Zeiss KINEVO 900 User Manual

KINEVO 900 from ZEISS

Advancing Surgical Certainty

Mastering the complex.

ZEISS KINEVO 900

// INNOVATION

MADE BY ZEISS

KINEVO 900 – The Robotic Visualization System

Just like you, we love challenging the status quo.

The result? Over 100 innovations to perfect the already acclaimed
surgical visualization platform. KINEVO® 900 from ZEISS is designed
to deliver more functionalities than any surgical microscope today.

ZEISS KINEVO 900 combines digital and optical visualization
modalities, offers a unique Micro-Inspection Tool and will
impress you with its Surgeon-Controlled Robotics. All to
enable you to gain greater certainty in a virtually disruption-free

workow.

Designed to meet real needs. To make a real dierence!

A lot more. And, a lot less too.

When treating complex vascular conditions, you typically work

at high magnication. Even the slightest vibrations can cause

disruptions. And constant manual repositioning to better
visualize structures or precisely approach deep-seated lesions

can become extremely tedious. Not anymore! ZEISS KINEVO 900
delivers a lot more positioning precision with a lot less eort.

PointLock

Focus Activate Swivel

Surgeon-Controlled Robotics adds a complete new level of ease to precise

positioning. Imagine being able to focus and move around a structure to visualize

the targeted anatomy – reducing any manual hassle. In addition, PointLock

enables you to do a KeyHole movement to observe a larger area inside a cavity –

a particular benefit in areas with narrow access. Simply put:

Focus. Activate. Swivel.

Active vibration damping

You know the problems that can be created by the tiniest vibrations. The active

damping provided by ZEISS KINEVO 900 minimizes collateral system vibrations,

ensuring rock-solid stability. Enabling you to completely, and steadily, focus on what

matters most: your treatment.

5

When you need it. Where you need it.

The new navigation interface of ZEISS KINEVO 900 is designed
to work in concert with your navigation device. When you require
precise repositioning to reexamine previously visualized structures
or when you need to align with a pre-mapped trajectory, making
use of all six axes, the Robotic Visualization System
precise positioning at the push of a button. Putting you exactly
where you need to be – when you need to be there.

PositionMemory

™

delivers

Save Move Recall

When working on a tumor case, you may already have identified regions of

concern where you want to protect the functional structure. After storing these

in PositionMemory, you can come back and visualize them at the exact same

magnification, working distance and focus – without losing time for manual

repositioning. In a nutshell: Save. Move. Recall.

Image-guided surgery

Image with Brainlab Microscope Navigation Software

Minimize time-consuming efforts in approaching challenging neurosurgical

pathologies. Combine the Surgeon-Controlled Robotics of ZEISS KINEVO 900

with navigation interface to approach deep-seated pathologies in cranial surgery,

brain stem or skull base tumor removals – right when you need it.

7

New dimensions. Freedom of choice.

Working through oculars at extreme angles can sometimes be
a pain in the neck. Literally. With no way out, you might have
to contend with uncomfortable working positions causing fatigue.
Now, relief and revolutionary dimensions in visualization are
in sight.

The Digital Hybrid Visualization with integrated 4K technology
of ZEISS KINEVO 900 welcomes you to a world of heads-up
ocular-free surgery, giving you freedom of movement. And
freedom of choice to use an optical setup, depending on the
application need.

Fully integrated 4K camera technology

During lateral lumbar or thoracic spine and posterior fossa approaches,

ZEISS KINEVO 900’s integrated 4K visualization can be essential. It provides

you with multimodal visualization capabilities – the exibility to decouple from

the classic optical approach and to work with outstanding 4K picture quality

and clarity. Even when magnifying tiny details.

What’s more… your assistant surgeon, OR sta and residents also benet from the

4K visual clarity of ZEISS KINEVO 900. They share the same high-resolution, digital

image to follow the procedure with comparable delity. Delivering indispensable

education and training.

9

Critical challenge. Vital solution.

Your challenge: When working from an external perspective
of a surgical microscope, your visualization of the anatomy is
limited to a straight line of sight – missing critical information

behind tissue or corners. Ecient and eortless access to this

comprehensive information is essential for treatment.

Our solution: QEVO

®

from ZEISS

The unique, proprietary Micro-Inspection Tool from ZEISS
complements intraoperative microsurgical visualization,
enabling you to discover unexplored areas during the surgical
intervention without additional footprint. You can look around
corners and eliminate blind spots. And most importantly, you
can gain greater insights – for better clinical decisions.

To support your surgical workow, ZEISS QEVO is engineered

with an angled design – keeping your hands out of the line

of sight during insertion in the surgical eld. And, it allows
for an easy t between the ZEISS KINEVO 900 and the situs,

eliminating the need to reposition the head of the device.

