E-Mail : [email protected]

E-mail : [email protected] Web : www.medibiotek.com E-mail : [email protected] Web : www.medibiotek.com The company is managed by a team of experienced professionals who are well versed in operations with decades of experience in the health care field.

The surgical equipment business of Medibiotek operates under the brand name of Pinaco and provides hospitals and surgeons with cutting edge equipment manufactured by the most advanced CNC machinery using the highest quality raw materials. The craftsmen who operate this equipment are renowned in the field with decades of experience and skills that have been passed down from one generation to the next. Skilled engineers also guide them and monitor the quality of the product at every step of the manufacturing process.

At Health care institutions all across India, The Pinaco brand will continue to offer the most precise way for skilled surgeons to perform cutting edge surgeries with ease and precision. We will strive to build the same precision into our products just like surgeons who use precision on every surgery they perform. Our endeavour has always been and will continue to be to serve you with the most innovative products at the best value to you both in quality as well as affordability.

E-mail : [email protected] Web : www.medibiotek.com Urology Instruments

E-mail : [email protected] Web : www.medibiotek.com Bookwalter Retractor

Ring Sizes

Small 203mm x 311 URO1601

Medium 267mm x 368 URO 1602 BOOKWALTER RETRACTOR CLAMPS Universal Machanisms (Set of 4) URO 1604 Large 300mm x 470 URO 1603

BOOKWALTER RETRACTOR ( Oval Ring )

URO 1607 - Post Coupling

URO 1605- Horizontalb Flex Bar

URO 1606 - Table Post

¼ ¼

E-mail : [email protected] Web : www.medibiotek.com 2 Bookwalter Retractor

BOOKWALTER MALLEABLE MALLEABLE Malleable Retractor Blade Width - 38mm RETRACTOR RETRACTOR Blade Height - 150mm Blade Width - 50mm Blade Width - 75mm Total Length - 310mm Blade Height - 150mm Blade Height - 150mm Total Length - 310mm Total Length - 310mm

URO 1608 URO 1609 URO 1610

BALFOUR RETRACTOR HARRINGTON KELLY Blade Width - 70mm RETRACTOR Blade Depth - 85mm RETRACTOR Blade Width - 68mm Blade Depth - 145mm 50mm X 75 URO 1611 URO 1612 URO 1613

KELLY RETRACTOR KELLY 50mm X 175 KELLY KELLY RETRACTOR RETRACTOR RETRACTOR 50mm X 150 50mm X 125 50mm X 100 ¼ URO 1614 URO 1615 URO 1616 URO 1617

3 E-mail : [email protected] Web : www.medibiotek.com Urethral Dilators

French English 0/2 - STD 6/10 1 - CVD 8/12 ½ / 3 - 10/14 1 / 4 - 12/16 2 / 5 - 14/18 3 / 6 - 16/20 4 / 7 - 18/22 5 / 8 - 20/24 6 / 9 - 22/26 7 / 10 - 24/28 8 / 11 - 26/30 9 / 12 - 28/32

½ CLUTTON 1/3 270mm/10 ½” LISTERS URO 1618 280mm/10 ¾” URO 1619

E-mail : [email protected] Web : www.medibiotek.com 4 Catheter Guides

1/3 1/3 1/3 1/3 GUYON GUYON DITTEL URO 1623 URO 1620 URO 1621 URO 1622 390mm/15 ½” 360mm/14 ¼” 360mm/14 ¼” 390mm/15 ½”

5 E-mail : [email protected] Web : www.medibiotek.com Bladder Retractors

100mm

MILLIN BLADDER 210mm/8 ¼” URO 1624

SWIFT - JOLY ½ SET OF 6 BLADES URO 1625

E-mail : [email protected] Web : www.medibiotek.com 6 Bladder Retractors

35mm Lateral Blade (Pair) 24 x 75 mm

25 x 90 mm

24 x 75 mm

LEGUEU URO 1628 URO 1626 270mm/10 ½”

THOMSON - WALKER URO 1627 Complete

35 x 100 mm

HRYNTSHCAK URO 1629 ½

7 E-mail : [email protected] Web : www.medibiotek.com Prostatic Retractors

25 x 25 mm 39 x 35 mm 38 x 64 mm

11 x 50 mm

½ ½ ½ ½

YOUNG YOUNG YOUNG YOUNG URO 1631 URO 1632 URO 1633 URO 1630 220mm/8 ¾” 210mm/8 ¼” 220mm/8 ¾” 210mm/8 ¼”

1/1 1/1 1/1 1/1

1/3

1/3 1/3 MILLIN MILLIN 1/3 MILLIN MILLIN URO 1634 URO 1635 URO 1636 URO 1637 240mm/9 ½” 230mm/9” 230mm/9” 230mm/9”

