CST-4000 and 4000i User Manual Rev E June 2015

©2009, 2012, 2014, 2015 Cogentix Medical, Inc. All rights reserved. Printed in the United States of America. The information contained herein is the exclusive and confidential property of Cogentix Medical, Inc. No part of this manual may be disclosed or reproduced in whole or in part without permission from Cogentix Medical, Inc.

How to Use This Manual This User’s Manual contains the recommended procedures for preparing and using the Cogentix Medical CST-4000/4000i Flexible Cystoscope/Hysteroscope with the Slide-On® EndoSheath® Technology. It is intended for physicians and other medical personnel who will come in contact with the equipment before, during, and after any patient procedures with it. The manual also contains pertinent information on the proper care and handling of the equipment. Please read and become familiar with this entire manual before using the endoscope and accessories. The manual contains the following information:     

Description of the endoscope and Slide-On® EndoSheath® Technology The endoscope’s intended use Components and features of the endoscope and peripheral equipment used in conjunction with the endoscope Complete instructions on endoscope preparation, inspection, operation, reprocessing, and storage Warning and Caution statements that must be observed by endoscope users to ensure patient and user safety

If you are a first time endoscope user, Cogentix Medical strongly recommends that you read this manual from beginning to end and become intimately familiar with the endoscope and its use. If you are an experienced endoscope user, select specific chapters and/or sections that pertain to features and procedures that you are using.

Organization of this Manual Following is a list of the chapters included in this User’s Manual. Each chapter’s title is listed at the top of all pages after the title page, so that you can quickly access the information you need.

Chapter 1, Symbols and Terms - This chapter defines the symbols on the endoscope and peripheral equipment. There is also a brief list of the terms that are commonly used in the manual.

Chapter 2, Important Information - The information in this chapter is a

summary of critical Warning and Caution statements in the manual. This information is essential to the safe operation and reprocessing of the endoscope. Cogentix Medical strongly recommends that this chapter be read thoroughly and completely understood by all users before working with the endoscope.

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How to Use this Manual

Chapter 3, Endoscope and Accessories - Introduces the CST-4000/4000i

Flexible Cystoscope/Hysteroscope, the Slide-On® EndoSheath® Technology, and compatible peripheral equipment. This chapter includes instrument diagrams, identifies components, and defines their functions.

Chapter 4, Installing and Removing the Slide-On® EndoSheath® Technology - The Slide-On® EndoSheath® Technology is a sterile, single use barrier placed over the endoscope’s Insertion Tube before the procedure, and removed and discarded after the procedure is completed. This chapter includes the procedures for installing the sheath prior to the procedure, and removing it when the procedure is over.

Chapter 5, Preparation, Inspection and Operation - This chapter describes

how to prepare the endoscope and peripheral equipment for use, and how to assemble the equipment into a system. The chapter also leads you through a detailed inspection procedure to confirm that the equipment is undamaged and working properly before it is used in a procedure.

Chapter 6, Reprocessing - This chapter contains important instructions on the proper cleaning, disinfection, and sterilization of the endoscope before its first use and after each subsequent use. Strict adherence to the instructions in this chapter will render the endoscope “patient-ready” for each procedure.

Chapter 7, Care and Storage - If the equipment will not be used for a prolonged period, refer to this chapter for instructions on safe, secure storage.

Chapter 8, Troubleshooting - Describes possible problems that may be

encountered with the endoscopic system, and suggests corrective actions to take towards resolving minor problems.

Chapter 9, Warranty and Service - This chapter contains the terms of the

Cogentix Medical warranty on the endoscope, any restrictions that apply and user actions that may void the warranty if taken. This chapter also includes shipping instructions in case the endoscope must be returned to Cogentix Medical for repair or service. The Appendix contains the technical specifications for the CST-4000/4000i Flexible Cystoscope/Hysteroscope, and infection control information.

Additional Information The information in this User’s Manual is subject to change without notice. If you have any questions regarding any of the material contained in this manual, or wish to confirm that this is the most comprehensive information available for these products, please contact your local distributor or Cogentix Medical Customer Service Department at 866 258-2182 (toll free in U.S.) or (+1) 952-426-6189 (international).

