THE GENUINE SWISS LITHOCLAST 2 THE EVOLUTION IN LITHOCLAST STONE THERAPY FROM THE INVENTOR OF THE SWISS LITHOCLAST METHOD

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SWISS LITHOCLAST 2

SWISS LITHOCLAST 2 SWISS LITHOCLAST 2 EVOLUTION EVOLUTION THE GENUINE SWISS LITHOCLAST 2 THE EVOLUTION IN LITHOCLAST STONE THERAPY FROM THE INVENTOR OF THE SWISS LITHOCLAST METHOD } BETTER TREATMENT RESULTS } BETTER HANDLING } EASIER REPROCESSING SETTING A NEW STANDARD FOR SAFETY AND EFFECTIVENESS

SWISS LITHOCLAST 2 SWISS LITHOCLAST 2 INNOVATION INNOVATION THE NEW PNEUMATIC pn3 HANDPIECE INNOVATIVE FUNCTION AND DESIGN } THE RESULT OF RESEARCH AND DEVELOPMENT THE INNOVATIVE HANDPIECE OF THE SWISS LITHOCLAST 2 } > The pn3 handpiece is extremely lightweight and ensures optimum operator control with its good ergonomic design. > The coupling section of the air supply tube rotates and the compressed-air tube is now longer without losing any pulse efficiency. This allows greater freedom of movement for the user in all treatment situations. > The pn3 handpiece and compressed-air tube is a sealed system and can be autoclaved or sterilized without additional sealing caps. This means no penetration of liquids and moisture, no blocking of the projectile and no related handpiece failure. > The quick-connection probe caps provide easy, fast and sterile probe change. > All components handpiece and probes remain extremely durable due to highest material and manufacturing quality. pn3} STATE OF THE ART INNOVATION IN THE HANDS OF THE PHYSICIAN } } GREATLY REDUCED PROBE DISPLACEMENT WITH THE pn3 HANDPIECE IMPROVES FRAGMENTATION CONTROL AND REDUCES PUSH-BACK EFFECT } SWISS LITHOCLAST pn3 HANDPIECE COMPARED TO STANDARD HANDPIECE PROBE DISPLACEMENT MEASURED AT A PRESSURE OF 2 BAR Displacement [mm] 2.50 2.00 1.50 1.00 0.50 Time/hs h 100 200 300 400 500 600 700 800 STANDARD HANDPIECE pn3 HANDPIECE Ratio 1:1

SWISS LITHOCLAST 2 SWISS LITHOCLAST 2 FLEXIBLE FLEXIBLE FLEXIBLE IMPULSE FREQUENCY, CONTROLLED BY THE PHYSICIAN} SELECTION OF IMPULSE FREQUENCY IN 12 STEPS, WITH SINGLE IMPULSE SHOTS OR WITH CONTINUOUS IMPULSES ON BOOST FREQUENCY CONTROLLED BY THE PHYSICIAN THROUGH A DUAL FOOT PEDAL } SELECTION OF HIGHER/LOWER IMPULSE FREQUENCY RANGE AND VARIABLE FREQUENCY ADJUSTMENT 1 12 Hz THE CHALLENGE FOR THE DEVELOPMENT TEAM OF THE SWISS LITHOCLAST METHOD WAS THE PUSH-BACK EFFECT } Loss of mobile stones up the ureter, caused by the lithotripsy impulse, was frustrating. This was often caused by an impulse frequency badly suited to the treatment situation. This problem occurs, if the physician cannot control or adapt the impulse frequency quickly and easily. > THE SWISS LITHOCLAST 2 FIGHTS THE PUSH-BACK EFFECT BY MEANS OF THREE ESSENTIAL INNOVATIONS } The impulse frequency can be adjusted in single Hertz increments by means of the dual foot pedal, the physician can intraoperatively select between single impulse, low impulse frequency and boost frequency. > The probe displacement has been greatly reduced this reduces forward momentum on the stone at impact. > The newly developed Swiss LithoVac suction system suction lithotripsy in the ureter enables continuous irrigation ureteroscopy and controls the push-back effect on its own. > } SELECTION OF SINGLE IMPULSES, OR PRESET IMPULSE FREQUENCY OR BOOST FREQUENCY VIA A DUAL FOOT PEDAL EVERYTHING IS UNDER CONTROL