E-mail : [email protected] Web : www.medibiotek.com 8 Kidney Pedicle Clamps

UIR 1640 Fig 1

1/1 URO 1641 Fig 2

1/1 1/1 URO 1638 URO 1639

½ GUYON GUYON 230mm/9” DESJARDINS 230mm/9” 230mm/9”

1/1 1/1 URO 1644 URO 1645

1/1 URO 1643 URO 1642

½ ½ BLAKE ½ 200mm/8” MAYO - BLAKE MAYO - BLAKE 200mm/8” 200mm/8”

9 E-mail : [email protected] Web : www.medibiotek.com Kidney Pedicle Clamps

1/1 URO 1646 URO 1647 URO 1648 200mm/8” 220mm/8 ¾” 240mm/9 ½”

½ 1/1 GUYON URO 1649

WERTHEIM - CULLEN 230mm/9”

E-mail : [email protected] Web : www.medibiotek.com 10 Gall Bladder Scissors, Probes, Dilators

4mm 2mm 3mm 1mm

URO 1654 URO 1655 URO 1656 URO 1657 # 1 # 2 # 3 # 4 8mm 7mm 6mm 5mm

6mm URO 1658 URO 1659 URO 1660 URO 1661 # 5 # 6 # 7 # 8 11mm 10mm URO 1650 9mm

8mm

URO 1651

9mm URO 1662 URO 1663 URO 1664 # 9 # 10 # 11 12mm 13mm

1/1

URO 1652

1/1 URO 1665 URO 1666 ½ # 12 # 13 ½ THOREK ½ BLAKE URO 1786 -190mm/7 ½” DESJARDINS 320mm/13” URO 1787 -230mm/9” 260mm/10 ¼” Malleable Shaft URO 1653 Set of 13 Diators

11 E-mail : [email protected] Web : www.medibiotek.com Bladder Neck Spreader, Meatus Clamps, Foreign Body Forceps

½ ½ ½ MILLIN URO 1667 STRAUSS STOCKMANN 280mm/11” URO 1668 URO 1669 120mm/4 ¾” 80mm 3/1/8”

MATHIEU URO 1670 - 200mm/8” URO 1671 - 280mm/11”

E-mail : [email protected] Web : www.medibiotek.com 12 Suprapubic Trocars / Bougies

12mm 12mm

10mm 10mm 8mm 8mm 6mm 6mm

1/1 1/1 URO 1676 URO 1677 URO 1678 URO 1679 URO 1672 URO 1673 URO 1674 URO 1675

SUPRAPUBIC TROCAR & CANNULA SUPRAPUBIC WITHOUT GROOVE TROCAR & CANNULA 210mm/8 ¼” WITH GROOVE URO 1672 -URO 1675 210mm/8 ¼” URO 1676 - URO 1679

½ ½

TURNER WARWICK RETROGRADE BOEGIE 180mm/7” URO 1680

13 E-mail : [email protected] Web : www.medibiotek.com Kidney Stone Forceps

1/1 URO 1686 URO 1685 190mm/7 ½” 190mm/7 ½” # 6 # 5

URO 1682 220mm/8 ¾” URO 1681 # 2 230mm/9” # 1

URO 1684 220mm/8 ¾” URO 1683 # 4 ½ 220mm/8 ¾” # 3 RANDALL URO 1681 - URO 1686

E-mail : [email protected] Web : www.medibiotek.com 14 Reverdin Needles

1/1 URO 1687 URO 1688 URO 1689 URO 1690 # 1 # 2 # 3 # 4

REVERDIN 140mm/5 ½”

1/1 ½ URO 1693 URO 1694 URO 1691 URO 1692 ½ REVERDIN URO 1695 190mm/7 ½” REVERDIN 225mm/8 ¾”

15 E-mail : [email protected] Web : www.medibiotek.com Bladder Retractor / Ligature Needles

TURNER-WARWICK BLADDER RETRACTOR OVAL FRAME 180mm x 140mm WITH 6 BLADES 4 PRONGS URO 1696

TURNER-WARWICK URETHROPLASTY NEEDLES URO 1697 - URO 1698 195mm/7 ¾”

URO 1700 SET OF 3

UIR 1697 UIR 1698 UIR 1699

E-mail : [email protected] Web : www.medibiotek.com 16 Vasectomy / Hernia Forceps

½ VASECTOMY ½ DISSECTION VASECTOMY 125mm/5” FIXATION URO 1701 RING Ø 4.8mm 140mm/5 ½” URO 1702

½ ½ HERNIA RING FORCEP HERNIA BISTOURY 150mm/6” 180mm/7” URO 1703 URO 1704

17 E-mail : [email protected] Web : www.medibiotek.com Instestinal, Rectal

E-mail : [email protected] Web : www.medibiotek.com Proctoscopes

KELLY URO 1708 - Ø 21mm x 50mm URO 1709 - Ø 25mm x 50mm

URO 1710 - Ø 23mm x 145mm URO 1711 - Ø 23mm x 205mm

HIRSCHMANN URO 1705 - Ø 16mm x 60mm URO 1706 - Ø 19mm x 70mm URO 1707 - Ø 22mm x 90mm

