MODULARIS Installation and Start Up

MODULARIS Variostar
Installation and Startup

System
MODULARIS Variostar
Answers for life.
Document Version / Disclaimer / Copyright

Document Version
Siemens reserves the right to change its products and services at any time.
In addition, manuals are subject to change without notice. The hardcopy documents cor
respond to the version at the time of system delivery and/or printout. Versions to hard
copy documentation are not automatically distributed. Please contact your local Siemens
office to order a current version or refer to our website http://www.health
care.siemens.com.
Disclaimer
Siemens provides this documentation as is without the assumption of any liability under
any theory of law.
The content described herein shall be used by qualified personnel who are employed by
Siemens or one of its affiliates or who are otherwise authorized by Siemens or its affiliates
to use such documents.
Assemblers and other persons who are not employed by or otherwise directly affiliated
with or authorized by Siemens or one of its affiliates are not entitled to use this documen
tation without prior written authority.
Copyright
Siemens, 2006 refers to the copyright of a Siemens entity such as:
Siemens Healthcare GmbH - Germany
Siemens Aktiengesellschaft - Germany
Siemens Shenzhen Magnetic Resonance Ltd. - China
Siemens Shanghai Medical Equipment Ltd. - China
Siemens Medical Solutions USA Inc. - USA
Siemens Healthcare Diagnostics Inc. - USA and/or
Siemens Healthcare Diagnostics Products GmbH - Germany
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Table of Contents
General information
1.1
1.2
1.3
1.4
1.5
1.6
Notes and symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Safety information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.2.1 General safety information (in existing documents) . . . . . . . . . .
1.2.2 General electrical safety information . . . . . . . . . . . . . . . . . . . . . .
1.2.3 Radiation safety information. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Important Notes Regarding Startup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.3.1 Applicability and regulations for regional companies . . . . . . . . . .
Overview of MODULARIS Variostar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.4.1 MODULARIS Variostar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Required technical documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Required Tools and Test Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.6.1 Required material . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5
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Installation
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2.1
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Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.1 SIREMOBIL and monitor trolley . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.2 ARCADIS Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.3 MODULARIS Uro Plus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.4 SONOLINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.5 Unpacking MODULARIS Variostar . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.6 Docking unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.7 Connection, e.g. to ARCADIS Orbic / ISO C . . . . . . . . . . . . . . . . . .
2.1.8 Unit association - labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.9 C-arm unit isocenter cross. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.10 Installing the isocenter cross on the C-Arm. . . . . . . . . . . . . . . . . .
2.1.11 External isocenter cross manufacturer . . . . . . . . . . . . . . . . . . . . .
2.1.12 Radiation release option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.13 MODULARIS Uro Table. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1.14 ECG triggering option (VARIOSTAR 101 42 974) . . . . . . . . . . . . .
Startup
3.1
3.2
3.3
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Operating elements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.1.1 Location. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.1.2 Individual keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.1.3 Membrane keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
C-arm unit and monitor trolley . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
MODULARIS Variostar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.3.1 Checking the Line Voltage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.3.2 Filling the cooling circuit and coupling circuit . . . . . . . . . . . . . . .
3.3.3 Connecting modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.3.4 Connecting the X-ray C-arm . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.3.5 Connecting MODULARIS Variostar . . . . . . . . . . . . . . . . . . . . . . . .
3.3.6 Checking/correcting the focus position. . . . . . . . . . . . . . . . . . . . .
3.3.7 Checking the isocenter with X-ray . . . . . . . . . . . . . . . . . . . . . . . .
3.3.8 Shockwave release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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MODULARIS Variostar
Table of Contents
3.4
3.5
3.6
3.7
Retrofitting MODULARIS Uro (old table)

4.1
3.3.9 Triggering shock waves with ECG (optional) . . . . . . . . . . . . . . . .

MODULARIS Uro (table). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Ultrasound localization (101 42 909), optional . . . . . . . . . . . . . . . . . . . . . .
3.5.1 SONOLINE G20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.5.2 Ultrasound localization retrofit . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.5.3 Selecting the MODULARIS cross on the SONOLINE G20 . . . . . . . .
3.5.4 Isocenter with ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
MUT MODULARIS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Final Work Steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
85
Retrofitting MODULARIS Uro (old table) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.1.1 Scope of the retrofit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.1.2 Replacing the electronics box . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Final Work Steps

5.1
5.2
5.3
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Customer and country-specific settings . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5.1.1 Setting the system clock (if necessary) . . . . . . . . . . . . . . . . . . . . .
Backup and error memory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Remaining work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Changes to previous version
90
List of Hazard IDs
91
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General information 1
1.1 Notes and symbols

Emphasized text in this technical documentation has the following meanings:
Tab. 1
GEFAHR / DANGER
Bei einer unmittelbar drohenden Gefahr, die bei Nichtvermeidung

zum Tod oder zu einer schweren Krperverletzung fhrt.
Indicates when there is an immediate danger that leads to death

or serious physical injury.
Tab. 2
WARNUNG / WARNING
Bei einer Gefahr, die bei Nichtvermeidung zum Tod oder zu einer
schweren Krperverletzung fhren kann.
Indicates a risk of danger that may lead to death or serious physi

cal injury.
Tab. 3
VORSICHT / CAUTION
Bei einer Gefahr, die bei Nichtvermeidung zu einer leichten oder

mittleren Krperverletzung und/ oder zu einer Sachbeschdigung
fhrt oder fhren kann.
Indicates a risk of danger that leads to slight or moderate physical
injury and/or damage to property.
Tab. 4
ACHTUNG / NOTICE
Bei einer Gefahr, die bei Nichtvermeidung zu einem uner

wnschten Ergebnis oder Zustand fhrt oder fhren kann (nicht
Tod, Krperverletzung oder Sachbeschdigung).
Indicates a risk of danger that if disregarded leads or may lead to
a potential situation which may result in an undesirable result or
state (not death, physical injury or property damage).
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Tab. 5
HINWEIS / NOTE
Ist als Tipp zu verstehen. Der Anwender muss diese Anweisung

nicht unbedingt beachten. Er erfhrt jedoch Vorteile, wenn er
dies tut.
Should be understood as a tip. The user does not absolutely have
to observe these instructions. However, there will be advantages
if he does.
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1.2 Safety information

