NDS ExpandOR User manual

ExpandOR™
Medical-Grade Video Streaming System
USER MANUAL
ENGLISH

© 2019NDS Surgical Imaging. All rights reserved.
Information in this document has been carefully checked for accuracy; however, no guarantee is given to the
correctness of the contents. This document is subject to change without notice. NDS provides this information
as reference only. Reference to products from other vendors does not imply any recommendation or
endorsement.
This document contains proprietary information protected by copyright. No part of this manual may be
reproduced by any mechanical, electronic, or other means, in any form, without prior written permission of
NDS.
All trademarks are the property of their respective owners.

i
Table of Contents
Section 1
Warnings and Cautions-------------------------------------------------------- ii
Declarations of Conformity-------------------------------------------------- iii
Legal Statement ---------------------------------------------------------------- iii
Section 2
About This Manual -------------------------------------------------------------1
Overview --------------------------------------------------------------------------1
Installation and Setup ---------------------------------------------------------1
Intended Use and Contraindications --------------------------------------2
Specications --------------------------------------------------------------------2
Section 3
ExpandOR Connections -------------------------------------------------------3
Cable Bend Radius--------------------------------------------------------------3
Section 4
Transmit ---------------------------------------------------------------------------4
Section 5
Receive-----------------------------------------------------------------------------5
Section 6
Simultaneous Transmit/Receive --------------------------------------------6
Section 7
Transmitting to Multiple Locations ----------------------------------------7
Audio Setup ----------------------------------------------------------------------7
Section 8
Privacy Feature ------------------------------------------------------------------8
Record and Capture Features -----------------------------------------------9
Record Video Feature -------------------------------------------------------9
Capture Still Feature ---------------------------------------------------------9
Section 9
Conguration Options ------------------------------------------------------- 10
Cleaning Instructions -------------------------------------------------------- 11
Electromagnetic Compatibility Tables-------------------------------------- 12

ii
1 Warnings and Cautions
This symbol alerts the user that important information regarding the installation and / or operation of this
equipment follows. Information preceded by this symbol should be read carefully in order to avoid damaging
the equipment.
This symbol warns user that un-insulated voltage within the unit may have sucient magnitude to cause
electrical shock. Therefore, it is dangerous to make contact with any part inside the unit. To reduce the risk of
electric shock, DO NOT remove cover (or back). There are no user serviceable parts inside. Refer servicing to
qualied service personnel.
This symbol cautions the user that important information regarding the operation and / or maintenance of this
equipment has been included. Information preceded by this symbol should be read carefully to avoid damage
to the equipment.
This symbol denotes the manufacturer.
This symbol denotes the manufacturer’s European Community representative.
To prevent re or shock hazards, do not expose this unit to rain or moisture. Also, do not use this unit's polarized plug
with an extension cord receptacle or other outlets unless the prongs can be fully inserted. The product is designed to
meet the medical safety requirements for a patient vicinity device.
This product is a Class I medical device. No modications are allowed.
This equipment/system is intended for use by healthcare professionals only.
Safety Compliance:
This product is T.U.V. approved with respect to electric shock, re and mechanical hazards only in
accordance with CAN/CSA C22.2 NO. 60601-1 and ANSI/AAMI ES60601-1.
Safety Compliance:
This product meets the requirements of EN60601-1 so as to conform to the Medical Device Directive
93/42/EEC and 2007/47/EC (general safety information).
Recycling:
Follow local governing ordinances and recycling plans regarding the recycling or disposal of this equipment.
This product complies to the above standards only when used with the supplied medical grade power supply.
Power Cord: Use a hospital grade power cord with the correct plug for your power source.
Disconnect the power cord from the AC mains. The power cord is the only recognized disconnect device.
The MEDICAL EQUIPMENT should be positioned so that its disconnect device is readily accessible.
The product should be powered from a center tapped circuit when used in the US at voltages over 120 volts. Product is
intended for continuous operation.
This product is energized from an external electrical power source for class 1 equipment. It is the responsibility of the
installer to test the product’s earth ground to verify that it complies with the hospital, local and national impedance
requirements.
Model ExpandOR
Power Supply GlobTek GTM91120-3024-T3A
AC Input 100 to 240 Volts at 50 to 60 Hz, 1.0A
DC Output 24 Volts at 1.25 A