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CST-4000/4000i Flexible Cystoscope/Hysteroscope User’s Manual

Table of Contents How to Use This Manual ... i Organization of this Manual ... i Additional Information ... ii 1 Symbols and Terms... 1 Symbols ... 1 Terms... 2 2 Important Information ... 3 Intended Use ... 3 Contraindications for Hysteroscopy... 3 User Qualifications ... 3 Reprocessing ... 4 Maintenance and Repair ... 4 Signal Words... 4 Important Safety Precautions ... 5 Preparation, Inspection and Assembly ... 5 During Use - General ... 7 During Use - Hysteroscopy ... 8 Reprocessing ... 10 3 Endoscope and Accessories ... 11 Inspect the Standard Set ... 12 Equipment Diagrams ... 13 CST-4000/4000i Flexible Cystoscope/Hysteroscope ... 13 CST-4000/4000i Flexible Cystoscope/Hysteroscope Control Body ... 14 Instrument Components ... 14 CF-2.1 Slide-On® EndoSheath® Technology ... 17 CF-1.5 Slide-On® EndoSheath® Technology ... 19 Accessories ... 22 Light Sources ... 22 BLS-1000 Battery Powered Light Source... 22 Light Guide Cables ... 22 Add-On Camera Systems ... 22 Leak Testing ... 22 Reprocessing ... 22 Therapeutic/Diagnostic Accessories ... 23 CST-4000/4000i Flexible Cystoscope/Hysteroscope User’s Manual

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Table of Contents Light Source Adapters (Light Guide Sleeves) ... 23 4 Installing and Removing the Slide-On® EndoSheath® Technology ... 25 Install the Slide-On® EndoSheath® Technology... 25 Prepare the Endoscope and Sheath ... 26 Insert the Endoscope Into the Sheath ... 26 Connect Irrigation Tubing / Complete Sheath Attachment ... 27 Observe the Endoscopic Image ... 28 Remove the Slide-On® EndoSheath® Technology ... 28 5 Preparation, Inspection and Operation ... 31 Preparation and Inspection ... 31 Endoscope Operation with BLS-1000 Battery Powered Light Source ... 32 Endoscope Operation - Other Light Source ... 34 Aspirating Fluids ... 34 Instilling Fluids ... 35 Inserting Accessories... 35 Electrosurgical Devices / Accessories ... 35 Laser Devices / Accessories ... 37 6

Reprocessing ... 39 Reprocessing Steps ... 40 Leak Testing ... 40 Attach the Leak Tester to the Endoscope ... 41 Leak Tester Connection Components ... 41 Pressurize the Endoscope ... 41 Cleaning / Disinfection / Sterilization ... 43 Use of the Vent Cap ... 43 Cleaning After Slide-On® EndoSheath® Technology Use ... 43 Recommended High Level Disinfection and Sterilization Procedures ... 44 Acceptable Reprocessing Materials ... 45 Incompatible Methods... 45 High-Level Disinfection Protocol ... 46 Cleaning... 46 Disinfection ... 46 Rinsing ... 46 Ethylene Oxide (EtO) Gas Sterilization ... 47 EtO Gas Sterilization Parameters ... 47 After EtO Gas Sterilization ... 47

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STERRAD® and STERIS® Sterilization ... 48 Care and Storage ... 49

Storage ... 49 Disposal ... 49 8 Troubleshooting... 51 9 Warranty and Service ... 57 Warranty Information ... 57 Cogentix Medical Service Information ... 58 Shipping to Cogentix Medical ... 58 Appendix ... 61 Specifications ... 61 Infection Control Information ... 62

Index of Figures Figure 2-1: Incorrect and Correct Sheath Alignment... 6 Figure 3-1: CST-4000/4000i Flexible Cystoscope/Hysteroscope ... 13 Figure 3-2: CST-4000/4000i Flexible Cystoscope/Hysteroscope-Control Body ... 14 Figure 3-3: CF-2.1 Slide-On® EndoSheath® Technology... 17 Figure 3-4: CF-1.5 Slide-On® EndoSheath® Technology... 19 Figure 3-5: Installation Stand ... 21 Figure 3-6: Compatible Light Guide Adapters ... 23 Figure 4-1: Incorrect and Correct Sheath Alignment... 27 Figure 6-1: Leak Tester Connection ... 41 Figure 6-2: Opening the EtO Valve ... 43

Index of Tables Table 3-1: CST-4000/4000i Standard Set ... 12 Table 6-1: STERRAD® and STERIS® Validated Systems/Cycles……………… ... 48 Table 8-1: Troubleshooting ... 52 Table A-1: Specifications ... 61

