions that go far beyond the existing horizon. The epitome of our tradition is innovation, which enables us to keep pushing the boundaries of what is technically feasible and thus enable applications that ultimately serve the well-being of patients.

Sharing knowledge - shaping the future together
Our recipe for success in the present is to focus on the future. This is why inomed is also involved in four national and international research projects with universities and institutes in 2017. Grants approved for this mean allocations that will create new jobs in the area of development and design at inomed, and will later also have an impact on the production area.

For the effectiveness of our applications and the safety of our patients, we are constantly working on the further development of our business areas - Intraoperative Neuromonitoring, Functional Neurosurgery, Pain Therapy and Neurological Diagnostics and Therapy.
The ability to share knowledge, to collect information and to transform it into innovative and trend-setting products results in regular training courses and workshops, which enable our users to use our inomed systems safely and efficiently.