NEWMAN URO 1712 - Ø 16mm x 63mm URO 1713 - Ø 19mm x 63mm URO 1714 - Ø 23mm x 63mm

E-mail : [email protected] Web : www.medibiotek.com 19 Rectal Specula

½ ½

SIMS SIMS URO 1715 - 160mm/6 ¼” URO 1716 - 160mm/6 ¼”

3 Blades

MATHIEU URO 1717 - 210mm/8 ¼”

20 E-mail : [email protected] Web : www.medibiotek.com Biopsy Punch Forceps

420mm/16 ¾”

UIR 1719

½ URO 1720 URO 1718 Handle only

URO 1721

URO 1722

URO 1723 1/1

350mm/13 ¾”

YEOMAN

1/1

Shaft Length 280mm/11” URO 1724 URO 1727 URO 1730 URO 1733 350mm/13 ¾” URO 1725 URO 1728 URO 1731 URO 1734 430mm/17” URO 1726 URO 1729 URO 1732 URO 1735

E-mail : [email protected] Web : www.medibiotek.com 21 Intestinal Clamp

1/1 URO 1736 URO 1737

½ 1/1 1/1 DOYEN BABY URO 1738 URO 1739 170mm/6 ¾” 230mm/9” 230mm/9” ½ DOYEN

1/1 A B C D E F

130mm/5 ¼” 160mm/6 ¼” 180mm/7” A URO 1740 B URO 1742 C URO 1744 ½ D URO 1741 E URO 1743 F URO 1745 DOYEN ATRAUMA

22 E-mail : [email protected] Web : www.medibiotek.com Intestinal Clamp

1/1 1/1 URO 1746 URO 1747 URO 1748 URO 1750 230mm/9” 260mm/10 ¼” 280mm/11” URO 1749 URO 1751 230mm/9” 260mm/10 ¼” 280mm/11”

½ ½ KOCHER KOCHER

E-mail : [email protected] Web : www.medibiotek.com 23 Intestinal Atraumatic Clamp

1/1 1/1 URO 1752 URO 1753 URO 1754 URO 1754 URO 1756 URO 1757 230mm/9” 260mm/10 ¼” 280mm/11” 230mm/9” 260mm/10 ¼” 280mm/11”

½ ½ KOCHER ATRAUMA KOCHER ATRAUMA

24 E-mail : [email protected] Web : www.medibiotek.com Intestinal Clamp

1/1 1/1 URO 17563 URO 1758 URO 1759 URO 1762 250mm/10” 210mm/8 ¼” 210mm/8 ¼” 250mm/10”

URO 1760 URO 1761 230mm/9” 230mm/9”

½ ½

MAYO ROBSON MAYO ROBSON

E-mail : [email protected] Web : www.medibiotek.com 25 Stomach Clamps

URO 1767 350mm/13 ¾”

URO 1766 280mm/11”

URO 1765 With Pin 200mm/8”

1/1 URO 1764 1/1 URO 1768 URO 1769 URO 1770 200mm/8” 280mm/11” 350mm/13 ¾” URO 1765 - URO 1767 Without Pin URO 1768 - URO 1770 Without Pin

½ ½ PAYR PAYR BABY 145mm/5 ¾”

26 E-mail : [email protected] Web : www.medibiotek.com Dissectors

1/1 1/1 1/1 165mm/6 ½” 1/1 165mm/6 ½” 165mm/6 ½” URO 1771 165mm/6 ½” URO 1773 URO 1774 URO 1772

½ ½ LOCKHARTMUMMERY ½ ½ 45° CURVED FISTULA PROBES 90° CURVED RETROGRADE CURVED STRAIGHT

URO 1775 1/1 140mm, 5 1/2

URO 1776 180mm, 7" WATSON CHEYNE DISSECTOR

E-mail : [email protected] Web : www.medibiotek.com 27 Haemorrhoidal Ligating Forceps

HAEMMORRHOIDAL LIGATING FORCEPS WITH GUN URO 1777

28 E-mail : [email protected] Web : www.medibiotek.com Anal Retractor

22mm x 92mm

17mm x 65mm

PARK ANAL RETRACTOR CHILD ADULT URO 1778 URO 1779

70mm

95mm

PARK ANAL RECTAL RETRACTOR Complete Set

Centre Blade - 95mm 140mm Lateral Blade - 70mm (1 pair) Lateral Blade - 93mm (1 pair) Total Length 140mm/5 ½” Opening 70mm

URO 1780

E-mail : [email protected] Web : www.medibiotek.com 29 Pelvis Retractor

130 x 60mm 35 x 45 mm UIR 1781 - 290mm/11 ½”