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1 Symbols and Terms Symbols The symbols listed below can be found on the CST-4000/4000i Flexible Cystoscope/Hysteroscope and on other components of the endoscopic system. Type BF applied part (Safety degree specified by IEC 60601-1) Alerts the user to the presence of important operating, maintenance, and service instructions. Refer to the user’s manuals for warnings and safety precautions associated with equipment used in the procedure. Equipment bearing this mark has been designed, tested, and certified as essentially compliant with all applicable European Union (EU) regulations and recommendations. Serial number of the endoscope

Up position for the angulation lever Down position for the angulation lever

Underwriters Laboratories Component Recognition Mark STERIS® and STERRAD® Reprocessing Compatibility (Refer to Chapter 6, Reprocessing)

Products do not contain natural rubber latex

Consult Instructions for Use The presence of this symbol on the product or packaging indicates that the device is RoHS compliant.

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Symbols and Terms

Terms Throughout this manual, the following terms are used: “Endoscope”, or “Cystoscope/Hysteroscope” refers to the Cogentix Medical CST-4000/ 4000i Cystoscope/Hysteroscope. “Slide-On® EndoSheath® Technology” or “Sheath” refers to the disposable CF-2.1 Therapeutic Slide-On® EndoSheath® Technology or CF-1.5 Diagnostic Slide-On® EndoSheath® Technology.

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CST-4000/4000i Flexible Cystoscope/Hysteroscope User’s Manual

2 Important Information The information in this chapter is essential for the correct and safe operation of the CST-4000/4000i Flexible Cystoscope/Hysteroscope and Slide-On® EndoSheath® Technology. Please read and understand this information before preparing or using the endoscope or any peripheral equipment with which it will be used.

Intended Use Cystoscopy: The Cogentix Medical CST-4000/4000i Flexible Cystoscope/Hysteroscope and Slide-On® EndoSheath® Technology are intended to be used for endoscopic access to and examination of the lower urinary tract, including the bladder. When combined with accessory instruments, the endoscopic system allows the user to perform various diagnostic and therapeutic procedures. Hysteroscopy: The Cogentix Medical CST-4000/4000i Flexible Cystoscope/Hysteroscope and Slide-On® EndoSheath® Technology is also intended to be used for direct viewing of the cervical canal and the uterine cavity, for the purpose of performing diagnostic and therapeutic surgical procedures. Do not use this equipment for any purpose other than these intended uses.

Contraindications for Hysteroscopy The CST-4000/4000i endoscope and Slide-On® EndoSheath® Technology should not be used to perform hysteroscopy if any one of the following conditions exists. Do not perform hysteroscopy using this equipment if:      

The patient is pregnant or suspected to be pregnant The patient’s cervix cannot be properly dilated The patient’s uterus cannot be distended The patient has acute pelvic inflammatory disease (PID) The patient has invasive carcinoma of the cervix The patient has had a recent uterine perforation

User Qualifications This equipment should only be used in a medical facility by or under the supervision of a physician trained in cystoscopy/hysteroscopy. Use of the system does not require any deviation from standard cystoscopy/hysteroscopy technique. However, the operator should have complete familiarity with the operation of the entire system prior to clinical use.

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Important Information

Only practitioners with appropriate training in hysteroscopy should perform hysteroscopic procedures. Cogentix Medical strongly recommends a thorough review of all relevant medical literature relative to techniques, complications, and hazards prior to undertaking any hysteroscopic procedure. Only use the endoscope and peripheral equipment according to the instructions and under the operating conditions described in this manual. Failure to do so could result in compromised safety, equipment malfunction and/or instrument damage. For preparation of the endoscope before use, and disassembly and proper cleaning after use, users should be thoroughly trained in the proper procedures. Failure to thoroughly understand these details, such as – but not limited to – EndoSheath® Technology installation and authorized disinfection or sterilization protocols, may pose an infection-control risk and/or cause equipment damage. If training assistance is desired from either the manufacturer or a local distributor or representative, please contact Cogentix Medical Customer Service at 866 258-2182 (toll free in U.S.) or (+1) 952-426-6189 (international).

Reprocessing The endoscope must be thoroughly cleaned, disinfected, and/or sterilized before its first use and after each subsequent use. This is the only way to ensure that a “patient-ready” endoscope is used in every procedure. See Chapter 6, Reprocessing, for information on reprocessing equipment and procedures.

Maintenance and Repair The endoscope contains no user-serviceable parts; never attempt to modify or repair it. Doing so may cause further equipment damage and/or compromise patient safety if the endoscope is subsequently used in a procedure. The endoscope may only be serviced / repaired at an authorized Cogentix Medical facility. The endoscope should be thoroughly inspected before each procedure, and should be periodically inspected to determine if there is damage or wear that requires attention.

