Medtronic RBT011003 Instructions for Use

Medtronic Surgical Instruments for
M708348B825E Rev. D
use with Mazor X Stealth™ Edition
2021-08-25
IMPORTANT INFORMATION ON THE MEDTRONIC SURGICAL INSTRUMENTS FOR USE WITH MAZOR X STEALTH™ EDITION
DESCRIPTION
Medtronic Surgical Instruments are non-sterile or sterile, single or re-usable instruments that may be used during the preparation and placement of various Medtronic spinal implants during spinal surgery. Medtronic Surgical Instruments are made of a variety of materials commonly used in orthopedic and neurological procedures which meet available national or international standards specifications.
Medtronic Surgical Instruments are specifically designed for use in spinal procedures with Mazor X Stealth™ Edition. Medtronic Surgical Instruments can be navigated or non-navigated manual instruments that may or may not be guided through the Mazor X Stealth™ Edition Arm Guide. Some Medtronic Surgical Instruments (e.g. drills, drivers, taps etc.) are also compatible with Medtronic’s IPC™ Powerease™ System. When connected to the Powerease™ Driver, these Medtronic Surgical Instruments may or may not be guided through the Mazor X Stealth™ Edition Arm Guide. Some Medtronic Surgical Instruments may or may not be compatible with AO* style quick connect drilling motors. Medtronic surgical drills shall only be used through the Mazor X Stealth™ Edition arm guides, Medtronic cannulas, and Medtronic drill guides. Placing Medtronic single-use sterile spheres on each of the NavLock™ Tracker passive stems allow Mazor X Stealth™ Edition to track the Medtronic Surgical Instruments in the surgical field. Medtronic cannulas may or may not be used with Midas Rex™ attachments and tools.
INTENDED USE
Medtronic Surgical Instruments are intended to be used during preparation and placement of Medtronic implants during spinal surgery to assist in precisely locating anatomical structures in either open, or minimally invasive, procedures. Medtronic Surgical Instruments are specifically designed for use with the Mazor X Stealth™ Edition, which is indicated for medical conditions in which the use of stereotactic surgery may be appropriate, and where reference to a rigid anatomical structure, such as a skull, a long bone, or vertebra can be identified relative to a CT or MR-based model, fluoroscopy images, or digitized landmarks of the anatomy. Medtronic Surgical Instruments can be navigated or non-navigated manual instruments that may or may not be guided through the Mazor X Stealth™ Edition Arm Guide. Medtronic surgical drills shall only be used through the Mazor X Stealth™ Edition arm guides, Medtronic cannulas, and Medtronic drill guides. Some of the Medtronic Surgical Instruments are also compatible with the IPC™ Powerease™ System or AO* style quick connect drilling motors. An instrument may incorporate a measuring function which has uses as described on the label and the instrument. Medtronic cannulas may or may not be used with Midas Rex™ attachments and tools.
Do not implant instruments. Medtronic does not and cannot warrant the use of these instruments nor any of the component parts upon which repairs have
been made or attempted, except as performed by Medtronic or an authorized Medtronic repair representative. Implied warranties of merchantability and fitness for a particular purpose or use are specifically excluded.
WARNINGS
Breakage, slippage, misuse, or mishandling of instruments, such as on sharp edges, may cause injury to patients or
operative personnel.
Improper maintenance, handling, or poor cleaning procedures can render instruments unsuitable for the intended purpose
or even dangerous to patients or surgical staff.
It is important the surgeon exercise extreme caution when working in close proximity to vital organs, nerves, or vessels and
the forces applied while correcting the position of instrumentation is not excessive, such that it might cause injury to patients.
During navigation, it is important to frequently confirm navigational accuracy by touching the tip of the instrument on known
anatomical points, including accuracy checkpoints, and comparing the position of the instrument tip in the image with its physical location.
Single-use instruments should never be reused or reprocessed under any circumstances. Reuse or reprocessing may
compromise the structural integrity of these instruments and create a risk of contamination, which could result in patient injury, illness, or death. This device was designed for single patient use only.