iii
Declarations of Conformity
Legal Statement
NDS may sell its products through other medical device manufacturers, distributors and resellers and therefore, purchasers of this NDS product should
consult with the entity through which this product was originally purchased regarding the terms of any applicable product warranties provided by such
entity, if any.
NDS neither assumes nor authorizes any person to assume for it any other liabilities in conjunction with and/or related to the sale and/or use of its
products. To ensure proper use, handling and care of NDS products, customers should consult the product specic literature, instruction manual, and/or
labeling included with the product or otherwise available.
Customers are cautioned that system conguration, software, the application, customer data and operator control of the system, among other factors,
aect the product’s performance. While NDS products are considered to be compatible with many systems, specic functional implementation by
customers may vary. Therefore, suitability of a product for a specic purpose or application must be determined by the consumer and is not warranted
by NDS.
NDS SPECIFICALLY DISCLAIMS ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS, IMPLIED AND/OR STATUTORY, INCLUDING, BUT NOT LIMITED TO
WARRANTIES OF MERCHANTABILITY, FITNESS AND/OR OF SUITABILITY FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT WITH RESPECT TO ALL
NDS PRODUCTS OR SERVICES. ANY AND ALL OTHER WARRANTIES, REPRESENTATIONS AND/OR GUARANTEES, OF ANY TYPE, NATURE OR EXTENT, BE IT
IMPLIED, EXPRESS AND/OR WHETHER ARISING UNDER OR AS A RESULT OF ANY STATUTE, LAW, COMMERCIAL USAGE, CUSTOM, TRADE OR OTHERWISE,
ARE HEREBY EXPRESSLY EXCLUDED AND DISCLAIMED.
NDS, its suppliers and/or distributors are not liable, directly or by way of indemnity for any special, incidental, consequential, punitive, exemplary or
indirect damages, including but not limited to alleged damages for delayed shipment, non-delivery, product failure, product design or production,
inability to use such products or services, loss of future business (lost prots), or from any other cause, whatsoever, in connection with or arising from
the purchase, sale, lease, rental, installation or use of such NDS products, these terms and conditions, or with respect to any the terms of any agreement
which incorporates these terms and conditions.
SOME JURISDICTIONS DO NOT ALLOW EXCLUSIONS AND DISCLAIMERS OF CERTAIN WARRANTIES OR LIMITATIONS OF LIABILITY, SO THE LIMITATIONS
AND/OR EXCLUSIONS, SET FORTH HEREIN, MAY NOT APPLY. IN THAT EVENT LIABILITY WILL BE LIMITED TO THE GREATEST EXTENT PERMITTED BY LAW
IN THE SUBJECT JURISDICTION.
The information provided in this document, including all designs and related materials, is the valuable property of NDS and / or its licensors and, as
appropriate, they reserve all patent, copyright, and other proprietary rights to this document, including all design, manufacturing reproduction, use,
and sales rights thereto, except to the extent said rights are expressly granted to others.
FCC and Council Directives of European Standards:
This device complies with Part 15 of FCC rules and 93/42/EEC of the Council Directives of European Standards Directive as amended by 2007/47/EC.
Operation is subject to the following two conditions: (1) This device may not cause harmful interference, and (2) this device must accept any
interference received, including interference that may cause undesirable results.
1. Use the specied cables with this device so as not to interfere with radio and television reception. Use of other cables and / or adapters may cause
interference with other electronic equipment.
2. This equipment has been tested and found to comply with the limits pursuant to FCC part 15 and CISPR 11. This equipment generates, uses and
can radiate radio frequency energy and, if not installed and used in accordance with the instructions, may cause harmful interference to radio
communications.
IEC:
This equipment has been tested and found to comply with the limits for medical devices to the IEC 60601-1-2. These limits are designed to provide
reasonable protection against harmful interference in a typical medical installation. This equipment generates, uses and can radiate radio frequency
energy and, if not installed and used in accordance with the instructions, may cause harmful interference to other devices in the vicinity.
FCC, Council Directives of European Standards and IEC:
There is no guarantee that interference will not occur in a particular installation. If this equipment does cause harmful interference to radio or television
reception, which can be determined by turning the equipment o and on, the user is encouraged to try to correct the interference by one or more of
the following measures:
• Reorient or relocate the receiving antenna.
• Increase the separation between the equipment and receiver.
• Connect the equipment into an outlet on a circuit dierent from that to which the receiver is connected.
• Consult your dealer or an experienced radio/TV technician for help.
Accessory equipment connected to this product must be certied according to the respective IEC Standards (i.e., IEC 60950-1) for data processing
equipment and IEC 60601-1 for medical equipment). Furthermore, all congurations shall comply with the system standard, IEC 60601-1-1. Anyone who
connects additional equipment to the signal input part or signal output part congures a medical system, and is therefore responsible that the system
complies with the requirements of system standard IEC 60601-1-1. Whoever is responsible for securing the unit to a system needs to insure that the
mounting equipment used with this product complies to IEC standard 60601-1. If in doubt, consult the technical services department or your local
representative.