1.2.1
General safety information (in existing documents)

WARNING
Danger of injuries, death or material damage.
Non-compliance can lead to death, injury or material damage.
Please note:
The product-specific safety information in these instructions,

The general safety information in TD00-000.860.01... and
The safety information in accordance with ARTD Part 2.
1.2.2
General electrical safety information

WARNING
Electrical safety!
Non-compliance can lead to severe injury or even death, as well as material dam
age.
Parts under electrical voltage are accessible when the covers are open. To
avoid danger, disconnect the system from the power supply before opening
the covers. Disconnect the power plug.
If an uninterruptible power supply (UPS) is installed in the system, the voltage

output of the UPS must also be deenergized or the voltage output plug must
be disconnected.
If work steps must be performed using electrical power, the general safety in
formation according to TD00-000.860.01... must be observed.
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1.2.3
Radiation safety information

WARNING
X-ray radiation!
Non-compliance can lead to illness, irreversible damage to body cells and the gen
otype, severe injury and even death.
During work on the system in which radiation must be released, the radiation pro
tection directives and the rules for radiation protection according to
ARTD-002.731.02... must be complied with.
Please note:
Use available radiation protection devices.

Wear radiation protection clothing (lead apron).
Stay as far away as possible from the radiation source.
Release radiation only if necessary.
Set the radiation activity as low as possible. (low kV and mA values, short radi
ation time)
Release radiation for as short a time as possible.

Checks requiring the release of radiation are identified by the radiation warn
ing symbol shown on the left.
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1.3 Important Notes Regarding Startup

The device was installed, programmed, and tested at the factory (refer to the test certifi
cate filed in the "Technical Documentation" system binder).
During start-up, you will only need to perform a few tests or measurements to ensure
that none of the settings have changed.
All measurement results from measurements labeled with p must be entered in the
test certificate listed in each instance.
1.3.1
These measurement values as well as the values determined during start-up can be cop
ied from the test certificate to the acceptance certificate.
Applicability and regulations for regional companies

Equivalent leakage current measurement
The equivalent leakage current must be measured where applicable under the require
ments of DIN VDE 0751 Part 1.
Where DIN VDE 0751 does not apply, the regional companies should comply with the fol
lowing regulations (refer to ARTD - 002.731.17, Safety-related regulations for installation
and maintenance).
The national regulations apply primarily for the regional companies.
In the event that there are no existing regulations, the following provisions should be ad
hered to in the interest of the safety of customers, patients, employees and third parties
as well as the company.
First measured value
The equivalent leakage current measurement was performed at the factory and the value
measured was entered in test protocol 1. The measurement was made at the line voltage
and line frequency indicated in test protocol 1.
If the on-site line voltage or line frequency deviates from the information indicated upon
delivery, the values given are invalid. The values should be marked invalid (crossed out
with the comment "invalid values" and the service engineer should sign and date this
copy).
The equivalent leakage current measurement must be repeated. According the DIN VDE
0751 Part 1, the resulting value may not exceed 1 mA.
The initial measured value must be documented.
Repeat measurements
When service or repair work is performed on the primary power supply circuit (e.g. repairs
to the power-on circuit), the equivalent leakage current test must be repeated. The values
determined from the repeat measurements must not exceed the threshold value of 1 mA
as specified in VDE 0751, Part 1. In addition, they must not exceed the initial measured
value by more than 50 %. If the value exceeds this threshold, the system must be re
paired. The measured value must be documented.
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1.4 Overview of MODULARIS Variostar

1.4.1
MODULARIS Variostar
Fig. 1: Variostar
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Fig. 2: Overview of complete system
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1.5 Required technical documents

n
Start-up, release for operation
SPL1-130.815.20..
*PG Variostar
SPL1-130.891.20..
Troubleshooting Instructions for MODULARIS Variostar SPL1-130.840.20..
**LITHOSTAR MODULARIS Variostar adaptation
SPR2-130.814.05..
MODULARIS Uro Plus operating instructions
SPL1-130.620.01..
MODULARIS Variostar operating instructions
SPL1-130.620.20..
C-arm unit operating instructions
n.a.
MODULARIS Uro Service Instructions
SPL1-130.061.02..
* Only in combination with a non-Siemens C-arm unit.

**Only in combination with Siemens C-arm units.
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1.6 Required Tools and Test Equipment

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Standard installation tools
Service PC, refer to intranet, service laptop for CSEs
PC connection cable, 5 m
99 00 440 RE999
Internal line resistance meter
84 28,104 RE999
ESD equipment
Protective conductor testing device
44 15 899 RV090
DVM, e.g.. Fluke 187
99 94 831
Bender safety meter
97 06 979 Y0526
1.6.1
Spray can or varnish applicator of the color white grained 99 00 705 RE999
MED surface no. 4146 similar to RAL grayish white 9002.
Required material
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Approx. 10 liters of sterile water
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2 Installation
2.1 Overview
2.1.1
SIREMOBIL and monitor trolley

Refer to the valid installation instructions of the two units when installing the SIREMOBIL
and the monitor trolley:
2.1.2
ARCADIS Systems
Refer to the valid installation instructions when installing the ARCADIS system.
2.1.3
MODULARIS Uro Plus

Also refer to the document SPL1-130.033.02... when installing the MODULARIS Uro (table
with Litho opening).
2.1.4
SONOLINE
SONOLINE does not require any special installation instructions
Simply unpack the unit according to the "Unpacking procedure" attached to the outside
and attach the accessories including the monitor.
2.1.5
Unpacking MODULARIS Variostar

Fig. 3: Head with focus phantom
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Installation 2
NOTICE
Risk of damage
Do not pull on the focus phantom (bracket ( 1/Fig. 3 Page 14)).
Do not use the phantom as a handle.

