nuvasive GE Pulse Lessray User Guide

nuvasive GE Pulse Lessray User Guide

GE Pulse Lessray Quickstart Guide

Completed by C-arm tech
This guide is intended to be used for Pulse as a refresher on how to quickly use the Navigation application. For additional support, please call the Support Hotline: 877.963.8768

Setting up Lessray

Prior to patient entering the room

1. Confirm Pulse is connected to GE via BNC cable and DVI dongle
   a) Center BNC port on GE
   b) DVI port labeled C-ARM on Pulse

2. Select appropriate GE model from the c-arm dropdown from the SETUP tab on Pulse.

3. Attach the Lessray tablet mount to the c-arm, and the tablet to the mount.
   

4. Power on the tablet and confirm it automatically connects to the Pulse system.

5. Attach the correct size collar to the c-arm. Attach with the c-arm in rainbow down and the arrow on the collar pointing up to the ceiling.
   
   Once the patient is on the table

6.  Attach the table array to the bed rail on the c-arm side using the table array clamp and a bed rail adapter (if necessary). Confirm the side that has the arrays is facing the camera.
   a) Note: Suggested to put at the furthest end of the foot or head of bed to be out of the working volume. Angle straight so the post is perpendicular to the bed.

7. Confirm the camera can see the table array and c-arm array in all positions by selecting the camera icon and clicking ARRAY VIEW

C-arm tracking

in Pre-Surgery from Setup LR tab or in Intra-op from Lessray application

1. With the c-arm and table array in view of the camera, take an x-ray image.

2. Adjust the c-arm as necessary using the provided tracking viewfinder and continue taking x-ray images until the desired image is taken.

3. Press the LEARN button to save the image and location of the c-arm in 3D space. Learned images will appear in the baseline rows that can be accessed by clicking the right arrow in the bottom left hand corner of the Lessray screen.
   a) Note: If it is the first image taken and LEARNED, you will have to confirm the PHI notification.

4. Continue Learning images as necessary in AP and Lateral until you have all saved.

5. To track back to a Learned image, manipulate the c-arm in all orientations until the three c-arm angle icons are aligned and outlined in green, and the image is centered in the main viewfinder and the outside line appears green
   

Note: to only use c-arm tracking and no advanced image enhancement features of Lessray, simply turn off the
IMAGE ENHANCEMENT toggle from the tool panel.

2D C-arm stitching

1. With the C-arm and table array in view of the camera, take the initial x-ray image of the desired anatomy.

2. Press the x-Ray image STITCH button

3. Translate the c-arm slightly so the next image has ~¾ overlap over the first image.
   
   a) Note: The viewfinder outside line should still appear green. If it appears yellow, the C-arm has been translated too far and should be moved back. Only translate in, out, left, right, up, and down. Do not angle while stitching.

4. Take a new image while the viewfinder is green.

5. Continue translating the c-arm and taking new images until the entire anatomical area has been captured.

6. Select END STITCH to finish and blend the stitch.

Labeling baselines and stitched images

1. After Learning a baseline image or taking a stitched image, click the Live photo in the top right screen.
2. Select the Label button. Drag and drop labels to the corresponding vertebral body.
3. Click Save to save the labeled image to the image bank.
   

Achieving crisp endplate X-Ray images with angle grid (Learning AP and Lateral baselines for prone patient)

1. Note: follow this process to take the initial learned AP and Lateral images.

2. Without any learned images, take an AP image of the anatomy of interest
   For important product safety information please visit nuvasive.com/eIFU

3. Press the GRID button.

4. Wag the c-arm using the c-arm base until the superior endplate of the inferior vertebral body is lined up with the center pink grid line in the viewfinder
   

5. Rotate the c-arm down into Lateral, adjust as necessary for height, and take a shot.

6. The resulting image should be a crisp endplate shot in lateral. Suggested to Learn this image for C-arm tracking back.
   

7. Using the grid still on the screen, Cant the c-arm until the superior endplate of the inferior vertebral body is lined up with the grid line.
   

8. The resulting image should be a crisp endplate shot in AP. Suggested to Learn this image for C-arm tracking back.

For important product safety information please visit nuvasive.com/eIFU

Low-dose image enhancement with alignment

1. To lower the dose settings on the C-arm with a previously Learned image:
   a) GE: press the LOW-DOSE and PULSE button
   

2. While keeping the viewfinder outline green, take a new low-dose image of the anatomy.

3. The resulting image should align with the learned standard-dose image which should enhance the low-dose image.

4. Continue imaging in low-dose whenever the viewfinder is green.

5. To adjust the amount of enhancement, simply move the image enhancement slider.

6. If adjusting the image enhancement slider is not adequate for visibility of metal, try selected the METAL BOOST button.

Alternating images

1. When an image alternate is desired, confirm the C-arm is in the same location as a previously Learned image using the c-arm tracking feature and green indicators.
2. Take a shot that aligns with the previously Learned image.
3. Press the ALTERNATE button from the tool panel.

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References

• Electronic IFU Information - NuVasive

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