1
This manual is designed to assist the user with operation of the ExpandOR.
A numbered tab on the side of the page indicates the beginning of a section.
About This Manual
ExpandOR™ is a stand-alone medical-grade video streaming system that enables video streaming across
existing networks and provides bi-directional or one-way HD video and audio streaming with low latency. The
ExpandOR can transmit a video stream to a single or multiple destinations. The main purpose of the product is
to provide a solution for enabling surgeons to conduct bi-directional consultations during surgery, transmit a
video stream to an auditorium for educational purposes, or send sample images to a Pathology lab.
Overview
2
The ExpandOR is designed to be easy to install and set up by a hospital’s IT Department, and be made ready
for doctors and nurses to operate it. After initial setup by the IT Department, a doctor or a nurse in the
operating room can easily:
• Initiate streaming and/or capturing session
• Enable privacy in compliance with security requirements (such as HIPAA)
• End streaming session
NDS recommends that the installation and initial setup is done by the hospital’s IT department by a technician
with a basic understanding of networking including an understanding of TCP/IP protocol, IP address, gateway,
subnet mask, network port, pinging a device on the same network, and conguring a laptop to work in a
corporate/hospital network. After initial setup, IT Department is required to explain to the operating room (OR)
sta how the ExpandOR is congured including the following items:
• One-way point-to-point
• Two-way point-to-point
• Multi-Node
• Multicast (Broadcast)
• Conguration to record incoming or outgoing video
Prior to hando of the ExpandOR to the OR sta, the IT Department must demonstrate functions of the Front
Panel buttons. The OR Sta will use the front panel buttons to operate the unit during procedures.
Installation and Setup

2
Intended Use and Contraindications
Intended Use:
This device is intended for use in a medical environment to deliver high quality video and graphic images.
Contraindications:
This device may not be used in the presence of ammable anesthetics mixture with air, oxygen or nitrous
oxide. Also, it is not intended for life support applications.
No part of this product may come in contact with a patient. Never touch the product and a patient at the
same time.
Initial set up must be done by the hospital's IT Department by a technician with a basic understanding of
networking including an understanding of TCP/IP Protocol, IP Address, Gateway, Subnet Mask, Network
Port, Pinging a device on the same network, conguring a laptop to work in a corporate/hospital network.
For mission critical applications, we strongly recommend that a replacement unit be immediately available.
Specications are subject to change without notice. Contact factory for current specications.
DC Input 24VDC / 1.25 A
DC Power Consumption (nominal) 22W
AC Power Consumption (nominal) 30W
System Weight 1.3lbs. (0.59 Kg)
Environmental
Operating Temperature +32 to 1040F (0 to 400C )
Operating Humidity 20 to 85% RH
Storage Temperature -4 to +1220F (-20 to +500C )
Storage Humidity 5 to 85% RH
Operating Altitude 6600 ft. (2,000 M)
Storage Altitude 33,000 ft. (10,000 M)
Specications