Signal Words Information included in this manual to warn users of the possibility of patient injury and/or equipment damage is signified by the Warning and Caution symbols shown in this section. Notes are also included, to advise of important information. Warnings, Cautions and Notes will appear throughout this manual; carefully read and follow all statements.

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Important Information

Alerts the user to situations which, if not avoided, could result in death or serious injury. Alerts the user to situations which, if not avoided, could result in moderate or minor injury to the user or patient. It is also used to alert the user to conditions and actions that could cause equipment damage.



NOTE: Indicates additional helpful information.

Important Safety Precautions The following precautions should always be exercised when using the endoscope and all medical equipment to ensure the safety of all involved parties – user(s), patient(s), etc. They are summarized here in the order of the stages of the endoscope’s use.

Preparation, Inspection and Assembly The CST-4000/4000i endoscope and Slide-On® EndoSheath® Technology are designed to operate as an integrated system. Neither component can be used independently of the other.

The Slide-On® EndoSheath® Technology is designed for single patient use only. Do not reuse or attempt to re-sterilize the Sheath. For installing the Sheath in a sterile environment, users should wear two (2) pairs of sterile gloves. Refer to Chapter 4, Installing and Removing the Slide-On® EndoSheath® Technology, for complete details. Carefully inspect all equipment before using it in a procedure, and do not use any equipment that is damaged or excessively worn. Doing so could lead to patient injury and/or further damage to the equipment. If inspection reveals difficulty in articulation of the endoscope’s Distal Bending Section, the endoscope may be damaged. Do not use the endoscope in this case. Contact your local distributor, representative, or call Cogentix Medical Customer Service Dept. All devices connected to the CST-4000/4000i Flexible Cystoscope/Hysteroscope must be Classified Medical Equipment. Before using any additional equipment, confirm that it complies with the appropriate end-product safety standard (such as IEC 60950-1) and the Standards for Medical Electrical Equipment (UL 60601-1 or IEC 60601-1).

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Important Information Never drop the equipment or subject it to severe impact, as it could compromise the functionality and/or safety of the equipment or system. Should the equipment be mishandled or dropped, do not use it. Immediately return it to an authorized Cogentix Medical service facility for inspection and repair. While the Sheath is being installed, the Cystoscope/Hysteroscope should move freely without the application of force. Should ANY resistance be encountered, verify that the Sheath’s channel is properly aligned. If the channel is misaligned as shown in Figure 2-1, straighten the channel before continuing endoscope insertion. If the problem continues, refer to Chapter 8, Troubleshooting for further instructions. If this does not help solve the problem, contact your local distributor or call Cogentix Medical Customer Service Department. DO NOT expose the Sheath to alcohol or other cleaning agents prior to use.



Note: The Cogentix Medical CST-4000/4000i Cystoscope/ Hysteroscope and Slide-On® EndoSheath® Technology are not made with natural rubber latex.

MISALIGNED

ALIGNED

Figure 2-1: Sheath Alignment 1

Figure 2-1: Incorrect and Correct Sheath Alignment

Figure 2-1: Sheath Alignment 2 Figure 2-1: Sheath Alignment 3

MISALIGNED

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Important Information

During Use - General Do not use this equipment in the presence of a flammable anesthetic mixture containing air, oxygen or nitrous oxide. There is a possibility of fire or explosion. If any component of the endoscopic system malfunctions during the procedure, or if the endoscopic image is lost or compromised, immediately move the endoscope’s Distal Bending Section to the neutral position and slowly withdraw the endoscope from the patient. Using an endoscope that is not functioning properly could cause patient injury and/or further damage to the equipment. DO NOT use any accessory instrumentation that is damaged. Doing so may result in instrumentation malfunction during the procedure, which could cause serious patient injury and/or further damage to the Cystoscope/Hysteroscope. Always wear appropriate personal protective equipment when using the endoscope and/or sheath, such as a gown, gloves, and face and eye shields. Avoid excessive bending or twisting of the endoscope’s Insertion Tube. Although they are designed to bend, excessive bending can damage the fiber bundles and internal components. Should the endoscope develop a severe kink or bend, do not attempt to straighten the Insertion Tube. Contact Cogentix Medical Customer Service for assistance. DO NOT apply excessive pressure to the angulation lever, as it could damage the endoscope and lead to patient injury. DO NOT look directly at the intense light emitted from the endoscope tip to avoid the possibility of eye injury. If resistance is encountered when inserting an instrument into the Sheath, do not force it, as it could damage the instrument, the Cystoscope/Hysteroscope and/or the CF-2.1 Slide-On® EndoSheath® Technology. The Irrigation Working Channel of the CF-2.1 Slide-On® EndoSheath® Technology accommodates instrumentation indicated by the accessory manufacturer to be compatible with a 2.1 mm or smaller working channel. All instrumentation must be tested for compatibility with the channel prior to clinical use. If assistance is needed to determine compatibility, contact your local distributor or Cogentix Medical Customer Service.

