Symmetry Surgical Bookwalter User manual

symmetry surgical confidential
Bookwalter®Retractor System
Assembly Instructions

symmetry surgical confidential
Instructions For Use
•Setup differs slightly for some product codes
•Always refer to the IFU pamphlet supplied with the product
WARNING
•The retractor system can exert a great amount of force on the
wound edges and on tissue. Release the retractor for short periods
of time or shift the blades to relieve the pressure on any one point.

symmetry surgical confidential
Electrosurgical Precautions
•If using monopolar electrosurgical equipment while using a
BOOKWALTER Retractor, consult the basic rules of usage
concerning electrosurgery, (see EN 60 601-2-2), as well as the
manufacturer’s instructions for use regarding specific warnings and
conditions.
•Be sure to electrically isolate the patient from (high frequency
leakage currents to) the operating table, in accordance with the
instructions provided by the manufacturer of the electrosurgical
equipment.
•Ensure that the patient does not come into contact with metal parts
that are earthed or that have an appreciable capacitance to earth
(for example: operating table, supports), in accordance with the
instructions provided by the manufacturer of the electrosurgical
equipment.
•Avoid small-area contacts with devices having a low impedance to
earth at high frequencies, as unwanted burns may result.

symmetry surgical confidential
Attach the Table Post To the OR Table
•Place the groove in the table post base on the OR table rail
in the desired location
•The table post should be attached on the same side where the
surgeon will stand during the case to facilitate adjustment
•Place the table post toward the head of the table for upper
abdominal cases and toward the foot of the table for lower
abdominal or pelvic cases
•Surgeons will develop a preferred location over time
•Be sure that the table post doesn’t exert excessive pressure
on the patient. It may be necessary to pad the table post or
reposition the patient to prevent pressure related necrosis.
•Pull up the handle at the top of the table post and turn it
clockwise to tighten onto the OR table rail

symmetry surgical confidential
Add the Post Coupling and Horizontal Bar
•Insert the horizontal bar or flexible
horizontal bar into the locking handle
side of the post coupling.
•Slide the other side of the post coupling
over the table post and turn the handle
clockwise to lock in position
•In this orientation the horizontal bar is
further from the surgeon and creates
slightly more space to work in
•Do not tighten the post coupling without
table post or horizontal bars inserted
Table Post Here
Horiz Bar Here

symmetry surgical confidential
Add the Ring
•Select a ring appropriate to the case
and patient size
•Insert the ring into holder at the distal
end of the horizontal or horizontal flex
bar
•Tighten by rotating the lock clockwise
•If using a horizontal flex bar adjust the
position of the ring to the desired
location and turn the locking handle
clockwise to lock it in place
Ring Sits On
This Surface
Tighten Here

symmetry surgical confidential
Add Ratchets & Blades
•Select blades appropriate to the case
•Select ratchets based on required function:
•Flat
•Tilting
•Rotating
•Self-retention
•Insert blade into the ratchet:
•From the side facing the wound
•So the gear rack faces the blade release lever
•Slide ratchet onto outside of ring
•Retract as required
•Periodically release blades to prevent
pressure necrosis of retracted tissue
Rack Facing Blade
Release Lever
Slide Onto
Ring Here