PRECAUTIONS
Excessive force applied by instruments to implants can dislodge devices.
Extreme care should be taken to ensure instruments remain in good working order. During the procedure, successful use of
this instrument is extremely important. Instruments should not be bent or damaged in any way. Misuse of instruments resulting in corrosion, seizing-up, scratching, loosening, bending, or fracture of any or all sections of an instrument may inhibit or prevent proper function.
Using drills that are in good working order is essential to maintaining trajectory guidance. Re-usable drills should be
disposed of and replaced if a drill is dull, indicated by excessive force required during drilling.
Never expose instruments to temperatures >275°F (135°C) that may modify the physical characteristics. If instruments are
exposed to temperature >275°F (135°C), perform an additional inspection to ensure they function as intended. See the EXAMINATION section for more information.
Reusable instruments should be carefully placed on trays, cleaned after each use, and stored in a dry environment.Non-sterile single-use instruments should be carefully placed on trays and discarded after use.Do not use instruments for any action for which they are not intended.Regularly review the operational state of all reusable instruments and, if necessary, make use of repair and replacement
services.
Preoperative and operating procedures, including knowledge of surgical techniques, are important considerations in the
successful use of the system. Further, proper selection and compliance of patients greatly affect results.
Proper patient selection and operative care are critical to success of surgery and avoidance of injury during surgery.Read and follow all other product information supplied by the manufacturer of implants and instruments.Special precautions are needed during pediatric use. Care should be taken when using instruments in pediatric patients
since these patients can be more susceptible to the stresses involved in their use.
Some surgeries require use of instruments which incorporate a measuring function. Ensure these are not worn and surface
engravings are clearly visible.
Dissimilar metals should be separated from direct contact during sterilization to resist corrosion.
POTENTIAL ADVERSE EFFECTS
Nerve damage, paralysis, pain, or damage to soft tissue, visceral organs, or joints.Infection if instruments are not properly cleaned and sterilized.Pain, discomfort, or abnormal sensations resulting from the presence of instruments.Nerve damage due to surgical trauma.Dural leak in cases of excessive load application.Impingement or damage of close vessels, nerves, and organs by slippage or misplacement of instruments.Damage due to spontaneous release of clamping devices or spring mechanisms of certain instruments.Cutting of skin or gloves of operating staff.Bony fracture in cases of deformed spine or weak bone.Tissue damage to patients, physical injury to operating staff, and/or increased operating time that may result from the
disassembly of multi-component instruments occurring during surgery.
Methods of use of instruments are determined by the user's experience and training in surgical procedures. A successful
result is not always achieved in every surgical case. This fact is especially true in spinal surgery where other patient conditions may compromise results.
Physician note: although the physician is the learned intermediary between the company and the patient, the important medical information in this document should be conveyed to the patient.
For US Audiences Only Caution: Federal law (USA) restricts these devices to sale by or on the order of a physician. This device should be used only by physicians familiar with the device, its intended use, any additional instrumentation, and any
available surgical techniques.
PACKAGING
Instruments may be shipped in stand-alone packaging or in Medtronic Transportation/Sterilization Cassettes. Stand-alone packaging, Medtronic Transportation/Sterilization Cassettes, and the contained medical devices should be intact upon receipt. Individual instruments, Medtronic Transportation/Sterilization Cassettes, and contained medical devices should be checked for completeness and signs of damage prior to use. Damaged packages, cassettes, or instruments should not be used and should be returned to Medtronic.
Only sterile instruments should be used in surgery. Damaged packages or products should not be used and should be returned to Medtronic. All products should be treated with care.
Non-Sterile Reusable Devices: remove all packaging material prior to sterilization. Instruments used in surgery must be cleaned and sterilized by the hospital prior to use. Always immediately clean and re-sterilize all instruments used in surgery. Instruments should be thoroughly cleaned prior to re-sterilization. This process must be performed before handling, or before returning product to Medtronic.