3
ExpandOR Connections
Connections Options:
Transmit:
Network connection must be set up and connected. Connect DVI-D source to DVI-IN port to stream to
the congured destination(s). Network video monitor, audio, DVI-OUT, USB, and GPI are all optional.
Receive:
Network connection must be set up and connected. Connect DVI-D display to DVI-OUT to display
received stream. Network video monitor, audio, DVI-IN, USB, and GPI are all optional.
Record:
To record video stream or capture still images, a USB drive must be inserted into the USB port. Implement
Option 1 or Option 2 above as appropriate.
Audio:
To transmit and receive audio, a microphone must be connected to the IN MIC connector and headphones
or an amplied speaker must be connected to the OUT LINE connector. Additionally, Options 1 or 2 above
must be implemented.
The diagram below shows the devices that may be connected to the ExpandOR. The unit’s application will
determine which of these devices is required. The devices required for a given function are described in the
Connections Options list below.
3
Cable Bend Radius
NDS recommends that the bend radius of metallic cables be no less than 2.5 inches (63 mm) or 7 times
the diameter of the cable whichever is greater. Sharper bends may damage the cable and/or degrade
the video signal.
DVI In
DVI Video
Source
▲
◄►
▲
Video and
still image
storage
▲
* *
Y/C Out
DVI Out
Audio Network
RS-232
connector
for NDS use
only
▲
Privacy
Record
Video
Capture
Still
GPI Control

4
4
Transmit
1. Press the power button until the ring illuminates. All 5 LEDs will ash twice. About 1 minute is required to
boot up.
2. Press the TRANSMIT button in front panel until the LED below it turns on.
ExpandOR allows streaming a surgical video of a patient in the OR/procedure room to one or multiple hospital
destinations. The steps required to transmit from the ExpandOR in the operating room to a single ExpandOR
within the hospital are shown below. Conrm with your IT department that the ExpandOR’s parameters are
set appropriately for your specic use prior to operation.
3. If during an operation or procedure, you decide not to transmit sensitive patient information, simply press
the PRIVACY button, as shown below, until the LED below it turns on. Turn privacy o by pressing the
PRIVACY button until the LED turns o. See page 8 for more on PRIVACY.
5. Pressing the CAPTURE STILL button as shown below, captures a video frame as a still image saved to the
USB drive. The CAPTURE STILL LED ashes once during the capture. See page 9 for more on the CAPTURE
STILL function.
6. Press the TRANSMIT button again to end transmission, turning o the TRANSMIT LED. If video was being
recorded, ending transmission will also stop video recording and turn o the RECORD VIDEO LED.
4. To record the video stream and/or capture images, verify with your IT department that the ExpandOR is
congured for video streaming and/or capturing images. Start recording video by pressing the RECORD
VIDEO button, as shown below, until the LED below it turns on. To stop recording video, press the
RECORD VIDEO button until the LED turns o. See page 9 for more on RECORD VIDEO.

5
5 Receive
1. Press the power button until the ring illuminates.
ExpandOR can receive streaming surgical video of a patient in the operating room/ procedure room from an-
other ExpandOR in the hospital. This section explains how to accomplish this task.
The steps required to receive surgical video from another ExpandOR within the hospital are shown below. Pri-
or to operating the unit, please conrm with your IT department and verify that the unit’s parameters are set
for your intended use.
2. Press RECEIVE button on the front panel until the LED below it turns on.
5. Stop receiving by pressing the RECEIVE button as shown in Step 2 above. The RECEIVE LED turns o. If vid-
eo was being recorded, ending receive also ends video recording and the RECORD VIDEO LED is turned o.
3. If you want to record the video stream and/or capture images, verify with your IT department that the
ExpandOR is setup for video streaming and/or capturing images. If it is, then proceed as shown below.
Start recording video by pressing the RECORD VIDEO button, as shown below, until the LED below it turns
on. Stop recording video by pressing the RECORD VIDEO button until the LED below it turns o. See page
9 for more on RECORD VIDEO.
4. Pressing the CAPTURE IMAGE button as shown below, causes the LED below it to ash. One image is cap-
tured per button press. See page 9 for more on CAPTURE IMAGE.