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Important Information

DO NOT attempt to advance an exposed needle or other sharp instruments through the working channel. Doing so could damage the sheath’s channel. A thorough understanding of the principles and techniques involved in laser, electrosurgical and ultrasonic procedures is essential to avoid shock and burn hazards to both patient and medical personnel and damage to the device and other medical instruments. Ensure that insulation or grounding is not compromised.

During Use - Hysteroscopy Prior to performing a hysteroscopic procedure, it is extremely important that the user review the following information which may be critical to ensuring patient safety. Continuous CO2 Flow Hysteroscopy If CO2 gas is used as a distention medium, operative hysteroscopy is contraindicated due to the risk of gas embolization, with the exception of non-electrosurgical polypectomy or directed biopsy. CO2 gas may be used for diagnostic procedures. It is extremely important that a hysteroscopic insufflator is used. Death has been reported when laparoscope CO2 insufflators were used during hysteroscopy. The CO2 flow rate should be limited to less than 100 ml/min, and the patient’s intrauterine pressure should not exceed 100 mm Hg. Potential complications of continuous flow hysteroscopy with CO2 include:  CO2 embolization  Circulatory collapse  Death Continuous Fluid Flow Hysteroscopy If a liquid distention medium is used, strict fluid intake and output surveillance should be maintained to ensure that fluid deficit is known at all times. Depending on whether a non-electrolytic or an electrolytic solution is being used, when excessive fluid deficit occurs, consideration should be given to stopping further infusion and concluding the procedure. When using a fluid distention medium, closely monitor fluid intake/output. Excessive intake of distention fluid can lead to fluid overload and complications. Potential complications of continuous flow hysteroscopy with fluid distention media include:  Hyponatremia  Hypothermia  Uterine perforation resulting in possible injury to bowel, bladder, major blood vessels and ureter  Pulmonary edema

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Important Information  

Cerebral edema Death

If pregnancy is suspected, perform a pregnancy test prior to performing hysteroscopy. DO NOT perform hysteroscopy if the patient is pregnant. If performing Endometrial Ablation or Hysteroscopic Myomectomy, verify that the patient does not have procedural contraindications. Vaginal ultrasonography before hysteroscopy may identify clinical conditions that will alter patient management. Gravity fed intrauterine fluid distention can usually be accomplished with pressures in the range of 35-75 mm Hg. Hanging the fluid distention medium 42 inches above the patient can generate intrauterine pressure of approximately 80 mm Hg. Unless the systemic blood pressure is excessive, it is seldom necessary to use pressures greater than 75-80 mm Hg.



NOTE: Hysteroscopes are used as tools to access the uterine cavity and are not, in and of themselves, a method of surgery.

     

Diagnostic hysteroscopy can be used to evaluate numerous conditions including the following: Abnormal uterine bleeding Infertility Evaluation of abnormal hysterosalpingogram or sonohysterogram Intrauterine foreign body Amenorrhea Pelvic pain

     

Operative hysteroscopy is used to perform numerous procedures including the following: Directed endometrial biopsy Polypectomy Submucous Myomectomy Transection of Intrauterine Adhesions Transection of Intrauterine Septa Endometrial Ablation

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Important Information

Reprocessing The endoscope must be properly reprocessed, by cleaning, disinfection and/or sterilization, before its first use and after each subsequent use. Using an endoscope that has not been properly reprocessed in a procedure presents an acute infection-control risk to both the patient and medical personnel performing or assisting in the procedure. Always wear appropriate personal protective equipment when reprocessing the Cystoscope/Hysteroscope. Personal protective equipment includes items such as a gown, gloves, and face and eye shields. Use extreme care when reprocessing the Cystoscope/ Hysteroscope. Do not forcefully pull, push, or drag wipes, towels, or cloths along the Insertion Tube. The use of excessive force could damage the endoscope. DO NOT immerse the endoscope in disinfectant solution for long periods of time (in excess of one 1 hour). Prolonged immersions may damage the outer coverings of the endoscope and allow fluid infiltration. DO NOT place the endoscope in or near contaminated areas after it has been reprocessed. Doing so can re-contaminate the endoscope and require reprocessing to be repeated. DO NOT place the endoscope in awkward or confining areas between procedures as this could result in equipment damage.