Greater insights, on demand.

ZEISS QEVO enables you to inspect the perforator or examine the distal neck of

the aneurysm to ensure the clip blades are fully extended.

11

Ease of use. Peace of mind.

Surgical certainty is your imperative. Enabling you to achieve it
is ours. That’s why, in the development of the Micro-Inspection
Tool, we placed a high priority on its ease of use.

ZEISS QEVO is truly integrated. You don’t have to plan for

an additional device during surgery. Just plug it into your
ZEISS KINEVO 900 for a seamless surgical workflow and to
easily switch back and forth between views.

ZEISS QEVO is fully autoclavable. So there’s no need for

any additional draping. This is another attribute that makes

ZEISS QEVO an indispensable tool – always available during

surgery. On demand.

ZEISS QEVO. Innovation in action.

ZEISS KINEVO 900 can support discerning regions that are not directly visualized –

avoiding unnecessary bone removal and retraction. During a Vestibular Schwannoma

case, for instance, it can help identify the course of facial nerves. And, can support

inspection of regions that are not directly visualized by a surgical microscope.

13

Deeper insights. Greater control.

Imagine being able to identify the blood flow in the tiniest blood vessels with an intraoperative
angiogram during any vascular procedure. Or to analyze the blood flow dynamics in real time.
Or to visualize fluorescence-stained structures while viewing the anatomy in natural-like colors.

Or, all of the above with one system!

In challenging neurosurgery, visualization adjuncts are essential for making the right decisions at

the right time. The redesigned Intraoperative Fluorescence Technologies from ZEISS oer you the

Power of Four – so you are always equipped with the tools you need. Check. Interpret. Decide.

ZEISS INFRARED 800 –
Now in HD resolution

Intraoperative visual assessment of blood ow

and vessel patency during aneurysm, bypass and

AVM surgery is critical to your treatment. During

such complex vascular procedures, the new high

denition visual quality of ZEISS INFRARED 800

enables visualization of sub-millimeter blood vessels

– for deeper insights into the blood ow dynamics.

Virtually uninterrupted focus. Always.

ZEISS KINEVO 900 optimizes the workow to

deliver a live overlay of the ZEISS INFRARED 800

image in the oculars – for a virtually uninterrupted

workow.

14

ZEISS FLOW 800

FLOW® 800 from ZEISS is a unique analysis tool generating blood ow dynamics data by identifying detailed vessel blood ow

from INFRARED 800 video sequences – intraoperatively. The newly transformed ZEISS FLOW 800 delivers a more convenient

visual assessment of the increase in the uorescence intensity during the procedure.

For the indicative time: The Delay Ma p (or

Summary Map) provides quick information about

the time when the uorescent signal appeared for

each image point in the map.

For a complete picture: The Diagram Function
outlines assessment of uorescence intensity

variation over time and fast access to the key
indicators for further analysis.

ZEISS BLUE 400

1

For the uorescence distribution: The Intensity
Map enables you to conveniently identify relative

uorescence levels reached during the INFRARED

800 observation period.

Before

For no compromises: The new optimized view option enables you to generate summaries from a

selected sequence of the INFRARED 800 video. For instance, removing video sequences with movement
artefac t, you can now generate a summary map without compromises. So, you can get the mos t vivid

and helpful representation of your procedure – for the right decisions and convincing podium talks.

BLUE 400 is an accessory for a Class 1 surgical microscope. It is

capable of supporting uorescence-based surgery by providing

visualization in the 620–710 nm range in HD quality.

For the speed of the ow: The Speed Map

indicates how fast the uorescence intensity

increased during the observation period –

indicating the speed of the blood ow.

After

ZEISS YELLOW 560

1

ZEISS YELLOW 560 is cleared as an accessory to a Class 1 device

for the visualization of blood ow. It is the rst intraoperative

uorescence module to highlight the uorescence-stained structures

while visualizing non-stained tissue in its natural-like color.

Visualization of uorescence-stained s truc tures using BLUE 40 0 during surgery.

1

Please use the uorescent agent as per the approval status for the application in your country.

Visualization of fluorescence-stained struc tures using YELLOW 560.

15

Setting new benchmarks. Shaping a new future.

When we envisioned the all-new Robotic Visualization System,
we conceived a design that can deliver so much more without
losing its familiarity. With ZEISS KINEVO 900, we continue to
live our vision of supporting you in becoming one with your
visualization system – of delivering purposeful innovations.

Among scores of leading-edge innovations

, here are the

ones that matter the most for you.

The Robotic Visualization System: The rst of its kind.