6
6
Simultaneous Transmit/Receive Video
1. Press the power button until the ring illuminates.
ExpandOR can simultaneously receive and transmit streaming patient surgical video in the operating room/
procedure room from one ExpandOR to another ExpandOR in the hospital. The steps required to simultane-
ously transmit and receive surgical video to/from the intended ExpandOR within the hospital are shown be-
low. Prior to operating the unit, please conrm with your IT department that the ExpandOR
parameters are set appropriately for your specic use.
2. Press TRANSMIT button in front panel.
3. Press RECEIVE button on the front panel.
6. Stop transmitting by pressing the TRANSMIT button as shown in Step 2 above. Stop receiving by pressing
the RECEIVE button as shown in Step 3. The TRANSMIT LED and the RECEIVE LED turn o. If video was be-
ing recorded, ending receive also ends video recording, turning o the RECORD VIDEO LED.
If you want to record the video stream and/or capture images, verify with your IT department that the
ExpandOR is setup for video streaming and/or capturing images. If it is, then proceed as shown below. Start
recording video by pressing the RECORD VIDEO button, as shown below, until the LED below it turns on. Stop
recording video by pressing the RECORD VIDEO button until the RECORD VIDEO LED turns o. See Record
Video Feature on page 9 for more information about this function.
5. Pressing the CAPTURE IMAGE button as shown below, causes the LED below it to ash. One image is
captured per button press. See Capture Still Feature on page 9 for more information about this function.

7
Transmitting to Multiple Locations
The ExpandOR can transmit streaming surgical video of a patient in the operating room/procedure room to
multiple ExpandORs in the hospital. The steps required to transmit surgical video to multiple ExpandORs
within the hospital are shown below. Prior to operating the unit, please conrm with your IT department that
the unit’s parameters are set appropriately for your specic use.
The ExpandOR is capable of simultaneously transmitting (broadcasting) to multiple locations. The IT
department can set it up if required. When the ExpandOR has been congured for broadcasting, press the
TRANSMIT button, shown below, to begin broadcasting to destinations dened in the ExpandOR
configuration.
7
Audio Setup
The ExpandOR can be congured to transmit and receive audio with its surgical video stream. If your
application requires audio, your IT department can congure the ExpandOR to support audio out and audio in,
and provide the appropriate audio equipment. ExpandOR to ExpandOR allows bi-directional communication.
ExpandOR can stream one way to a PC using ViewOR (provided on the ExpandOR CD). See Conguration
Options on page 10 for a detailed description of ExpandOR device to device communications.
Audio
◄►
Network

8
Privacy Feature
The purpose of the Privacy Mode is to prevent transmission of sensitive parts of a surgical video stream. When
privacy is enabled, the receiving end will see the screen shown below and audio will be muted.
Privacy is enabled or disabled by pressing the PRIVACY button on the front panel. When Privacy Mode is on,
the LED below the PRIVACY button will be on. When the Privacy Mode is o, the LED will be o.
Note: HIPAA is the Health Insurance Portability and Accountability Act, which sets the standard for
protecting sensitive patient data.
8

