Article Date: 3/1/2010

Disposable Instruments to Meet Your Needs
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Disposable Instruments to Meet Your Needs

LESLIE GOLDBERG, ASSOCIATE EDITOR

Instrument preference and surgical technique vary greatly between surgeons. For this reason, Synergetics has developed its first line of fully disposable instruments — the Pinnacle 360°. The instruments are offered in 13 different tip configurations and are available in 20-, 23-, or 25-g, with certain types offered in 27-g.

PHYSICIAN FEEDBACK

John Kitchens, MD, of Retina Associates of Kentucky, has been using a prototype of the Pinnacle forceps. “I like the fact that they have a handle that you can actuate from any angle,” says Dr. Kitchens. “It is unusual to get this kind of dynamic range with other disposables and have a variety of unique tip configurations. In addition, I seem to get more purchase with these forceps. They have a very good grasping platform. Synergetics has been pushing the envelope as far as tip design.”

He comments that the anticipated price point is another positive of these instruments, as forceps are one of the most expensive disposables. Dr. Kitchens is eager to see different types of grasping platforms available in the future.

“The Pinnacle forceps bring Synergetics instrumentation in line with the best forceps on the market in 23-g and 25-g,” says Mandar Joshi, MD, of Retina Vitreous Associates in Toledo. “The rigidity of the instrumentation imparts outstanding intraoperative control on the eye without sacrificing maneuverability. The forceps' stroke is intuitive and you can rotate the forceps easily and safely.”

Dr. Joshi appreciates the fact that because the forceps are disposable, he doesn't have to worry about getting it cleaned or damaging the tips. “Synergetics Pinnacle forceps have achieved outstanding control and ease-of-use,” says Dr. Joshi. “However, price will play a part in how the Pinnacle instruments will be received.”

FORCEPS

There are eight different types of forceps offered in the Pinnacle 360° line. They are:

Tano. The Tano asymmetrical micro forceps are perfect for peeling ILM and fine ERM. The asymmetrical design facilitates safe grasping and the cut-out center enhances visualization. They also feature microserrations at the tip to enhance grasping.
Eckardt. These forceps are used for tangential ILM peels. The nail-like platforms provide precise grasping and are microserrated to prevent slip ping and tearing.
Fine-tip Eckardt. These forceps feature a thinner tip that allows for better viewing and positioning.
Apte. The Apte forceps were designed with a wide platform, giving surgeons the ability to remove the toughest membranes in a single maneuver. It features a corset shape to expanded visualization and is rounded inward at the tip to prevent trauma to the retina.
Pyramid tip. These forceps taper to a point for enhanced visualization and fine grasping, but have a broad base for coarse grasping.
Pick. The pick has a dual-purpose tip that allows the surgeon to initiate, grasp, and extract membranes with one instrument.
Serrated jaw end-gripping. This tip contains a series of blunt and atraumatic serrations that prevent shredding.
End-grasping. This multipurpose tip can be used for fine ILMs as well as tough ERMs.

ADDITIONAL INSTRUMENTS AND HANDLES

Two types of scissors are also offered. The horizontal curved scissors are curved on the back of the tip to prevent “heeling in,” and the Pinnacle 360° vertical scissors have a curved heel designed to interact atraumatically with the retina. The distal tip can be utilized as a pick.

For rare but tough cases, three types of foreign-body instrumentation are available: Foreign-body forceps, BB removal forceps, and a foreign-body magnet.

The Pinnacle handles were designed to fit comfortably in the hand with lightweight materials. Dr. Joshi says the handles are “very maneuverable, allow the forceps to work into tissue plains well, and make it easy to change the direction of your grasp and approach.” RP

For more information on Pinnacle 360° instruments, visit www.synergeticsusa.com/pinnacle360



Retinal Physician, Issue: March 2010