n
Remove the packaging above the unit.
Fig. 4: Transport pallet
Disconnect the yellow transport safety bracket ( 1/Fig. 4 Page 15) that secures the
device from both sides.
Remove all the other transport brackets ( 2/Fig. 4 Page 15) and pull out the wooden
braces from underneath the unit by applying and then releasing the brake
( 3/Fig. 4 Page 15).
Remove the ramp and set it at the rear side, securing it from slippage.
Carefully move the unit off the transport pallet and down the ramp.
Appropriately dispose of the packaging according to the country-specific regulations.
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Adapt the power cord to the country-specific requirements, if required. If necessary,

materials will have to be purchased locally. Use a hospital grade plug for the USA and
for Canada.
Connect the control panel.
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2 Installation
2.1.6
Docking unit
This chapter first describes mechanical coupling for Variostar in combination with SIRE
MOBIL Compact .
The procedure is the same for all C-arm units. Mechanical installation of the bridge on
the front extension of the C-arm unit must always be adapted. Technical clarification
must be known and in conformance with PG (SPL1-130.890.20...).
For the sake of clarity regarding technical work on all components, the coordinates used
in this document are defined in this diagram: ( Fig. 5 Page 17) (Variostar with shock
wave focus, C-arm unit with isocenter, patient table). For the Variostar and C-arm unit,
the designations "left" and "right" are always from the viewpoint of the operator with the
unit moving forward.
The docking mandrel is pre-installed on the Variostar centrally in relation to the longitudi
nal axis ( 1/Fig. 5 Page 17) and can be adjusted by 30 mm in height (200 to 230 mm
above the floor). The height is determined depending on the installation of the docking
bridge. The docking bridge is installed centrally ( 4 mm) on the front C-arm unit exten
sion ( 2/Fig. 5 Page 17).
The following figures are not displayed to scale, and apply to the Variostar with Sir
emobil ISO C / Compact and the Compact L/ ARCADIS Family. Any other C-arm unit
requires prior clearance by the local project management. The procedure is then
the same.
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Installation 2
Fig. 5: Docking unit
Fig. 6: Docking securing_4
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2 Installation
Prepare the Variostar to the left of the C-arm on a level floor (fix C-arm)
Set the C-arm vertically to approx. 1070 mm in the center (( 3/Fig. 5 Page 17)_ Z di
rection)
Remove the top part of the docking bridge.
Unscrew the docking bridge ( 1/Fig. 6 Page 17) or detailed view ( 1/Fig. 7 Page 18)
and pull the docking bridge apart so that the complete adjustment range is available.
Place the bottom part of the docking bridge on the C-arm extension, at least 140 mm
in the X direction ( 1/Fig. 9 Page 19) and centered ( 4 mm).
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Installation 2
n
The docking bridge can be positioned horizontally via Allen screws

( 2/Fig. 7 Page 18). If the adjustment range is insufficient, the preinstalled Allen
screws ( 1/2/3/Fig. 8 Page 18) can be replaced with the included longer screws.
Tighten the eight fastening screws ( 1/Fig. 6 Page 17) and ( Fig. 7 Page 18).
Set the Variostar docking mandrel in the horizontal position ( 1/Fig. 5 Page 17).
Move the shock wave head to the UT (undertable) therapy position.

When the Variostar moves in, the mandrel must move over the lower part of the
sleeve - check heights from the floor ( 2/Fig. 10 Page 20). Clamping screws for ad
justing the height of the mandrel, see ( 1/Fig. 10 Page 20). Use a level for this ad
justment.
Fig. 9: Docking unit 2
Move Variostar in, to a distance of approx. 20 mm ( 2/Fig. 9 Page 19).

Align the lower part of the docking bridge to the mandrel in X direction
( 1/Fig. 9 Page 19).
Secure the bottom part with the Allen screw ( 1/Fig. 11 Page 20).
Position the top part of the docking bridge and secure it ( 1/Fig. 12 Page 21).
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Test the inward movement and locking of the Variostar. The latch must lock securely.
Correction is performed using the black Allen screw in the latch
( 2/Fig. 12 Page 21).
Finally, perform a rough visual inspection to check whether the central ray (X-ray) can
pass through the focus of the shock wave head.
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2 Installation
Fig. 10: Variostar connection
Fig. 11: Lower part_
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Installation 2
Fig. 12: Upper part
Fig. 13: Block
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2 Installation
Fig. 14: Docking bridge
Fig. 15: Block_mounted
2.1.7
Connection, e.g. to ARCADIS Orbic / ISO C

For Siremobil ISO C with serial number 1024 - 1687 the interface and the internal
cabling must be retrofitted as described in the document SPL 1-130.814.03 (Modu
laris Uro Plus). Serial numbers 1024 and lower cannot be retrofitted. Siremobil
Compact serial numbers < 4150 and Compact L < 1702 must also be retrofitted. Also
refer to the instructions for Modularis Vario Adaption SPR2-130.814.05.
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Installation 2
For ARCADIS Orbic / ISO C, the docking bridge has to be adapted accordingly
( Fig. 13 Page 21).
n
Attach these blocks to the bridge with 2 screws ( 3/Fig. 13 Page 21).
Position the docking bridge according to ( Fig. 14 Page 22).
2.1.7.1
Screw the clamping screws from the enclosed material into the fastening block
( 1 und 2/Fig. 13 Page 21).
Remove both clamping screws ( 3/Fig. 8 Page 18).
Horizontally position the docking bridge with the adjustment screw

( 1/Fig. 14 Page 22) (or see ( 2/Fig. 7 Page 18) for more detail).
Position the top part of the docking bridge and secure it ( 1/Fig. 12 Page 21).
Test the inward movement and locking of the Variostar. The latch must lock securely.
Correction is performed using the black Allen screw in the latch ( 2/Fig. 12 Page 21).
If the docking bridge is not fastened with screws, it can be removed whenever necessa
ry. This will prevent the C-arm from colliding with the docking bridge in the event of a
"non-lithotripsy application."
Collision warning labels
When the Variostar is used with the Orbic C-arm, the warning labels included with deliv
ery must be affixed to the docking bridge and the table, as shown in the illustrations.
Fig. 16: Warning labels 1
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Fig. 17: Warning labels 2
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2.1.8
Unit association - labeling

Label the supplied stickers with a permanent marker as shown in Figure:
( Fig. 18 Page 24). All combinable C-arm units must be listed on the Variostar. The
combinable Variostar must be labeled on the C-arm unit. Affix Label 1 (Figure:
( 1/Fig. 18 Page 24)) to the Variostar (Figure: ( 1/Fig. 19 Page 25)). Affix Label 2
(Figure: ( Fig. 19 Page 25)) to the C-arm unit at one of the indicated areas (Figure:
( 2/Fig. 19 Page 25)) in such a way that no manufacturer's information is covered up.
Cover both labels with adhesive transparent film (included in delivery).
Fig. 18: Label__1
(1)
(2)
(3)
(4)
(5)
MODULARIS Variostar
Variostar_serial_number
Manufacturer and type, C-arm unit
C-arm_unit_serial_number
C-arm_unit_serial_number
Variostar_serial_number
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Installation 2
Fig. 19: Label 2
2.1.9
C-arm unit isocenter cross