SWISS LITHOCLAST 2 CONTROLLED FLEXIBILITY LINKED TO CONTROL } NEWLY DEVELOPED SWISS LITHOVAC SUCTION SYSTEM FOR CONTINUOUS IRRIGATION URETEROSCOPY HELPS TO CONTROL THE PUSH-BACK EFFECT } CLINICAL PROOF FOR THE EFFECTIVENESS OF THE SWISS LITHOVAC SUCTION SYSTEM } > Stenzl, Seibold et al. Pneumatic lithotripsy with an optional suction device (LithoVac ) for treatment of ureteric stones Japanese Journal of Endourology, vol. 9, No. 1, 1996 > Haupt, Pannek et al. The LithoVac : New suction device for the Swiss LithoClast, Journal of Endourology, vol. 9, No. 5, 1995

SWISS LITHOCLAST 2 SWISS LITHOCLAST 2 RELIABLE RESULTS UNIVERSAL FIRST-SHOT SOLUTION} LARGE, MEDIUM, SMALL } SAFE AND SUCCESSFUL LITHOTRIPSY WITH VERY SHORT TREATMENTS, INDEPENDENT OF STONE COMPOSITION } SUCCESSFUL TREATMENT OF ALL TYPES OF URINARY STONES 1 2 1 Flexible lithotripsy with the Swiss LithoClast in the ureter 2 Suction lithotripsy of ureteric stones with Swiss LithoClast and Swiss LithoVac 3 Percutaneous application with flexible nephroscope and flexible Swiss LithoClast probe 3 5 4 4 Percutaneous stone fragmentation with Swiss LithoClast and Swiss LithoVac 5 Pneumatic suction lithotripsy using Swiss LithoClast and Swiss LithoVac in the bladder Urinary stones, fragmented Image scale approx. 4:1 URINARY STONES OF DIFFERENT COMPOSITION FRAGMENTED WITH THE SWISS LITHOCLAST METHOD } > The Swiss LithoClast transmits energy from the probe onto the stone thermal tissue damage is excluded. > The urothelium remains intact even after being hit repeatedly with impulses at the highest energy setting of the Swiss LithoClast 2. THE SWISS LITHOCLAST METHOD TREATS ALL STONES IN ALL LOCATIONS

SWISS LITHOCLAST 2 GENUINE METHOD SWISS LITHOCLAST 2 COMPATIBLE SWISS LITHOCLAST 2, SWISS LITHOCLAST ENDOSCOPES, SWISS LITHOVAC SUCTION } THE GENUINE SWISS LITHOCLAST METHOD > Safe, effective and cold: these are the main features of the genuine Swiss LithoClast Method developed by EMS since it s market introduction in 1990. > The Swiss LithoClast generates energy without heat development thermal damage in the urinary tract is eliminated for maximum tissue safety. > No electrical energy is used for generating the acoustic waves the highest safety for the patient and physician is guaranteed. > The outstanding effectiveness of the Swiss LithoClast results in short treatment duration, independent of the stone composition, with the flexibility of use in the entire urinary tract. And, last but not least, it is the quality of all components, as well as their ease of use and maintenance which made this a unique success. THE ROAD TO SUCCESS } > The newly developed Swiss LithoVac suction system is user friendly and easy to clean and to sterilize. > The new generation of Swiss LithoClast endoscopes has an impressive and outstanding optical system ureteroscopy with 50 000 Pixel image resolution in small-diameter scopes represents a new dimension in endoscopic image quality. > The Swiss LithoClast endoscopes enhance stone therapy simple, safe handling, no kinking of lithotripsy and suction probes thanks to special guidance adapters. THE GENUINE SWISS LITHOCLAST METHOD FOR MORE THAN A DECADE THE MODERN TERM FOR ENDOSCOPIC LITHOTRIPSY, SETTING THE BENCHMARK FOR SAFE AND EFFECTIVE STONE THERAPY SWISS LITHOCLAST pn3 HANDPIECE AND SWISS LITHOVAC SUCTION SYSTEM WITH SWISS LITHOCLAST URETEROSCOPE} ONE OPTIMIZES PLUG THE AND OTHER TREAT