URO 1782 290mm/11 ½” 35 x 45 mm 130 x 60mm

URO 1783 330mm/13” 60 x 45 mm 180 x 60mm

URO 1784 330mm/13” ST.MARKS 180 x 60mm (LLOYD DAVIS) 60 x 45 mm

30 E-mail : [email protected] Web : www.medibiotek.com Instrument Container for Sterilization

Style A

Style B

L W D 165 x 90 x 35 mm 200 x 100 x 35 mm 200 x 100 x 50 mm 230 x 130 x 50 mm 260 x 150 x 50 mm 280 x 140 x 60 mm 300 x 200 x 50 mm

L W D 165 x 90 x 35 mm 200 x 100 x 35 mm 200 x 100 x 50 mm 230 x 130 x 50 mm 260 x 150 x 50 mm 280 x 140 x 60 mm Style C 300 x 200 x 50 mm

L W D 165 x 90 x 35 mm 180 x 80 x 50 mm 200 x 100 x 35 mm 200 x 100 x 50 mm 230 x 130 x 50 mm 250 x 120 x 60 mm 260 x 180 x 50 mm 280 x 140 x 60 mm 300 x 200 x 50 mm 320 x 150 x 60 mm 360 x 160 x 70 mm

L = Length W = Width D = Depth

93 E-mail : [email protected] Web : www.medibiotek.com INDEX

E-mail : [email protected] Web : www.medibiotek.com INDEX DESCRIPTION B T

BOOK WALTER RING RETRACTOR COMPLETE SET 2 & 3 TURNER-WARWICK URETHROPLASTY NEEDLES 16 BAKES BILE DUCT DILATORS 11 U BALKE GALL BLADDER FORCEPS 9 UNIVERSAL BIOPSY FORCEPS 21 C UNIVERSAL HANDLE FOR BIOPSY FORCEPS 21 CLUTTON-URETHERAL DILATORS 4 V D VASECTOMY DISSECTION FORCEPS 17 DESJARDINS GALL BLADDER PROBES 11 VASECTOMY FIXATION FORCEPS 17 DESJARDINS KIDNEY STONE FORCEPS 9 W 2 DITTEL CATHETER GUIDES 5 WATSON-CHEYNE DISSECTOR , DOUBLE ENDED 6 DOYEN INTESTINAL CLAMP, TRAUMATIC JAWS 22 WERTHIEM-CULLEN KIDEY PEDICAL CLAMP 10 DOYEN-BABY INTESTINAL CLAMPS 22 Y G YEOMAN BIOPSY FORCEPS 21 GUYON CATHETER GUIDES 5 YOUNG PORSTATIC RETRACTOR 8 GUYON KIDEY PEDICAL CLAMPS 9/10 H

HAEMMORRHOIDAL LIGATING (PILES GUN) GUN WITH FORCEPS 28 HERNIA BISTOURY KNIEF" 17 HERNIA RING FORCEPS 17 HIRSCHMANN RECTAL SPECULAMS 19 HRYNTSHCAK BLADDER RETRACTOR 7 I INSTRUMENT STERILIZATION CONTAINERS 31 K KELLY RECTAL SPECULAMS 19 KOCHER INTESTINAL CLAMPS 23 KOCHER INTESTINAL CLAMPS, TRAUMATIC JAWS 24 L LEGUEU BLADDER SPATULA / RETRACTOR 7 LISTERS-URETHERAL DILATORS 4 LOCKHART-MUMMERY FISTULA PROBES 26 M MAITHIEU FOREIGN BOBY FORCEPS 12 MATHIEU INTESTINAL RECTAL SPEULAM 20 MAYO ROBSON INTESTINAL CLAMPS 24 MAYO-BALKE GALL BLADDER FORCEPS 9 MILLIN BLADDER NECK SPEADER 12 MILLIN LOBE GRASPING FORCEPS 8 MILLINS-BLADDER S/R RETRACTOR 6 N NEWMAN RECTAL SPECULAMS 19 P PARKS ANAL S/R RETRACTORS 29 PAYR BABY INTESTINAL STOMACH CLAMP 25 PAYR INTESTINAL STOMACH CLAMPS 25 R RANDALL KIDNEY STONE FORCEPS 14 REVERDIN NEEDLES 15 S SIMS INTESTINAL RECTAL SPEULAM 20 ST.MARKS (LLOYD DAVIS) PELVIS RETRACTOR 30 STOCKMANN PENILE CLAMP 12 STRAUSS PENILE CLAMP 12 SUPRAPUBIC TROCAR & CANNULAS 13 SWIFT JOLY RING RETRACTOR 6 T THOMPSON WALKER RETRACTOR 7 THOREK GALL BLADDER SCISSOS 11 TURNER WARWICK RETROGRADE BOUGIE 13 TURNER-WARWICK RING RETRACTOR 16