Fig. 20: Cross
Fig. 21: I.I. 1
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Fig. 22: I.I. 2
Fig. 23: Image_intensifier_Universal_crosshairs
Installing the isocenter cross on the SIREMOBIL Compact

n
Remove the front screw on the I.I. and replace it with the M4 x 16 screw included in
the shipment ( 1/Fig. 23 Page 26).
The crosshairs must be positioned in the center of the mounting ring. Check this with
a tape measure and correct it if necessary.
Snap the isocenter cross onto the I.I.
Affix the arrows (Figure: ( Fig. 21 Page 25)). Note the centering bolts.
Place the supplied "serial number" labels on the isocenter cross ( 1/Fig. 23 Page 26)
and the I.I.
( 2/Fig. 23 Page 26).
Replace the I.I ring if necessary; see following instructions.
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Installation 2
2.1.10
Installing the isocenter cross on the C-Arm
Fig. 24: Installation, isocenter cross_01
2.1.10.1
Installing the grid ring

In order to be able to attach the centering cross, it is necessary to replace the existing grid
ring.
n
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Remove grid ( 1/Fig. 24 Page 27) and grid ring ( 2/Fig. 24 Page 27) after removing
the attachment screws ( 3/Fig. 24 Page 27).
Mount the grid in the new grid ring. Note the position of the grid's plastic covers
( 1/Fig. 26 Page 27). Use the existing fasteners ( 2/Fig. 26 Page 27) to secure the
grid.
With the Modularis, the switch located in the grid ring need not be connected.
Set the grid ring on the I.I. and secure it using the screws ( 1/Fig. 25 Page 27) inclu
ded with delivery.
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2.1.11
External isocenter cross manufacturer

Depending on the I.I. diameter, select one of the three delivered crosshairs and attach the
corresponding retaining brackets.
2.1.12
Install the movable bracket ( 3/Fig. 23 Page 26) in the crosshair extension.
Install the two fixed brackets accordingly ( 4/Fig. 23 Page 26).
Set the crosshair unit in place and center it using a ruler.
Tighten the adjustment screws ( 5/Fig. 23 Page 26).
Attach the C-arm unit and the Litho module.
Swing up the focus phantom on the shock wave head.
Affix the arrows ( 6/Fig. 23 Page 26) to the I.I.
Radiation release option

The radiation release option of the Variostar operating panel is released only for Siremo
bil Compact L and ARCADIS Varic / Orbic.
This option is performed according to the instructions SPR2-130.814.05... "Installation In
structions for LITHOSTAR Modularis Variostar". A paper version of this document is part of
conversion kit number 71 40 952 .
2.1.13
2.1.13.1
MODULARIS Uro Table

Installing the positioning yoke
n
The positioning yoke is packed separately in the shipment (part no. 81 25 333).
Attach the yoke to the table with the two screws as shown in
(( 1/Fig. 27 Page 29)). The attachment blocks must be selected according to the
height of the docking bridge.
The positioning yoke must be adjusted so that its height corresponds to that of the
docking bridge (( 1/Fig. 28 Page 29)). Adjustment can be performed by turning the
two rubber stoppers (( 2/Fig. 28 Page 29)).
The rubber stoppers must be secured by the screw (( 1/Fig. 29 Page 30)).
No mechanical connection is created when operating the system for therapeutic pur
poses. The C-arm is simply docked in the yoke.
In the table park position, the yoke must be collapsed to the table base.
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Fig. 27: Positioning_yoke_1
Fig. 28: Positioning_yoke_2
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Fig. 29: Securing screw
Fig. 30: Positioning yoke
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Installation 2
2.1.14
2.1.14.1
ECG triggering option (VARIOSTAR 101 42 974)

Mounting the docking station
n
Unscrew the rectangular plate ( 1/Fig. 31 Page 31) from the docking station of the
ECG monitor. It is no longer required. The screws will be used to secure the support
arm.
Unscrew the two covers.
Remove the cover from the system trolley.
Attach the power supply unit and the power supply cable of the ECG monitor in the
system trolley to the support, using cable ties. Insert the non-heating apparatus plug
in the power supply ( Fig. 34 Page 32).
Push the 24 V cable of the power unit through the column from below and route it in
the same way as the trigger cable (using a pull wire if necessary).
Route both cables so that a length of approx. 35 cm is available outside the column.
Screw the plate firmly onto the column so that the cables emerge - as shown in .
Fig. 31: Docking station ECG 1
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Fig. 33: ECG monitor installation 1
Fig. 34: Installing the ECG power supply
ECG Infinity Gamma set, part no.: 1158158

n
Install the ECG monitor (including the interface card) and the mounting plate, in ac
cordance with the ECG monitor instructions included with delivery.
Push the monitor into the holder, as shown in the illustration: ( Fig. 33 Page 32).
Optional external ECG monitor (10142927)

n
Set up the monitor in the location desired by the customer.
Connect the power supply.
Connect the ECG signal cable at the rear of the monitor.

Connect the other end of the ECG signal cable to the ECG monitor; see:
( 1/Fig. 33 Page 32).
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Installation 2
Fig. 35: ECG monitor installation 2
The Monitor setup menu is described in the monitor instructions.
Select "Auto adjustment".
Compare the ECG monitor input signal to the signal information at the external ECG
monitor.
Activate ECG triggering.
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2 Installation
7. Service tab card: System setup
Handheld remote control displays
Fig. 36: System setup
Display
item
Description
ECG triggering Enable/disable ECG triggering for

option
shock wave release.
Fmax
Maximum shock frequency, for ex

ample:
US = 120
Europe = 240
Start potenti
ometer cali
bration (but
ton)
Starts the calibration procedure for

the "US probe holder" potentiome
ter.
Potentiometer Possible statuses:

calibration
- Not calibrated
- calibrated
Procedure: refer to chapter on US
calibration.
Potentiometer Shows the potentiometer calibra
calibration val tion value in mV.
ue
1: see
( 1/Fig. 36
Page 34)
Delete the "patient ID" in the Vario

star.
2: see
( 2/Fig. 36
Page 34)
SW update
Insert the SP card with the new soft
ware.
Select the "disk" symbol and follow
the instructions.
3: see
( 3/Fig. 36
Page 34)
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Select the language.