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CST-4000/4000i Flexible Cystoscope/Hysteroscope User’s Manual

3 Endoscope and Accessories The Cogentix Medical CST-4000/4000i Cystoscope/Hysteroscope and SlideOn® EndoSheath® Technology are designed to perform safe, sterile, and efficient cystoscopic/hysteroscopic procedures. The two major components of the endoscopic system are: 

The CST-4000/4000i Cystoscope/Hysteroscope, which is shown in Figures 3-1 and 3-2 on pages 13 and 14. The endoscope’s Insertion Tube has no working channel; it contains the fiberoptic image and illumination bundles only. 



Be sure to handle the endoscope with care during use, reprocessing and storage. The fiberoptics are comprised of thin glass fibers which can be damaged by physical trauma, extreme temperatures, high humidity, and/or fluid invasion of the scope.

The disposable EndoSheath® Technology. The sterile, disposable Sheaths are installed over the endoscope’s Insertion Tube, acting as a protective barrier to protect patients and users from the spread of potentially pathogenic materials. The Sheaths also contain working channels through which irrigation and/or accessory equipment can be used. There are two types of Sheaths available for use with the CST4000/4000i : 



The CF-2.1 Therapeutic Slide-On® EndoSheath® Technology (see Figure 3-3 on page 17). This Sheath contains a channel through which irrigation fluids can be instilled into the patient, or accessory instruments can be inserted. The CF-1.5 Diagnostic Slide-On® EndoSheath® Technology (see Figure 3-4 on page 19) has a smaller channel that supports irrigation, but cannot accommodate the insertion of accessory devices. This Sheath is intended purely for diagnostic purposes.

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Endoscope and Accessories

Inspect the Standard Set Do not use any equipment that is observed to be damaged or excessively worn. Doing so could lead to patient injury and/or further damage to the equipment. When the endoscope is received from Cogentix Medical, immediately confirm that all of the items listed in Table 3-1 below have been shipped, and inspect them for damage. If any item is missing or damaged, do not use the endoscope. Contact Cogentix Medical to obtain a replacement part. CST-4000/4000i CYSTOSCOPE/HYSTEROSCOPE STANDARD SET COGENTIX MEDICAL CATALOG NO. DESCRIPTION 08-4201 CST-4000 Flexible Cystoscope/Hysteroscope OR

08-4202

CST-4000i Flexible Cystoscope/Hysteroscope

07-3060 07-6180

Detachable Light Guide Cable, 1.8m Cogentix Medical CST-4000/4000i Carrying Case

07-6015

Vent Cap CST-4000/4000i User’s Manual (this document)

OPTIONAL ITEMS AND ACCESSORIES (NOT SHIPPED WITH ENDOSCOPE) 07-6010 Endoscope Leak Tester 07-6160 07-6161 07-6162

Installation Stand, Floor Model Installation Stand, Clamp Model Installation Stand, Wall Mount

See List on Page 23

Light Guide Sleeve Adapter BLS-1000 Battery Powered Light Source Kit (includes Batteries and Battery Charger) BLS-1000 Battery Powered Light Source (Replacement) Battery Charger (Replacement) Batteries (2 batteries) (Replacement)

07-3053* 07-3050 07-3058* 07-3059

SLIDE-ON® ENDOSHEATH® TECHNOLOGY (NOT SHIPPED WITH ENDOSCOPE) 08-4101 CF-2.1 Therapeutic Slide-On® EndoSheath® Technology (2.1mm Working Channel) for the CST-4000/ 4000i Cystoscope/Hysteroscope 08-4102

CF-1.5 Diagnostic Slide-On® EndoSheath® Technology (1.5mm Channel) for the CST-4000/4000i Cystoscope/Hysteroscope

Table 3-1: CST-4000/4000i Standard Set

*Contact distributor for region-specific configuration

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Endoscope and Accessories

Equipment Diagrams CST-4000/4000i Flexible Cystoscope/Hysteroscope

Figure 3-1: CST-4000/4000i Flexible Cystoscope/Hysteroscope

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