379 E-mail : [email protected] Web : www.medibiotek.com NUMERICAL INDEX URO URO URO URO-1601 2 URO-1672 13 URO-1744 22 URO-1602 2 URO-1673 13 URO-1745 22 URO-1603 2 URO-1674 13 URO-1746 23 URO-1604 2 URO-1675 13 URO-1747 23 URO-1605 2 URO-1676 13 URO-1748 23 URO-1606 2 URO-1677 13 URO-1749 23 URO-1607 2 URO-1678 13 URO-1750 23 URO-1608 3 URO-1679 13 URO-1751 23 URO-1609 3 URO-1680 13 URO-1752 24 URO-1610 3 URO-1681 14 URO-1753 24 URO-1611 3 URO-1682 14 URO-1754 24 URO-1612 3 URO-1683 14 URO-1755 24 URO-1613 3 URO-1684 14 URO-1756 24 URO-1614 3 URO-1685 14 URO-1757 24 URO-1615 3 URO-1686 14 URO-1758 25 URO-1616 3 URO-1687 15 URO-1759 25 URO-1617 3 URO-1688 15 URO-1760 25 URO-1618 4 URO-1689 15 URO-1761 25 URO-1619 4 URO-1690 15 URO-1762 25 URO-1620 5 URO-1691 15 URO-1763 25 URO-1621 5 URO-1692 15 URO-1764 26 URO-1622 5 URO-1693 15 URO-1765 26 URO-1623 5 URO-1694 15 URO-1766 26 URO-1624 6 URO-1695 15 URO-1767 26 URO-1625 6 URO-1696 16 URO-1768 26 URO-1626 7 URO-1697 16 URO-1769 26 URO-1627 7 URO-1698 16 URO-1770 26 URO-1628 7 URO-1699 16 URO-1771 27 URO-1629 7 URO-1700 16 URO-1772 27 URO-1630 8 URO-1701 17 URO-1773 27 URO-1631 8 URO-1702 17 URO-1774 27 URO-1632 8 URO-1703 17 URO-1775 27 URO-1633 8 URO-1704 17 URO-1776 27 URO-1634 8 URO-1705 19 URO-1777 28 URO-1635 8 URO-1706 19 URO-1778 29 URO-1636 8 URO-1707 19 URO-1779 29 URO-1637 8 URO-1708 19 URO-1780 29 URO-1709 URO-1781 URO-1638 9 19 30 URO-1710 URO-1782 URO-1639 9 19 30 URO-1711 URO-1783 URO-1640 9 19 30 URO-1712 URO-1784 URO-1641 9 19 30 URO-1713 URO-1786 URO-1642 9 19 11 URO-1714 URO-1787 URO-1643 9 19 11 URO-1715 20 ISC 31 URO-1644 9 URO-1716 20 URO-1645 9 URO-1717 20 URO-1646 10 URO-1718 21 URO-1647 10 URO-1719 21 URO-1648 10 URO-1720 21 URO-1649 10 URO-1721 21 URO-1650 11 URO-1722 21 URO-1651 11 URO-1723 21 URO-1652 11 URO-1724 21 URO-1653 11 URO-1725 21 URO-1654 11 URO-1726 21 URO-1655 11 URO-1727 21 URO-1656 11 URO-1728 21 URO-1657 11 URO-1729 21 URO-1658 11 URO-1730 21 URO-1659 11 URO-1731 21 URO-1660 11 URO-1732 21 URO-1661 11 URO-1733 21 URO-1662 11 URO-1734 21 URO-1663 11 URO-1735 21 URO-1664 11 URO-1736 22 URO-1665 11 URO-1737 22 URO-1666 11 URO-1738 22 URO-1667 12 URO-1739 22 URO-1668 12 URO-1740 22 URO-1669 12 URO-1741 22 URO-1670 12 URO-1742 22 URO-1671 12 URO-1743 22 388 E-mail : [email protected] Web : www.medibiotek.com Metal Products - Limited Warranty on PINACO Brand Products:

Medibiotek - its wholly owned subsidiaries warrants to the original purchaser only that each new Pinaco product is free from manufacturing defects in material and workmanship under normal use and service for a period of Two (2) year’s (except as otherwise expressly provided as to accessory items) from the date of delivery by Medibiotek to the first purchaser, but in no event beyond the expiration date stated on any product labeling.

Surgical instruments are guaranteed to be free from defects in material and workmanship when maintained and cleaned properly and used normally for their intended purpose.

Any covered product that is placed by Medibiotek under a lease, rental or installment purchase agreement and that requires repair service during the term of such placement agreement shall be repaired in accordance with the terms of such agreement.

If any covered defect occurs during the warranty period or term of such placement agreement, the purchaser should communicate directly with Medibiotek’s home office. If purchaser seeks to invoke the terms of this warranty, the purchaser should contact Medibiotek’s customer service department to arrange for a return merchandise authorization (RMA). Once the return is authorized, the product should be returned promptly and properly packaged with postage prepaid. Loss or damage in return shipment to Medibiotek shall be at customer’s risk. Medibiotek’s sole responsibility under this warranty shall be repair or replacement, at Medibiotek’s sole discretion at Medibiotek’s expense, subject to the terms of this warranty and applicable agreements.