English, German, French, or Span
ish
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Startup 3
3.1 Operating elements

The hand-held remote control is divided into three areas:
Fig. 37: Hand-held remote control
(1) Display for menu guidance

(2) Individual keys for menu control of radiation and shock wave release
(3) Membrane keys for setting the therapy parameters and controlling the patient table and X-ray C-arm
3.1.1
Location
Menu guidance in the display is implemented with tab cards whose arrangement and
content are based on the typical procedure of urological treatment.
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Fig. 38: Display
(1)
(2)
(3)
(4)
3.1.2
Info line: display of shock wave parameters

Tab card tabs
Display of the set parameters or setting of different parameters
Dynamic menu function: refer to individual keys, reset, patient position
Individual keys
The keys under the display are for releasing radiation and shock waves as well as for se
lecting menus in the display.
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Startup 3
Fig. 39: Individual keys
(1)
(2)
(3)
(4)
(5)
Dynamic menu key; current key assignment is shown on the display

Menu navigation keys (up/down arrow keys) and parameter input keys (left, right arrow keys)
Confirmation key for executing the selected menu entry
Key for releasing shock waves
Key for radiation release (digital radiography); only available with a Siemens C-arm (ARCADIS Varic, ARCADIS
Orbic/3D, SIREMOBIL Compact L, SIREMOBIL Iso-C3D)
(6) Key for releasing radiation (fluoroscopy)
3.1.3
Membrane keys
Pre-programmed functions for stone localization and treatment are assigned to mem
brane keys.
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Fig. 40: Membrane keys
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
MODULARIS Variostar
Increase coupling pressure

Decrease coupling pressure
Increase the shock wave energy
Decrease the shock wave energy
Raise the patient table
Move the patient table in direction: (a) head-end, (b) left patient side, (c) foot-end, (d) right patient side Note:
The patient position must be selected correctly
Move the patient table to the basic ESWL position
Lower the patient table
Increase the shock wave frequency
Decrease the shock wave frequency
Storage of the currently displayed fluoroscopic image (Last Image Hold)
Change the patient position. "Patient in right head position" or "Patient in left head position"
Angulate the X-ray C-arm 20
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Startup 3
3.2 C-arm unit and monitor trolley

Use the documentation of the system type for the start-up.
P
If it is a "non-Siemens system", the following points must be fulfilled:

n
Perfect functioning must have already been ensured by the responsible start-up engi
neer.
The release from the planning guide must be available from Siemens project manage
ment. Implementation of the combination by the documentation with the dimension
protocol from planning guide SPL1-130.891.01...
NOTICE
Liability for the complete therapy system.
If no documents covering the above points are available, the combination

with MODULARIS Variostar may not be implemented!
With the SIREMOBIL Compact and ARCADIS Varic, radiation can be triggered from the litho
module control panel. Use instructions SPR2-130.814.05... and tool kit 7140952 (depend
ing on the SIREMOBIL serial number) for this purpose. With non-Siemens C-arms, radia
tion cannot be released from the litho module.
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40
3.3 MODULARIS Variostar

3.3.1
Checking the Line Voltage
Measure the line voltage at the power outlet.

Compare the measured line voltage to the value in the test protocol. The voltage can
be changed. The jumpers are located on the transformer in the MODULARIS Variostar.
Fig. 41: Air bleeder valve
Fig. 42: Cooling unit
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Startup 3
3.3.2
Filling the cooling circuit and coupling circuit

n
Remove the front cover from the system trolley and then open the right cover panel
door (magnetic holder).
The cooling unit can be pulled partially out of the trolley for better access, after the 4
hex screws on the side have been removed.
(wrench size 10).
Check the bleeder valve at the back, and if closed, open (cap) in the cooling unit with
one turn ( 1/Fig. 41 Page 40) (the valve must remain open at all times).
Open the Velcro strap, remove the water reservoir tank, and fill it with approximately
10 liters of clean water.
Reinstall the water reservoir tank.
Set service switch S2 on board D3 to position 1 (normal operation, service off).
Set the shockwave head (50) to the undertable position, see ( Fig. 43 Page 41).
Switch on the system.
The coupling circuit and cooling circuit are filled automatically in sequence (cooling
circuit pump M1 runs the appropriate period of time, V188 on board D3 illuminates).
Filling the unit without creating bubbles takes approximately 5 minutes. During filling,
check the coupling bellows for bubbles. If necessary, remove the bubbles by pressing
on the coupling bellows. If necessary, start the rinsing cycle again.
Once the system is filled completely, check the fill level of the water reservoir. If it is
not filled to the 10 liter mark, add water until it is.
Finally, check the system for any leaks and reinstall the covers.
Fig. 43: Shock_wave_head_50_degree_undertable_position
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3.3.3
3.3.3.1
Connecting modules
Setting up the patient table
Adhere to the MODULARIS Uro operator manual and the safety information contained
therein (Safety register).
Positioning the patient table

n
Move the patient table to the desired position in the treatment room.
Lock all brakes.
Connect the patient table to the line voltage and switch it on.
The MODULARIS Uro patient table and its hand-held remote control are ready for
operation.
Preparing coupling
Before coupling the X-ray C-arm, the patient table must be moved sideways via the MOD
ULARIS Uro hand-held remote control.
MODULARIS Uro hand-held remote control:
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Startup 3
Fig. 44: MODULARIS Uro hand-held remote con
trol
(1)
Moves the patient table longitudinal

ly in headward
direction, footward direction
(2)
Moves the patient table laterally

toward the table cutout, away from
the table cutout
(3)
Raises the patient table, lowers

the patient table
(4)
Tilts the patient table

to reverse Trendelenberg position, to
Trendelenberg position
(5)
(6)
Moves patient table to upper or low

er
basic position
Select/deselect lithotripsy (when
selected, the corresponding LED illu
minates)
Coupling position
Fig. 45: Coupling position
Move the patient table sideways, away from the table cutout.
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The C-arm can be moved in more easily in this position.
Remove the table cutout.
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n
3.3.4
Fold the adjusting device forward.
Connecting the X-ray C-arm