SWISS LITHOCLAST 2 SYSTEM DEVICES, OPTIONS, ACCESSORIES} COVERING ALL NEEDS FOR A SUCCESSFUL STONE THERAPY EMS IS THE GOLD STANDARD} SWISS LITHOCLAST 2 EMS HIGH TECH SINCE 1981 SWISS LITHOCLAST 2 Swiss LithoClast 2 basic unit 100-240 VAC, 40 VA, 50/60 Hz incl. dual foot pedal, compressed-air connection, pneumatic pn3 handpiece, Swiss LithoClast probes 0.8/1/1.6/2 mm STONE CATCHER Stone catcher holder Stone catcher sterile (box of ten) FT-158 FR-126 DT-059 SWISS LITHOCLAST PROBES Probe Ø 2 mm, 425 mm length Probe Ø 1.6 mm, 605 mm length Probe Ø 1 mm, 605 mm length Probe Ø 0.8 mm, 605 mm length Probe Ø 3.2 mm, 425 mm length Handpiece probe cap for 3.2-mm probe Probe Ø 1.6 mm, 453 mm length for suction probe EL-212 Probe Ø 0.8 mm, 668 mm length for suction probe EL-213 Flexible probe Ø 0.89 mm, 940 mm length for flexible ureterorenoscopes Flexible probe Ø 0.89 mm, 600 mm length for flexible nephroscopes EL-044 EL-058 EL-045 EL-046 EL-092 AD-425 EL-081 EL-080 EL-254 B EL-304 B > EMS Electro Medical Systems has been setting the standards in the development and production of medical devices since 1981. Each product is individually produced and tested in Switzerland with Swiss precision. > With over 8,000 Swiss LithoClast devices in daily use, EMS is the world s largest supplier of intracorporeal shockwave lithotriptors for the treatment of kidney, ureteral and bladder stones. > EMS is one of the world s leading manufacturers of prophylactic dental devices. > With its patented Swiss DolorClast, EMS offers products that benefit from the expertise and experience with pneumatically generated shockwaves. Since its market introduction in 1999, Swiss DolorClast has been the reference for successful pain therapy and has made EMS the number one in Radial Shockwave Therapy. > Product certification received by EMS: ISO 9001, EN 46001 (Medical Devices), GMP (Good Manufacturing Practice) and CE guidelines. > Like all EMS products, Swiss LithoClast meets the highest European and international quality standards. > Stone catcher: collection of stone fragments URETERORENOSCOPE HANDPIECE ADAPTER Handpiece adapter for EMS FR-107/108/132 FR-114 SWISS LITHOVAC Swiss LithoVac set lv3 Suction probe Ø 1.6 mm, 595 mm length Suction probe Ø 3.5 mm, 380 mm length Suction probe Ø 4 mm, 353 mm length FR-127 EL-213 EL-212 EL-211 Handpiece adapter for EMS FR-023 Handpiece adapter for Olympus type A-29xx Handpiece adapter for Olympus type A-24xx FR-024 FR-075 FR-010 STERILIZATION TRAY Sterilization tray 700x120x75 mm, autoclavable FR-112 EMS ELECTRO MEDICAL SYSTEMS SA Ch. de la Vuarpillière 31 CH-1260 Nyon Tel. +41 22 99 44 700 Fax +41 22 99 44 701 welcome@ems-ch.com www.ems-medical.com

WWW.EMS MEDICAL.COM EMS SA FA-212/EN Edition 11/2009