E-mail : [email protected] Web : www.medibiotek.com Metal Products - Limited Warranty on PINACO Brand Products:

THIS LIMITED WARRANTY IS EXCLUSIVE AND IN LIEU OF ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, AND OF ALL OTHER OBLIGATIONS OR LIABILITIES ON Medibiotek’s PART, AND Medibiotek NEITHER ASSUMES NOR AUTHORIZES ANY REPRESENTATIVE OR OTHER PERSON TO ASSUME FOR IT ANY OTHER LIABILITY IN CONNECTION WITH Pinaco PRODUCTS. Medibiotek DISCLAIMS ALL OTHER WARRANTIES, EXPRESS OR IMPLIED INCLUDING ANY IMPLIED WARRANTY OR MERCHANTABILITY OR OF FITNESS FOR A PARTICULAR PURPOSE OR APPLICATION OR OF FITNESS FOR A PARTICULAR PURPOSE OR APPLICATION OR WARRANTY OF QUALITY AS WELL AS ANY EXPRESS OR IMPLIED WARRANTY TO PATIENTS.

No warranty or guarantee may be created by any act or statement nor may this standard warranty be modified in any way, except as a result of a writing signed by an officer of Medibiotek.

IN NO EVENT SHALL Medibiotek BE LIABLE FOR ANY INCIDENTAL, INDIRECT, CONSEQUENTIAL OR PUNITIVE DAMAGES IN CONNECTION WITH THE ACQUISITION OR USE OF ANY Pinaco PRODUCT. Further, this warranty shall not apply to, and Medibiotek shall not be responsible for, any loss arising in connection with the purchase or use of any Pinaco product that has been repaired by anyone other than an authorized Medibiotek service representative or altered in any way so as, in Medibiotek’s judgment, to affect its stability or reliability, or which has been subject to misuse, negligence or accident, or which has been used otherwise than in accordance with the instruction furnished by Medibiotek. THIS LIMITED WARRANTY IS EXCLUSIVE AND IN LIEU OF ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, AND ALL OTHER OBLIGATIONS OR LIABILITIES ON Medibiotek’s PART, AND Medibiotek NEITHER ASSUMES NOR AUTHORIZES ANY REPRESENTATIVE OR OTHER PERSON TO ASSUME FOR IT ANY OTHER LIABILITY IN CONNECTION WITH Pinaco PRODUCTS. Medibiotek DISCLAIMS ALL OTHER WARRANTIES, EXPRESS OR IMPLIED INCLUDING ANY IMPLIED WARRANTY OF MECHANTABILITY OR OF FITNESS FOR A PARTICULAR PURPOSE OR APPLICATION OR WARRANTY OF QUALITY AS WELL AS ANY EXPRESS OR IMPLIED WARRANTY TO PATIENTS. No warranty or guarantee may be created by any act or statement nor may this standard warranty be modified in any way, except as a result of a writing signed by an officer of Medibiotek. These limitations on the creation or modification of this warranty may not be waived or modified orally or by any conduct.

E-mail : [email protected] Web : www.medibiotek.com CLEANING, STERILIZATION & MAINTENANCE OF SURGICAL INSTRUMENTS

1. RINSING I. Use stiff plastic cleaning brushes (nylon, etc.) Immediately after surgery, rinse instruments under Do not use steel wool or wire brushes except warm(not hot) running water. Rinse should remove specially recommended stainless steel wire brushes all blood, body fluids and tissue. for instruments such as bone files, or on stained areas in knurled handles. 2. CLEANING (If not done immediately after rinsing, instruments II. Use only neutral PH(7) detergents because if not should be submerged in a solution of water and rinsed off properly, low PH detergents will cause neutral PH(7) detergent.) breakdown of stainless protective surface and black staining. A. Ultrasonic Cleaning High PH detergent will cause surface deposit of For micro and delicate instruments, use manual brown stain, which will also interfere with smooth cleaning (step C). operation of the instruments.

Instruments should be processed in a cleancer for the III. Brush delicate instruments carefully and, if full recommended cycle time usually 5 to 10 minutes. possible, handle them totally separate from general instruments. Place instruments in open position into the ultrasonic cleaner. Make sure that “sharp” (scissors, knives IV. Make sure all instrument surfaces are visibly clean osteotomes, etc.)blades do not touch other and free from stain and tissue. instruments. This is a good time to inspect each instrument for All Instruments have to be fully submerged. proper function and condition. Check and make sure that: Do not place dissimilar metals (stainless, copper, Scissors blades glide smoothly all the way (they must chrome plated, etc.) in the same cleaning cycle. not be loose when in closed position). Test scissors by cutting into thin gauze. Three quarters of the length Change solution frequently - at least as often as of blade should cut all the way to the scissor tips, and manufacturer recommends. not hang up.

