Phantom Retractor System Overview

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Spine Phantom Retractor System Overview Minimally invasive procedures Dual-directional expandable retractor 30 degree pivoting blades Fiber-optic light source for better visualization

Key Design Features Dual-directional expandable retractor Modular setup offered by two, three, or four point retraction 30 degree pivoting blades All arms and blades move independently for better wound exposure Various blade options Offers a wide variety of hooks and retractor blades Cool, shadowless lighting component Continuous lighting that will keep the retractor at a lower temperature 1

Arm Assembly Positioning The Articulating Arm mounts to the hospital bed rail. Check compatibility of the Articulating Arm to the hospital bed prior to surgery. Mount the Table Clamp to the hospital bed side rail. Hold Table Clamp up to align to side rail and tighten down wing nut to secure it to the bed. Once the Table Clamp is secure, insert the Articulating Arm into the Table Clamp and lock into place. Position the Articulating Arm as desired and lock into place. 2

Lighting Preparation Attach the Light Source to the appropriate adapter. Insert the Light Cable into the Light Source. Turn on the light source power to verify light output. Note: The Light Source may need to be checked for electrical safety by the hospital before bringing it into the OR. Check local policy at least one day prior to surgery. Establishing Access Carefully determine the appropriate entry point and trajectory for the Phantom Retractor. Using A/P imaging, insert the K-Wire to establish the initial location and entry point. 3

Dilation Option 1: Subsequent Dilator Insertion Slide Dilator #1 over the K-Wire. After the initial Dilator is inserted the K-Wire can be removed. Slide Dilator #2, Dilator #3, and Dilator #4 to sequentially penetrate and gently dissect soft tissue down to the lamina. Remove the previous Dilator after inserting the larger one. Note: Dilator #3 is 18mm in diameter and Dilator #4 is 22mm in diameter. Option 2: Finger Dilation Select desired Retractor Blade size and the corresponding Obturator size. Place the Obturator in-between the Retractor Blades. Insert the Obturator pegs into the side slots on the Retractor Blades. Manually insert into the wound. 4

Retractor Assembly & Insertion Option 1: Retractor Insertion then Assembly Insert the Retractor Blades by sliding each down the appropriate Dilator. Attach the Base Retractor to the Retractor Blades by lowering it over the ball snaps onto the blade. Push down the Base Retractor to make sure it is fully seated. Note: The Base Retractor is etched to aid in lining up the Retractor Blades. For proper blade placement, use the etched right and left areas to assist in lining up the right and left arms. Note: Use the same method of retractor assembly if using the Obturator for dilation. Option 2: Retractor Assembly then Insertion Based on the Dilator diameter, obtain the corresponding Retractor Blades. Pre-attach the Retractor Blades to the Base Retractor body. Slide the closed Retractor assembly over the Dilator. Note: Make sure the pivoting arms are flush with the Base Retractor body before lowering over the Dilator. 5

Loosen the Articulating Arm and attach onto the Base Retractor. After desired position is determined, lock the Articulating Arm into place by tightening the knobs. Once the Articulating Arm is locked in place and positioned to the proper angle, remove the final Dilator or Obturator. Note: Lift up on the Obturator and crank open the Base Retractor to remove the Obturator. Insert the Light Cable into the Retractor Blades. The bifurcated Light Cable should be inserted into the corresponding holes on each blade. 6

Retractor Variable Opening/Closing Mechanism Attach the T-Handle to the Base Retractor and turn clockwise to expand the distal end of the Retractor Blades up to 30 degrees. Note: Each arm moves independently to customize retraction area. Turn metal wing nuts on the Base Retractor rack for translation. Three Point Retraction Three point retraction allows you to retract lateral or medial, depending on the retractor orientation. Attach desired Hook Straight, Fan Blade, or Counter Retractor Blade to the Pivoting Center Blade. Lower the Pivoting Center Blade into the wound over the Base Retractor rack and ratchet into place. Attach the T-Handle to the Pivoting Center Blade and turn clockwise to pivot up to 30 degrees. 7

Four Point Retraction Slide the Rack Connector onto the open end of the Base Retractor rack. Insert the Counter Retractor into the Rack Connector. Attach the T- Handle to the Rack Connector and turn clockwise to secure into place. Note: A Counter Retractor arm can be removed to use with Pivoting Center Blade for four point retraction. Remove Counter Retractor arm before inserting into Rack Connector. Make sure to use the right or left arm for the appropriate direction. Slide the desired Hook Straight, Fan Blade, or Counter Retractor Blade into the end of the Retractor Blade Handle. Turn purple handle on the Retractor Blade Handle clockwise to secure hook/blade. Position the blade or hook in the wound and slide into the blade holder on the Counter Retractor to lock into place. Turn purple handle on the Retractor Blade Handle counter-clockwise to disengage from hook/blade. Attach the T-Handle to the Counter Retractor and turn clockwise to expand the distal end of the blade up to 30 degrees. 8