9
The ExpandOR can record surgical video and/or capture still images. Contact your IT department to
verify that your ExpandOR is set up for this application. After your IT department verifies that your
ExpandOR is correctly configured, follow the steps below to record video or capture still images.
Record and Capture Features
Capture Still Feature
A USB drive must be installed in the USB connector on the back of the ExpandOR before using this feature.
Pressing CAPTURE STILL button, as shown below, captures a single frame from either the transmitting or
receiving video stream. After pressing the button, the CAPTURE STILL LED ashes once as the captured frame
is stored on the USB drive. Subsequent frames can be captured after the capture ash.
Note: If the CAPTURE STILL LED ashes three times after pushing the button, the image has failed
capture.
Captured images are saved as a .jpg les, and are stored in the Image folder of the installed USB drive. No
additional action by the user is required.
Note: The capture feature may be congured to capture frames from either the output video stream or
Record Video Feature
1. A USB drive must be installed in the USB connector on the back of the ExpandOR before using this
feature. USB drives must be USB 2.0 or better, capable of a minimum write speed of 5 MB/sec
Video recording starts when the RECORD VIDEO button, shown below, is pressed. The RECORD VIDEO LED
illuminates when the RECORD VIDEO button is pressed and will remain on throughout the recording session.
If the available free storage space drops below 200 MB, the RECORD VIDEO LED will begin blinking.
Recorded video streams are saved in the Transport Stream (.ts) format, and are stored in the Video folder of the
installed USB drive.
Note: The record stream feature may be congured to record either the output video stream or the
incoming video stream. Your IT department can tell you how the ExpandOR is congured.

10
9
Conguration Options
The ExpandOR can transmit to and receive from an ExpandOR or can transmit to a computer. Signal
capabilities of an ExpandOR are constrained by the device with which it is communicating. The table below
each device shows direction parameters for device combinations.
From ExpandOR
Signal Direction
Transmit Yes
Receive Yes
Both Yes
Signal Direction
Transmit Yes
Receive Yes
Both Yes
To ExpandOR
Signal Direction
Transmit Yes
Receive No
Both No
Signal Direction
Transmit No
Receive Yes
Both No
From ExpandOR To PC

11
Cleaning Instructions
Prior to cleaning and surface disinfection, the unit should be turned OFF and disconnected from its
power source.
Cleaning:
Thoroughly wipe all exterior surfaces with a lint-free cloth that has been dampened with an acceptable
cleaning agent. Acceptable cleaning materials are listed below. Remove residual detergent by wiping all
exterior surfaces with a lint-free cloth dampened with distilled water.
Disinfecting:
Disinfect the unit by wiping all exterior surfaces with a lint-free cloth dampened with 80% Ethyl Alcohol. Allow
the unit to air dry.
Cautions:
Do not allow liquids to enter the interior of the unit, and do not permit exterior surfaces to come into contact
will unacceptable solvents such as those listed below, as severe damage to the unit may result.
Acceptable Cleaning Materials:
Vinegar (distilled white vinegar, 5% acidity)
Ammonia-based glass cleaner
Acceptable Disinfecting Material:
Ethanol 80 % by volume
Unacceptable solvents:
MEK (Methyl Ethyl Ketone)
Toluene
Acetone
Note: The acceptable cleaning and disinfecting materials listed above have been tested on NDS
products and, when used as directed, do not harm the product’s nish and or its plastic components.

12
Electromagnetic Compatibility Tables
All medical electronic devices must conform to the requirements of IEC 60601-1-2. Precautions, adherences to
the Electromagnetic Compatibility (EMC) guideline information provided in this manual and verification of all
medical devices in simultaneous operation are required to ensure the electromagnetic compatibility and co-
existence of all other medical devices prior to a surgical procedure.
The emissions characteristics of this equipment make it suitable for use in industrial areas and hospitals (CISPR 11
class A). If it is used in a residential environment (for which CISPR 11 class B is normally required) this equipment
might not offer adequate protection to radio-frequency communication services. The user might need to take
mitigation measures, such as relocating or re-orienting the equipment.
The following EMC tables are provided for your reference:
• “Electromagnetic Emissions”onpage 13
•“Electromagnetic Immunity”onpage 14
•“Recommended Separation Distances”on page 15