Rinse instruments after ultrasonic cleaning with Forceps (pickups) have properly aligned tips. water to remove ultrasonic cleaning solution. Hemostats and Needle Holders do not show light between the jaws, lock and unlock easily, joints are B. Automatic Washer Sterilizers not too loose. Check Needle Holders for wear on jaw Follow manufacturers recommendations but make surface. sure instruments are lubricated after last rinse cycle and before sterilization cycle. Suction tubes are clean inside.

C. Manual Cleaning Retractors function properly. Most instrument manufacturers recommend Cutting instruments and knives have sharp ultrasonic cleaning as the best and most effective undamaged blades. way to clean surgical instruments, particularly those with hinges, locks and other moving parts. If ultra V. After scrubbing, rinse instruments thoroughly sonic cleaning is not available observe the following under running water. While rinsing, open and close steps. Scissors, Hemostats, Needle Holders and hinge areas are rinsed out, as well as the outside of the instruments.

E-mail : [email protected] Web : www.medibiotek.com CLEANING, STERILIZATION & MAINTENANCE OF SURGICAL INSTRUMENTS

3. AFTER CLEANING CAUTION - At the end of the autoclave cycle - If instruments are to be stored, let them air dry and before the drying cycle - unlock autoclave door and store them in a clean and dry environment. open it more than a crack (about 3/4”). Then run dry 4. AUTOCLAVING cycle for the period recommended by the autoclave If instruments are to be reused or autoclaved: manufacturer. If the autoclave door is opened fully before the drying cycle, cold room air will rush into A. Lubricate all instruments which have any “metal to the chamber, causing condensation on the metal” action such as scissors, hemostats, needle instruments. This will result in water stains on holders, self-retaining retractors, etc. instruments and also cause wet packs. Recommend surgical lubricants such as instrument If you have any unusual staining on your instruments milk are best. Do not use WD 40, oil or other industrial during sterilization, contact your local instrument lubricants. representative. B. Put instruments up for autoclaving either individually or in sets. 5. COLD STERILIZATION Most cold sterilization solution render instruments Individual Instruments sterile only after a 10 hour immersion. This prolonged Disposable paper or plastic pouches are ideal. Make chemical action can be more detrimental to the sure you use a wide enough pouch (4” or wider) for surgical instruments than the usual 20minute instruments with ratchet locks such as needle holders autoclave cycle. If the instruments need to be and hemostats so the instrument can be sterilized in “disinfected” only, cold sterilization is okay as an open (unlocked) position. disinfection will place in only 10 minutes.

Instrument Sets But keep in mind the difference between: Unlock all instruments and sterilize them in an open position. Place heavy instruments on bottom of set STERILE - an absolute term (no living organism (when two layers are required). survives)

Never lock an instrument during autoclaving. It will & not be sterile as steam cannot reach the metal to metal surface. The instrument will develop cracks in DISINFECTED - basically clean. hinge areas because of heat expansion during the autoclave cycle. Always use the proper sterilization / cleaning technique to render the instrument in required Do not overload the autoclave chamber as pockets condition for use. may form that do not permit steam penetration. Place towel on bottom of pan to absorb excess For instruments with Tungsten Carbide inserts moisture during autoclaving. This will reduce the (Needle Holders, Scissors, Tissue Forceps), we do chances of getting “Wet packs”. Make sure the towels not recommend use of solutions containing Benzyl used in sterilization of instruments have no detergent Ammonium Chloride which will destroy the residue and are neutral - PH(7) if immersed in water. Tungsten Carbide Inserts. This can be a real problem as laundries frequently use inexpensive but high PH(9-13) detergent and do not properly rinse out or neutralize those detergents in the final wash / rinse cycle. Also, some times bleaches such as Clorox are added and are not neutralized.