Phantom Retractor WCS Part Number Stryker Order Number Description Quantity WML-0400 48252234 Accessory Arm Complete Set (Articulating Arm + Table Clamp) 1 CS-0105 48252020 Retractor Blade Handle 2 LS-0086 48252040 Hook Straight, 40mm 1 LS-0087 48252050 Hook Straight, 50mm 1 LS-0088 48252060 Hook Straight, 60mm 1 LS-0089 48252070 Hook Straight, 70mm 1 LS-0090 48252080 Hook Straight, 80mm 1 LS-0091 48252090 Hook Straight, 90mm 1 LS-0092 48252100 Hook Straight, 100mm 1 LS-0093 48252120 Hook Straight, 120mm 1 ML-0200 48252007 Base Retractor 1 ML-0270 48252340 Counter Retractor Blades, 40mm 2 ML-0272 48252350 Counter Retractor Blades, 50mm 2 ML-0274 48252360 Counter Retractor Blades, 60mm 2 ML-0276 48252370 Counter Retractor Blades, 70mm 2 ML-0278 48252380 Counter Retractor Blades, 80mm 2 ML-0280 48252390 Counter Retractor Blades, 90mm 2 ML-0281 48252300 Counter Retractor Blades, 100mm 2 ML-0282 48252310 Counter Retractor Blades, 110mm 2 ML-0283 48252312 Counter Retractor Blades, 120mm 2 ML-0204 48252010 Counter Retractor 1 ML-0290 48252450 Fan Blades, 50mm 2 ML-0291 48252460 Fan Blades, 60mm 2 ML-0292 48252470 Fan Blades, 70mm 2 ML-0293 48252480 Fan Blades, 80mm 2 ML-0294 48252490 Fan Blades, 90mm 2 ML-0295 48252400 Fan Blades, 100mm 2 ML-0296 48252410 Fan Blades, 110mm 2 ML-0297 48252412 Fan Blades, 120mm 2 ML-0310 48252008 Dilator #1, 8mm 1 ML-0312 48252013 Dilator #2, 13mm 1 ML-0314 48252018 Dilator #3, 18mm 1 ML-0316 48252022 Dilator #4, 22mm 1 ML-0300 48252011 K-Wire, 1.4mm x 9, Disposable 10 per Pack 9

Phantom Retractor (continued) WCS Part Number Stryker Order Number Description Quantity ML-0045 48252005 Light Cable 1 ML-0051 48252106 Light Source 1 ML-0320 48252118 Obturator, 18mm 1 ML-0322 48252122 Obturator, 22mm 1 ML-0203 48252009 Pivoting Center Blade 1 ML-0221 48252150 Retractor Blades (L&R), 18mm Dia. x 50mm, Violet 1 ML-0222 48252160 Retractor Blades (L&R), 18mm Dia. x 60mm, Gold 1 ML-0223 48252170 Retractor Blades (L&R), 18mm Dia. x 70mm, Light Green 1 ML-0224 48252180 Retractor Blades (L&R), 18mm Dia. x 80mm, Turquoise 1 ML-0225 48252190 Retractor Blades (L&R), 18mm Dia. x 90mm, Fuchsia 1 ML-0226 48251800 Retractor Blades (L&R), 18mm Dia. x 100mm, Chocolate 1 ML-0227 48251810 Retractor Blades (L&R), 18mm Dia. x 110mm, Turquoise Splash 1 ML-0228 48251812 Retractor Blades (L&R), 18mm Dia. x 120mm, Purple Splash 1 ML-0251 48252250 Retractor Blades (L&R), 22mm Dia. x 50mm, Violet 1 ML-0252 48252260 Retractor Blades (L&R), 22mm Dia. x 60mm, Gold 1 ML-0253 48252270 Retractor Blades (L&R), 22mm Dia. x 70mm, Green 1 ML-0254 48252280 Retractor Blades (L&R), 22mm Dia. x 80mm, Turquoise 1 ML-0255 48252290 Retractor Blades (L&R), 22mm Dia. x 90mm, Fuchsia 1 ML-0256 48252200 Retractor Blades (L&R), 22mm Dia. x 100mm, Chocolate 1 ML-0257 48252210 Retractor Blades (L&R), 22mm Dia. x 110mm, Turquoise Splash 1 ML-0258 48252212 Retractor Blades (L&R), 22mm Dia. x 120mm, Purple Splash 1 ML-0700 48252000 Sterilization Tray 1 ML-0201 48252019 Rack Connector 1 LS-0451 48252001 T-Handle 2 10

US Operations 2 Pearl Court Allendale, New Jersey 07401 - USA Phone: +1 201 760 8000 Fax: +1 201 760 8108 Web: www.stryker.com Manufactured for Stryker by: West Coast Surgical A surgeon must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Stryker does not dispense medical advice and recommends that surgeons be trained in the use of any particular product before using it in surgery. The information presented is intended to demonstrate the breadth of Stryker product offerings. A surgeon must always refer to the package insert, product label and/or instructions for use before using any Stryker product. Products may not be available in all markets because product availability is subject to the regulatory and/or medical practices in individual markets. Please contact your Stryker representative if you have questions about the availability of Stryker products in your area. Literature Number: TLPHTBR10012 LFM/GS 2.0m 3/11 Copyright 2011 Stryker Printed in USA