Non-Sterile Single-use Devices: remove all packaging material prior to sterilization. Instruments used in surgery must be cleaned and sterilized by the hospital prior to use. Always immediately discard instruments used in surgery. This product is intended for single patient use only. Do not reuse, reprocess, or re-sterilize this product. Medtronic assumes no liability for products which have been re-processed, re-used, or re-sterilized by health care facilities.
Sterile Devices: this device is supplied sterile and is clearly labeled as such on the package label. Sterility can only be assured if packaging is intact upon receipt. Medtronic assumes no liability for products which have been re-processed, re-used, or re­sterilized by health care facilities.
EXAMINATION
Instruments must always be examined by the user prior to surgery. Examination should be thorough and must include a visual and functional inspection of the working surfaces, pivots, racks,
spring, or torsional operation and the presence of any cracks, bending, deformation, or distortion, and that all components are complete.
Never use instruments with signs of damage or that are incomplete or otherwise nonfunctional.
Visual Inspection
Make certain of the following:
Laser etchings, engravings, and other markings are legible.No cracks are present in instrument handles or any part of the instrument.Discoloration, corrosion, stains, or rust do not exist.There is no handle/shaft separation, and the handle-to-shaft connection is secure.No cuts or gouges in silicone are present.There is no damage (cuts, tears, etc.) to insulation.There is no damage to the working ends or tips. The working ends should be free of cracks, sharp edged gouges, and other
damage. When applicable, the working ends should be sharp.
The instrument tip and/or shaft is not bent.There is no damage to threads.All parts are present and free of damage and deterioration. Examples of parts that may be missing, loose, or damaged
include set screws, springs, curved springs, pins, and prongs.
Mating ends are free of damage (nicks, gouges, bends, etc.) that would interfere with the mating function.Cannulated instruments with a guide wire or other insertion tool are visually checked.
Functional Inspection
Make certain of the following:
Parts intended to move do so freely without sticking, binding, or grinding.Springs return the handle of the instrument to its original position.Retention tabs hold appropriate mating parts and are not damaged.Instruments function as intended with the appropriate mating parts.Ball detents hold mating parts and are free from damage.Sharp edges are sharp to the touch and are not dull, have no nicks, or any other damage.Ratcheting mechanisms are functional. This includes handles, latches, and other mechanisms. Teeth should be present
and functional.
Driver tips are not worn beyond functional use. If necessary, mate the instrument with the appropriate part.
DIRECTIONS FOR USE
Instruments are precision devices, which may incorporate a measuring function and have uses as described on the label. Instruments which incorporate a depth measuring function have an accuracy level equivalent to ±0.45mm.
Unless labeled for single use, the instruments may be re-used.
Use with AO* Style Quick Connect Drilling Motors or with compatible Manual Handle
Follow manufacturer instructions of general orthopedic drilling motor for connection of AO* style quick connect drill bits.
Use with Midas Rex™ Attachments and Tools
Follow the instructions provided with the Midas Rex™ attachments and tools.
Use with the IPC™ Powerease™ System
See the IPC™ Powerease™ System package insert (M726750B246) for instructions on how to set up and operate the IPC™ Powerease™ System.
Using the Powerease™ Adapter is optional. See the Powerease™ Adapter package insert (9734925) for instructions on using the adapter with the Powerease™ Driver.
1. Place single-use sterile spheres on each of the four NavLock™ Tracker stems. Push each sphere onto the stem until it “clicks” into place. Ensure the sphere is firmly seated on the stem.
2. Place the instrument into the NavLock™ Tracker. A. Insert the proximal end of the instrument shaft until it is fully seated in the NavLock™ Tracker.
B. Verify the tool is secured in the NavLock™ Tracker by ensuring it cannot be pulled out of the device.
3. Attach the NavLock™ Tracker and instrument assembly to the Powerease™ Driver (Figure 1). A. On the Powerease™ Driver, pull back and hold the quick disconnect to unlock the collet.
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