Surgeon-Controlled Robotics

Delivering precise positioning with a lot

less eort – with motors in all axes.

ZEISS QEVO – The Micro-Inspection Tool

Complementing intraoperative microsurgical

visualization to discover unexplored areas

during surgical intervention. Gain greater

insight. On demand.

16

Digital Hybrid Visualization

Providing an opportunity for ocular-free

surgery, with the freedom to use a traditional

optical setup – depending on the application

need.

Integrated Intraoperative Fluorescence –

The Power of Four.

The redesigned intraoperative uorescence

technologies from ZEISS oer you the Power

of Four – so you always have the tools you

need.

ZEISS Observe

1

– Live stream in real time

with ZEISS VR ONE Plus.

ZEISS Transfer – Easily transfer surgical

images and videos to your iOS device.

ZEISS Transfer

1

Available soon.

17

Technical Data

KINEVO

®

900 from ZEISS

Technical Data

Rated Voltage 100 V – 240 V
Current

Consumption
Rated Frequency 50 Hz – 60 Hz
Electrical Standard Complying with IEC 60601-1:2005+A1:2012

Weight Weight max. 395 kg

Max. 1.350 VA

Protection class I, degree of protection IP20
Class 2 laser product as per

IEC 60825:2007, IEC 60825:2014

Weight of system incl. transport container:
approx. 525 kg

Axis 6

-225° / +225°

Axis 5

±45°

Axis 2

-23° / +22°

Axis 3

-28° / +20°

Axis 1

6

3

n x

Axis 4

-25° / +135°

Monitor

Rotation: ±125°
Tilting: -20° / +5° (±3°)

max. ca. 1760 mm

ca. 530 - 1635 mm

0°

ca. 1940 - 2660 mm

18

820 mm

QEVO® from ZEISS and QEVO ECU

Technical Data

Direction of View 45° upwards
Shaft Diameter 3.6 mm
Shaft Length 120.0 ± 1.0 mm
Total Diameter 13.0 mm
Field of View 100° ± 5° wide angle view
Illumination 20 – 35 lumen LED
Weight (without cable) 250 g
Sterilization Autoclavable
Image Resolution 1920 x 1080 pixel full HD
Length of Cable 5000 mm
Operation Temperature +10 to +40 °C (500/1000 s intermittent use)

QEVO ECU

Dimensions Length = 265.0 ± 1 mm, height = 59.3

± 1 mm and depth = 212.2 ± 1

Weight 2.5 kg
Operating Voltage 24V (+/- 10%) ADC
Video Output DVI-D full HD

161 mm

mm

120

Cable length: 5 m

Diameter: 3.6 mm

Connecting simplicity and innovation.

ZEISS SMARTDRAPE

Your visualization needs are paramount to us. And, so are

the needs of your team. That’s why, we gave a special

focus to the OR preparation process in the development of

ZEISS KINEVO 900.

Being an integral part of the optical path, the SMARTDRAPE

with VisionGuard

ZEISS KINEVO 900 so you and your team can have the

benefits of a vivid view, uninterrupted movement and

effective patient protection. At the same time – the new

innovations make the draping process simply simple!

®

from ZEISS is designed together with

• Innovative folding: to eliminate guesswork and complexity.

• Intuitive attachment: for an eortless and simple self-

locking mechanism.

• Integrated RFID chip: for easy activation of AutoDrape

Designed for ZEISS KINEVO 900.

®

.

20

20

Technical Data

Standard Conguration

Apochromatic
Optics

Illumination 2 x 300 W Xenon, with automatic

System Operation Multifunctional programmable handgrips

System Setup AutoBalance

Video Integrated 3-chip Full HD video camera, 1080p

Connectivity /
Data Management

Sterile Drape ZEISS SMARTDRAPE

Motorized focus; Varioskop® with
working distance 200 – 625 mm

Motorized zoom; zoom ratio 1:6,

magnication factor y = 0.4x – 2.4x
10x magnetic wide eld eyepieces

with integrated eyecups
AutoFokus with 2 visible laser dots,

automatic mode with magnetic brakes

lamp exchange
Automatic Iris Control for adjusting

the illumination to the eld of view

Individual light threshold setting
Focus Light Link: working distance

controlled light intensity
Additional illumination beam to

brighten up shadows, motorized

Magnetic clutches for all system axes
Central user interface with full-screen video
XY robotic movement in 6 axes

(variable speed)
Active damping
Manual and motorized PointLock function
PositionMemory
Motorized XY lateral movement
MultiVision System

