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My name
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Hospital name
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OR #
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This is the exact OR that we will be using epiqar in:
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YES
NO
I don’t know
Is this an Opthalmic Surgery OR ?
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YES
NO
Email address (for follow-up questions, if any)
Please share photos of the OR:
PHOTO #1 – NETWORK
Please take a picture of an ethernet jack in the OR. Ideally, this would be an empty one, and near where the epiqar laptop would be placed. If there is not an empty one, take photos of any ethernet jacks you can locate. The ethernet jack likely has a code on it, and often looks something like this:
PHOTO #2 – BACK OF THE CAMERA TOWER
Please take a picture of the BACK of the camera tower (Stryker, Storz, Olympus, daVinci, etc). We need to see the connector types in a detailed shot that covers the different ports.
PHOTO #2 – OCULAR DEVICE OUTPUT
Please take a picture of any area where you see video cables are connected or can be connected. We need to see the connector types in a detailed shot that covers the different ports. The area to photograph will likely look like what is shown in one of these pictures:
PHOTO #3 – OPHTHALMIC MICROSCOPE DETAILS
Please take a picture of the microscope, beam-splitter & beam-splitter video component (if present). One goal here is to identify the make and model of the ocular system (eg, Zeiss Artevo-800). The items to photograph will look something like this:
PHOTO #3 – FRONT OF THE CAMERA TOWER
Please take a picture of the FRONT of the camera tower (Stryker, Storz, Olympus, daVinci, etc). A photo showing the camera tower manufacturer name and model # is the goal.
PHOTO #4 (optional) – TV DISPLAY AND/OR VIDEO RECORDER DEVICE
If there is a video DISPLAY showing the output of the microscope, take a photo of the front and back the display. If there is a VIDEO RECORDER used, please photograph the front and back of that, mostly to show the connections that are available.
PHOTO #5 – Wide Shot of the OR
Please take a wide picture of the OR. The goal is to see the relationship between the patient location and the ethernet drop & camera tower. A wide view is best, including the ethernet connection area, camera tower and patient area if possible.
FINISHED & SUBMIT