The docking tunnel for connecting the MODULARIS Variostar must be installed on the
cross-arm base of the X-ray C-arm according to the installation instructions.
3.3.4.1
Observe the instructions in the operator manual of the X-ray C-arm and the safety infor
mation contained therein.
Installing the crosshair disk
Depending on the X-ray C-arm system being used, different crosshair disks for the image
intensifier are used.
CAUTION
The crosshair disk could fall.
Risk of injury!
After assembly, ensure that it is secure.
Siemens C-arm (7" and 9" I.I.s)

For Siemens X-ray C-arm systems, the appropriate crosshair disks for the specific C-arm
type must be used.
In the case of LithoShare, only the crosshair disk assigned to the X-ray C-arm in use may
be installed. The serial numbers on the labels on the image intensifier and on the cross
hair disk must match.
With the Lithoreport option (ARCADIS Varic, ARCADIS Orbic) no crosshair disk is installed
because the crosshair is displayed digitally via the imaging system.
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Startup 3
Fig. 46: Crosshair disk
Align the triangular marker of the crosshair disk with the one on the image intensifier.
Attach the crosshair disk to the image intensifier.
The spring clips of the crosshair disk must snap audibly into the recess in the image
intensifier when pressed.
Ensure that the crosshair disk is securely in place.
Third party C-arm

For X-ray C-arm systems from third-party manufacturers, the universal crosshair disk must
be used.
Fig. 47: Flexible mounting
(1) Rigid fastening hooks

(2) Flexible spring clip with triangular marker
n
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Align the triangular marker on the spring clip of the crosshair disk with the one on the
image intensifier.
Attach the crosshair disk to the image intensifier with the rigid hooks.
Press the spring clip back against the resistance until the crosshair lies fully on the im
age intensifier and then carefully release the spring clip.
Ensure that the crosshair disk is securely in place.
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3 Startup
3.3.4.2
Preparing the X-ray C-arm

The X-ray C-arm is moved to the patient table and started up but is not yet connected.
n
Move the X-ray C-arm to the patient table.
Position it at approx. 90 with respect to the longitudinal axis of the patient table.
Lock the foot brakes of the X-ray C-arm.
Switching on
n
Connect the X-ray C-arm to the power supply plug of the monitor trolley.
Connect the monitor trolley to the line voltage.
Switch the X-ray C-arm system on.
Positioning the C-arm

Fig. 48: Positioning the C-arm
Move the swivel, angulation, and orbital position of the X-ray C-arm to the 0 posi
tion. Lock the brakes again.
When using SIREMOBIL Iso-C, SIREMOBIL Iso-C3D, or ARCADIS Orbic/3D, the triangu
lar marker of the C-arm guide must match the triangular marker on the C-arm ex
actly.
Move fully in the horizontal travel direction and lock the brake.
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Startup 3
3.3.4.3
Connecting the X-ray C-arm
CAUTION
Insufficient alignment of the C-arm or coupling of a C-arm with an insufficient Cshape (third-party manufacturer).
Damage to the support arm and the C-arm caused by collision!
Be particularly careful when using C-arms from other manufacturers.

Align the C-arm very carefully.
Fig. 49: Coupling the C-arm
Release the foot brakes and move the X-ray C-arm to the adjusting device of the pa
tient table.
Pay attention to exact positioning of the C-arm in relation to the adjusting device. Unfav
orable positioning of the C-arm system and table reduces the safety distances during
lithotripsy operation and can require additional radiation exposure during X-ray localiza
tion operations. The coupling procedure may have to be repeated.
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Fig. 50: Coupling tunnel
Move the X-ray C-arm and cross-arm to the end stop in the docking tunnel. Use the
adjusting device for fine positioning.
Pay attention to the C-arm height during insertion into the docking tunnel.
Under certain circumstances, it is necessary to raise the ends of the adjusting device so
that they meet the intended position of the docking tunnel.
n
3.3.5
Lock the brakes on the X-ray C-arm.
Connecting MODULARIS Variostar

Adhere to the detailed description of the subsequently used device functions in ESWL
Therapy Unit.
3.3.5.1
Preparing MODULARIS Variostar
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Fig. 51: Preparing Variostar
3.3.5.2
Move the support arm and the shock wave head to the basic position for UT with the
shock wave head in the 50 orbital position.
Check for correct locking in the end positions.
Coupling MODULARIS Variostar

n
Move the tabletop away from the C-arm and then to the lowest patient entry position.
This prevents damage to the coupling bellows during the coupling procedure.
Fig. 52: Locking lever
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Open the locking lever of the docking tunnel on the X-ray C-arm by turning it counter
clockwise.
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3 Startup
Fig. 53: Folding out the coupling arm
Open the transparent doors on the front side of the MODULARIS Variostar and fold out
the coupling arm by lifting the lock.
Close the transparent doors.
Fig. 54: Locking in the coupling arm
Use the coupling arm (1) to move the MODULARIS Variostar to the end stop in the
docking tunnel (2) of the X-ray C-arm.
The coupling arm must lock perceptibly into place.
Ensure that the shock wave head does not collide with the tabletop and that the support
arm does not collide with the C-arm.
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Startup 3
Fig. 55: Locking
Close the locking lever of the docking tunnel by turning it clockwise.
This locks the coupling between the X-ray C-arm and MODULARIS Variostar.
Check the coupling by pulling on the MODULARIS Variostar.
The coupling arm must not move in the docking tunnel.