AutoDrape – air evacuation system

1

Park Position
Drape Position

24” HD video touchscreen on extendable arm,
16:9 aspect ratio

Integrated still image capturing both on
HDD and USB-media

Video-in for external HD video sources
Remote diagnosis via internet / VPN

Options

Video Stereo video camera 3D HD, fully integrated,

2 x 3-chip HD, 1080p incl. 2nd HD 3D monitor
4K video camera, fully integrated 3-chip 4K,

2160p incl. 2
Stereo video camera 4K 3D, fully integrated,

2 x 3-chip 4K, 2160p
Integrated HD video recording, editing

and streaming

nd

system monitor HD 2D

2
Attachment for consumer (SLR) photo camera
External 55” 4K 3D video monitor,

with mobile cart

Intraoperative
Fluorescence

BLUE 400
INFRARED 800
INFRARED 800 with FLOW 800
YELLOW 560

Connectivity /
Data Management

DICOM module for image and video data
transfer from/to PACS. Patient management
by modality worklist management.

Shared Network Data storage
WLAN option, with WiFi Hotspot
Navigation Interface Standard
Navigation Interface Extended

Accessories ZEISS QEVO and QEVO ECU

12.5x magnetic wide eld eyepieces
with integrated eyecups

Stereo co-observation tube
Foldable Tube f170 / f260, including the

PROMAG function for additional 50%

magnication and integrated rotate function

Tiltable binocular tube, swivel range 180°,
focal length f = 170 mm

14-function, wired foot control panel
14-function, wireless foot control panel
2-function foot switch
Mouth switch

3-step magnication changer

nd

HD 3D monitor

1

Available with ZEISS SMARTDRAPE only.

View of the cerebellar tonsils and medulla. Image courtesy of Dr. Robert F. Spetzler, Barrow Neurological Institute, Phoenix, Arizona, USA. (Cover page)

View onto cerebellum and lower cranial nerves. Image courtesy of Dr. Robert F. Spetzler, Barrow Neurological Institute, Phoenix, Arizona, USA. (Page 2)

Front temporal area for STA-MCA bypass procedure. Image courtesy of Dr. Peter Nakaji, Barrow Neurological Institute, Phoenix, Arizona, USA (Page 2)

View onto optic nerve and internal carotid artery. Image courtesy of Dr. Peter Nakaji, Barrow Neurological Institute, Phoenix, Arizona, USA (Page 4)

Image-guided surgery. Image courtesy of BrainLab AG (Page 6 and 7)

View onto spinal cord dura. Image courtesy of Dr. Robert F. Spetzler, Barrow Neurological Institute, Phoenix, Arizona, USA (Page 8 and 9)

Small view of the cerebellum through the Retrosigmoid Approach. Image courtesy of Dr. Peter Nakaji, Barrow Neurological Institute, Phoenix, Arizona, USA (Page 10)

Left mini-pterional approach for clipping an aneurysm. Image courtesy of Dr. Peter Nakaji, Barrow Neurological Institute, Phoenix, Arizona, USA (Page 11)

View onto corpus callosum and septum pellucidum. Image courtesy of Dr. Peter Nakaji, Barrow Neurological Institute, Phoenix, Arizona, USA (Page 12)

Transnasal transspenoidal for re-exploration and excision of recurrent pituitary Macroadenoma with possible abdominal fat. Image courtesy of

Dr. William White, Barrow Neurological Institute, Phoenix, Arizona, USA (Page 13)

Right temporal Craniotomy for AVM. Image courtesy of Dr. Robert F. Spetzler, Barrow Neurological Institute, Phoenix, Arizona, USA (Page 14 and 15)

Glioma surgery using BLUE 400. Image courtesy of Prof. Dr. Walter Stummer, University Clinic, Münster, Germany (Page 15)

Left-temporal craniotomy for tumor resection with YELLOW 560. Image Courtesy of Dr. Peter Nakaji, Barrow Neurological Institute, Phoenix, Arizona, USA. (Page 15)

SUR. 8733 Rev C Printed in the United States. CZ-IV/ 2018 United States Edition. Only for s ale in selected countries.

The contents of the brochure may differ from the current status of approval of the product or service of fering in your country. Please contac t our regional representatives for more information.

Subject to changes in design and scope of delivery and due to ongoing technical development. Robotic Visualization System, KINEVO, QEVO, FLOW, AutoDrape, Varioskop and

VisionGuard are either trademarks or registered trademarks of Carl Zeiss Meditec AG.

© Carl Zeiss Meditec AG, 2018. All rights reserved.

Carl Zeiss Meditec AG

Goeschwitzer Strasse 51–52
07745 J ena
Germany
www.zeiss.com/med
www.zeiss.com/kinevo

Carl Zeiss Meditec, Inc.

5160 Hacienda Drive
Dublin, CA 94568
USA
www.zeiss.com/med/us