This instructional video is for anyone who uses or sets up the Karl Storz MultiLASE TFL. Learn how to properly set up the laser and adjust key settings to ensure a safe and smooth procedure.
Carl Stewart's multi las TFL is the latest laser technology from Carl Stewarts. Our thulium fiber laser is an essential tool in endo urology and is key in supporting Carl Stewart's mission to be an all in one integrated solution provider. In this video, we will cover starting up your multi lays TFL user interface, navigating the home screen presets and creating a new profile device settings. Marketing tools, main display screen, laser settings, RF ID fiber connection, laser operation, aiming beam and ready standby mode, safety precautions and lastly shut down procedure before proceeding with the start up procedure of the device, verify the proper connection of the following components, power supply cable, interlock connector, key switch and lastly the foot wedge on the rear panel, turn the key switch clockwise, ensure the interlock connector is locked in place and secured and lastly set the main switch to the eye configuration on the front panel, ensure that the foot pedal is plugged in and locked in place, turning the screw clockwise, push the on off frontal button at the start up the led bar on the upper front panel turns blue. If the laser fails to start check that the emergency push button is not pressed. If the emergency push button is pressed, twist it to allow its release and push the frontal on off button to start the laser. When the system powers on a loading screen will appear. Once the software is fully loaded, the screen will automatically change to the home screen. Please note that this may take several minutes to calibrate. Once the start up is successfully completed, you have the option to quickly choose your desired application. Lithotripsy BPH or other. You also have the option to set your desired laser settings manually or to load a previously saved profile. When selecting the desired application, a list of presets and possible emission modes will appear. The procedure can be selected for both the right foot switch and the left foot switch. When Lithotripsy is selected, you will select the preset with the preloaded parameters for lithotripsy procedure which include dusting, renal stone or dusting, ureteral stone. Press the check mark to confirm the choice and enter the main display screen. When BPH is selected, your available procedure options include Thule pulsed Thule, continuous or coagulation. Other can be selected for bladder stone procedures to skip the guided selection of output settings and enter directly into the main display screen. Select manual to load a previously saved set of treatment parameters, select load presets to create a new profile, select the new profile icon in the lower right hand corner of the screen type. The new preset name and touch the check mark. To confirm the preset name will now be shown on the screen to overwrite a profile. Click on the down arrow icon, the device settings panel displays the following functions, audio device info and service. By entering the audio menu, it is possible to independently tune the sound level of the laser emission associated with the pressure of the foot switch. Moreover, it is possible to tune the sound level of the keyboard, confirm your selection and return to the device settings. Screen the device info panel displays the serial number software version, firmware, version date and time total energy, total time and total pulses emission. The service area is only for technical service. However, system diagnostics can still be accessed without inserting the service password by tapping the diagnostics button on the diagnostic screen. It is possible to check the device functioning parameters, scroll up and down using the arrows and press the back arrows to return to the home screen. When marketing is selected from the home screen, you may either select multimedia to enter the list of multimedia files or PDF files to enter the list of available files that can be viewed on the main display screen. The current application selected will appear at the top of the screen as well as the current status of the laser system. Possible system status are stand by ready lacing error or off on the left hand tool bar. You will find ready stand by laser pilot fiber info counters of emitted energy and lacing time save settings and shut down below the current status. You will find the foot switch one area in orange and the foot switch two area in blue. For each foot switch the mode energy frequency, pulse length output power settings and emission mode settings are displayed. Emission parameters of the presets are intended as suggested settings. Only the surgeon has to consider changing the settings in order to have the desired effect over the target tissue based on his or her visual feedback and best clinical advice. Click on the CW pulse button to choose the desired pulse length or to switch to continuous mode. When pulse mode is selected, the pulse length can be changed from short pulses to long pulses. Tap on the square bar to choose the length note that there are seven levels of pulse modes to choose from. You may also increase or decrease the energy and frequency settings. The counters for emitted energy in jewels and lacing time in seconds increase during radiation emission. All information regarding the user session can be reached by selecting the user window pane. The latest 30 sessions are displayed when an RF ID fiber is connected and the RF ID system is active. The system automatically recognizes the type of the fiber and the number of the previous uses. Further showing the fiber info panel on the display lock in the RF ID fiber by rotating clockwise until the laser fiber is locked in place. Note, the outer ring will change colors to a light blue when an RF ID chip is present, caution the optical fiber size visualized on the display must be the same of the used optical fiber. Before starting laser emission, please check that the optical fiber size matches the indications impressed on the fiber connector. The laser output can damage the working channel of a flexible endoscope if energy is emitted when the laser tip is within the working channel, prior to firing the laser, be certain that the laser tip is clearly visible through the endoscope. And the fiber tip must protrude from the endoscope when firing. Now that the laser system is fully connected, you may choose to turn on the aiming beam. If desired, touch the plus minus buttons to adjust the aiming beam, intensity, touch the check mark to confirm and return to the main display screen. When you are ready to activate the laser, you may click on ready through the touch screen panel or hold the black button on the foot pedal to set the system to ready. If an optical fiber is missing or an invalid fiber is inserted, an error message will appear when the user pushes the ready standby button. If this is the first time the device is going from stand by to ready mode with a desired fiber size three safety prompts will appear on the screen read through each safety prompt and touch the check mark, confirming the information has been acknowledged if a new fiber is used, these three prompts will appear again when going from standby to ready mode. When the machine goes from stand by to ready, an audible sound will be heard during laser radiation emission. The device status turns into lacing and the ready stand by buttons will be inactive before emitting the laser. There are a few things to keep in mind ensure all personnel present in the laser working area are wearing protective items for class four laser devices. While keeping the fiber tip inside of the patient body, users should switch from ready to standby status when performing provisionally any procedure other than lacing. And lastly before removing the fiber from patient body, the user must switch from ready to standby status both when treatment is completed and when performing provisionally any procedure other than lacing once device operation is accomplished and the laser is in standby mode. One can proceed with its shutdown procedure as follows. Disconnect the optical fiber from the device and cover the laser device output connector with its dedicated protection shutter. Use the shut down power button on the user interface to properly power down the system, disconnect the foot switch, turn off the main switch on the rear panel, turn the key switch to the off position and unplug the power cable, the device and its accessories in a dry and safe Place. Carl Stortz offers a number of laser fiber sizes, both disposable and reusable options. Should there be a need for additional accessories? Please work with your local representative.