The connection procedure may need to be repeated.
Fig. 56: Checks
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n
Lock the locking brake on the MODULARIS Variostar by stepping on the pedal.
3.3.5.3
Press the pedal until the end position is reached (locks in place).
The feet of the device box extend.
Establishing the cable connections

The cable connection between the coupled modules is necessary to allow shared control
by the MODULARIS Variostar hand-held remote control.
When using X-ray C-arms from other manufacturers, MODULARIS Variostar cannot be
connected to the X-ray C-arm. As a result, X-ray images cannot be generated or stored
via the handheld remote control. For this purpose, use the control of the respective Xray C-arm.
Patient table
Fig. 57: Cable connection 1
Coil the cable with the plug marked in gray in the cable compartment of the MODULA
RIS Variostar.
Run the cable through the cable gap and out of the cable compartment.
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Startup 3
Plug the cable into the base of the patient table.
During lithotripsy operation, this connection allows table movement via the handheld remote control of the MODULARIS Variostar.
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n
Run the cable with the plug marked in yellow through the cable gap and out of the
cable compartment of the MODULARIS Variostar.
Connect the cable to the front of the Siemens X-ray C-arm.
3.3.5.4
This connection facilitates the generation and storage of X-ray images via the MOD
ULARIS Variostar handheld remote control.
Additionally, for ARCADIS Varic and SIREMOBIL Compact L, connect the cable marked
in blue for the C-arm angulation motor drive (if present).
Switching On MODULARIS Variostar
CAUTION
Control of the X-ray C-arm and the patient table is activated via the MODULARIS
Variostar hand-held remote control.
Unintentional radiation release, C-arm angulation, or table movement possible!
Make sure that the keys of the hand-held remote control are not pressed inad
vertently.
Switch on the MODULARIS Variostar and the other components.

- The coupled modules are now ready for operation.
3.3.6
Checking/correcting the focus position

The connected modules, X-ray C-arm, and MODULARIS Variostar must be adjusted with
respect to one another. For this purpose, the X-ray central beam must run in the 0 and
oblique projection of the X-ray C-arm through the focus phantom.
Display on the monitor
The metal ball located in the focus phantom is displayed as a dark circle on the live moni
tor. The correct focus position is assessed with respect to its position relative to the cross
hair.
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Fig. 60: Focus position
(1) Correct setting: circle is centered in crosshair

(2) Tolerance range: circle touches the imaginary extension of the horizontal and vertical crosshair bars
(3) Correction required
3.3.6.1
Preparing the focus phantom

Fig. 61: Preparing the focus phantom
3.3.6.2
Move the support arm and the shock wave head to the basic position for UT with the
shock wave head in the 50 orbital position.
Press the two sliders on the side of the focus phantom in the direction of the arrow
and fold the focus phantom bracket up.
Allow the focus phantom bracket to snap audibly into place and ensure that it is se
cure.
Performing check/adjustment
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Fig. 62: Check adjustment 1
Make sure that the orbital movement of the X-ray C-arm is locked in the 0 position.
Move the X-ray C-arm at an angle to the 0 position

(vertical position) and release fluoroscopy.
The focus phantom (1) and the crosshair appear

on the fluoroscopic image.
X axis (horizontal swivel)
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Adjust the X axis of the system under fluoroscopic

control by swiveling the X-ray C-arm about its vertical
axis of rotation.
In the fluoroscopic image, the focus phantom (1)

must lie on the X line of the crosshair or in its ex
tension.
Lock the horizontal swivel movement direction in

this position.
Y axis (horizontal travel)

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Adjust the Y axis of the system under fluoroscopic

control by moving the X-ray C-arm along the horizon
tal longitudinal axis of the unit.

must lie in the crosshairs.
Lock the horizontal travel direction in this position.
Z axis (vertical travel)

Angulate the X-ray C-arm by at least 15 from its ver

tical position and release fluoroscopy.
MODULARIS Variostar
In the event of an incorrect adjustment of the Z ax

is, the focus phantom (1) is shifted by the oblique
projection along the Y line of the crosshair.
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Adjust the Z axis of the system under fluoroscopic

control by raising/lowering the X-ray C-arm along the
horizontal vertical axis of the unit.

must lie in the crosshairs.
Lock the vertical travel direction in this position.
Completing the check/adjustment
CAUTION
Move the X-ray C-arm out of the adjustment position.
Patient subjected to unnecessary shock wave application due to an incorrect fo
cus position!
Check the locking of the following movement directions:

- Orbital movement (locking in 0 position)
- Horizontal swivel
- Horizontal travel
- Vertical lift
During lithotripsy treatment, the only allowable movement of the X-ray C-arm
is angular.
Focus phantom
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Press the two sliders on the side of the focus phantom in the direction of the arrow
and fold the focus phantom bracket back into the locking position.
X-ray C-arm
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Move the X-ray C-arm at an angle in

to the 0 position (vertical position).
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3.3.7
3.3.8
Checking the isocenter with X-ray

If all the work steps described up to this point for non-Siemens C-arms have been suc
cessfully completed, please fill out the fax for release of operation and send it (release
for operation, initial start-up, SPL1-130.815.01...). Release can then be available by the
time of handover to customer.
This individual release is always required, regardless of the C-arm manufacturer (includ
ing Siemens units).
Shockwave release
n
3.3.9
Pump water into the coupling bellows.

Apply some coupling gel to the coupling bellows to protect them (the coupling gel
will prevent the coupling bellows from being significantly damaged when shock
waves are triggered without a patient).
Increase the shock wave energy in steps from the lowest energy level to the highest
energy level and release additional shock waves at every energy level.
Triggering shock waves with ECG (optional)

n
Attach the ECG monitor to the docking station in accordance with the operating in
structions.
Connect the power and signal cables to the back of the ECG monitor.
Connect the ECG electrodes to a test subject or connect the ECG simulator to the
the ECG device.
Select ECG triggering on the MODULARIS Variostar control panel.
Spread some coupling gel on the coupling bellows to protect it.
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Increase the shock wave energy in steps from the lowest energy level to the highest
energy level and release additional shock waves at every energy level.
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3.4 MODULARIS Uro (table)
If the Uro table was not included in the delivery volume of the Variostar, the old table
must be installed - for the second table position - in accordance with the following in
structions; refer to the chapter "Retrofitting MODULARIS Uro (old table)".
The following documents are required to start up the MODULARIS Uro:
Start up the table according to the instructions SPL1-130.814.05.01...
NOTICE
The table may only be moved using the motor if it is in the working position.
This means that the foot lever is in the "braked" position (see the MODULARIS
Uro operating instructions).
Connect the cables between the MODULARIS Variostar and MODULARIS Uro.
Move the table into Litho mode and check the table movements with the MODULARIS
Variostar control panel. The following motorized movements are possible from the
MODULARIS Variostar control panel:
Table movement in the Litho mode (green LED on the table control panel goes on)
e.g. key for longitudinal movement pressed.
Table movement approx. 2-3 mm - stops for approx. 2-3 seconds - and then con
tinues movement without pausing.
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3.5 Ultrasound localization (101 42 909), optional