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Corrosion Brownish Stain Problem : Debris and residue in box locks, serration and ratchets. Problem : This stain is more obvious on dull finish Solution : serration, box locks and ratchets should be instruments. Most likely, it is a deposit of chromium carefully cleaned and rinsed. A soft bristle brush is effective oxide. The thin hard layer protects stainless steel from in these difficult areas. corrosion precipitated by the atmosphere. The Problem : Moisture remaining on the instruments within atmosphere. The brownish film (sometimes dull blue) the sterile wrapped packs, excessive moisture in autoclave occurs naturally when stainless is heated. Occasionally during sterilization and termination of cycle. this stain can be traced to the sterilizer. Improper cleaning compounds could contain polyphosphates that Solution : Preheat autoclave, drying time cannot be cause the copper components in the sterilizer to be accelerated, open autoclave door slightly. Routinely deposited by electrolytic action on the stainless steel inspect valves, Malfunctioning vales can precipitate instruments. corrosion. Problem : Some local water supplies contain excessive Solution : water supply to autoclave should be cold quantities of alkali. This can manifest itself by depositing and demineralized. corrosive matter on the instrument. Bluish Gray Stains Solution : It is generally accepted that cold distilled or demineralized water be used during sterilization. An Problem : Cold sterilizing solutions. alternative is to use the local water supply, while instituting Solution : In the preparation of the solution make a program of preventive maintenance. certain the manufacture’s directions are followed Pitting accurately. To minimize discoloration use distilled water Problem : Instruments are inevitably exposed to chemical and add a rust inhibitor. Using the solution beyond compounds that initiate pitting. The most common are recommended time limitations will cause the solution to saline solutions and blood. become corrosive. Solution : It is essential that instruments be rinsed with distilled or demineralized water and then cleaned Rust Deposit routinely. Problem : Sterilizing instruments of different metals in Problem : Some Non - BHN detergents contain a chloride the same cycle will cause rusting. An electrolytic action or have an acid base. If rinsing is not thorough, the residual carries the carbon particles from the exposed metal and detergent can precipitate pitting. Hydrochloric acid can be deposits them on the stainless steel instruments. The formed by the combination of chloride in the cleaner and rapid oxidation of molecules results in a surface film of steam, causing the instrument to pit. rust. Solution : Evaluate detergents without a chloride base. Solution : The ideal technique would be to sterilize the Problem : Instruments may be pitted when the detergent two type of instruments separately. It is recommended used has an excessively high PH. If instruments are not that chrome plated instruments that indicate signs of rinsed thoroughly, and then autoclaved, the heat increases peeling or flaking be replaced with stainless steel the effect of the solution on the instruments. instruments. Solution : Use only detergents specifically developed for Problem : The rust film on the surface of stainless steel instrument cleaning. instruments can be caused by chemicals in the detergent. Excess amounts of iron or other minerals No Steel is Truly “ Stainless” from the local water supply may cause the rust deposits. It’s a fact that so-called stainless steel is subject to both water- It is recommended that instruments be rinsed with spotting and staining. However what many people identify as a distilled or demineralized water. “rust” problem usually turns out to be something else. Most often the problem is actually a stain caused by a surface deposit. These Light and Dark Colored Spots deposits appear in a variety of colors depending upon the type of Problem : Spotting Caused by slow evaporation of deposit involved. Once the cause is found and eliminated, most of water drops identified with the mineral content of the the time the problem quickly diminishes or disappears completely. water. As you probably know, stainless steel is ideally suited for the surgical suite because it is rust resistant, it can be honed to an Solution : Eliminate water droplets by adhering to extremely sharp edge or fine point, and it can be hardened to autoclave manufacturer’s operating instructions. maintain the delicate, yet precise, requirements of the surgeon. But it is this hardenable quality - the amount of carbon that renders Autoclave door should not be opened until steam s t a i n l e s s s t e e l s u s c e p t i b l e t o c o r r o s i o n . has been completely vented.

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Pitting Corrosion Due to Halides & Organic Reside (Eg.,Blood, Pus, Secretions)

Scissors with Pitting Examples of Pitting Corrosion on Chisel Corrosion Caused By Immersion In Physiological Salt Solution Over a Period of Several Hours

Microscopically Magnified (200x Corrosion Hole Deposits on Instruments Pitting Induced By Formed By Substance Chlorides on Instruments Containing Chloride

Aluminium Surface Damage Material Attack. Rust Formation on a Chromium Plated Due to Use of Highly Alkaline Cause : Alkaline Cleaner Saw Blade Made of Carbon Made of Cleaner Carbon Steel. Cause: Defects in Chromium Layer.

Fretting Corrosion Due to Insufficient Lubrication Surface Corrosion

Scissors Hinge Area Suture Holder with S t a i n l e s s S t e e l I n s t r u m e n t Damage to Aluminium Components only. Spring Abrasion with Acid Attack (Brown Tarnishing). Cause: Use of Highly Alkaline Detergent C a u s e : O v e r D i s p e n s i n g .

Improper Care Crevice Corrosion

Deformation Caused By Improper Handling Forceps Hinge MIS Instrument Hinge Tweezers

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Deposits - Silicate & Other Mineral Compounds

Various Discoloured Instruments Instruments Discoloured By Silicic Acid Stained, Discoloured Instruments

Stress Corrosion Cracking

Scissors with Breakage Around Hinge Breakage at Countersunk Screw Head Fracture at Hinge Pin

Jaw Breakage on Suture Holder Fracture at Hinge Jaw Breakage

Coloured Deposits Consisting of Blood, Protein, Drug Residues

Clamps Close-up of Scissor Hinge Area Tweezers

Spotting Cause By Lime

Tweezers Instruments Surface with Insert Mesh Contact Pattern

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