Fig. 76: SONOLINE G20
3.5.1
SONOLINE G20
n
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Attach the connector adapter ( 1/Fig. 76 Page 63) to the serial interface (RS 232) and
secure the screws.
Install software version V1.0.302 or higher in the SONOLINE G20 (see the SONOLINE
G20 operating instructions, chapter 4).
Enable ultrasound localization (refer to the Chapter "Ultrasound localization").
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3.5.2
Ultrasound localization retrofit
Fig. 77: Deinstalling the cover
Fig. 78: US case
Fig. 79: US installation plate
3.5.2.1
Routing the US interface cables

With the US localization option, the interface cable for the US unit from the ultrasound
localization kit (part no. 10142909) must also be inserted into the right-hand cable feedthrough.
Free cable length, measured from the cable feed-through to the end of the plug
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n
Interface cable for the US unit (optional) 2850mm +5mm

Route the US interface cable through the device box; see ( Fig. 80 Page 65) and
( Fig. 81 Page 65).
Make sure the cable feed-throughs fit securely around the cables.
Fig. 80: Cable feed-through 1
Fig. 81: Cable feed-through 2
Connect the US interface cable according to the instructions on the label.
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Fig. 82: Installing the shock wave head
Remove the two cover panels ( 1/Fig. 77 Page 64).

Remove the two installation plates ( 1/Fig. 78 Page 64) with the centering sleeves
( 2/Fig. 78 Page 64) from the US case.
Insert 2 centering sleeves in each of the installation plates ( 1/Fig. 79 Page 64).
Then, attach the installation plates to the shock wave head with the screws provided
( 3/Fig. 82 Page 66).
The screws( 2/Fig. 82 Page 66) must not becovered up!
The following section outlines the work steps for the old D3, serial number < 3000.
Fig. 83: Electronics unit D3 D4
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Fig. 84: Controller 2
Remove the controller cover ( 1/Fig. 83 Page 66).
The retaining pins are already mounted on the board (AS 03).
Plug the additional MUP D3 board from the conversion kit into position
( 1/Fig. 84 Page 67) and screw it in place.
Reattach the controller cover ( 1/Fig. 83 Page 66).
The following section outlines the work steps for the US connection of the new D3 board
(10142950), serial number 3000 and higher.
After the US localization option is installed, no further configuration is necessary. When
communication is taking place between the US unit and the Variostar, the "US" field in the
tableside control unit is active.
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Fig. 85: D3 board, new
Fig. 86: D3 connections
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Fig. 87: D3 connections_2
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Fig. 88: D3_Layout
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3.5.2.2
Adhesive labels for ultrasound unit

Fig. 89: Adhesive label
3.5.2.3
Attach the "MODULARIS Litho" label (included with shipment) to the monitor of the
ultrasound unit ( 1/Fig. 89 Page 71) (this label is used to identify which ultrasound
unit is functioning with the MODULARIS Variostar).
Adjustment and start-up

n
Switch the system on.

Connect the US probe holder, with the cable provided, to the connector on the Vario
star support arm, and slide forward to the end stop.
Set the S2 switch on the D3 board to "Service".
Adjust the potentiometer in the ultrasound mount.

To do so, open Service > System Setup menu on the handheld remote control.
3.5.2.4
Select the Calibrate menu and confirm with the OK key (center navigation key).
After you follow the instructions on the tableside control unit field, the calibration is
complete.
Check the US isocenter as described in this document in the Start-up chapter.
LithoShare with several ultrasound units

Perform for each ultrasound unit.
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SONOLINE G20
Fig. 90: SONOLINE G20
Screw the connector adapter ( 1/Fig. 90 Page 72) to the serial interface.
Install software version V1.0.302 or higher in the SONOLINE G20 (see the SONOLINE
G20 operating instructions, chapter 4).
Enable ultrasound localization (Chapter: Selecting the MODULARIS cross on the SO
NOLINE G20" in this document).
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3.5.3
3.5.3.1
Selecting the MODULARIS cross on the SONOLINE G20

Ultrasound localization
Fig. 91: G20 cross_01
For ultrasound localization, a mount for an ultrasound probe is installed on the shock
wave head.
Only the following probes can be used:

C5-2 Convex Array 3.5 MHz
n
Press the "F6" key.
Select MUP with the track ball.
Press the
Enter the password.
Use the track ball to select "Litho Mode no X-ray".
Select "save" via the track ball.
Press the
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key.
key.
Deselect the screensaver on the SONOLINE G20 (see the SONOLINE G20 operating
instructions).
A cross is displayed when a probe is selected.
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3.5.4
3.5.4.1
Isocenter with ultrasound

Preparations
Fig. 92: View of unit
Fig. 93: Applicator_1
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Only approved probes may be used for the corresponding SONOLINE. When installing
the probe in the holder, tighten the screws equally (see figure). The holder and probe
may not be offset.
n
Install the mount ( 1/Fig. 92 Page 74) (see also operating instructions).
Insert an ultrasound probe (array probe) ( 2/Fig. 93 Page 74) into the mount
( 3/Fig. 92 Page 74). Carefully lay the cable for the probe in the long slot
( 4/Fig. 92 Page 74) and carefully secure it.
Plug in the cable ( 2/Fig. 92 Page 74) and connect the probe to the ultrasound unit.
Establish the line connection (marked orange) between the MODULARIS Variostar and
the ultrasound unit.
Checking the target on the SONOLINE G20

Fig. 94: Target_Test_1
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Fig. 95: Target_Test_2
The button designations can vary depending on the language version.

See the SONOLINE operating instructions for a comparison table.
Set the value ( 1/Fig. 95 Page 76) to 180 with the "image field/zoom" knob.
Slide the ultrasound probe all the way forward to the shock wave head.
Press the "Measurement" key and select the "Set" measurement marker.
Use the track ball to move to the center of the crosshair. A value of 13 mm 1 mm
( 2/Fig. 94 Page 75) must appear in the display ( 2/Fig. 94 Page 75) .
Press the "Measurement" key ("Freeze" is deselected).
Move the ultrasound probe all the way in the other direction (acoustic signal).
Use the trackball to position the crosshairs on the upper cross, click the "Measure
ment" button and select the "Set" measurement marker.
Press the "Measurement" key and select the "Set" measurement marker.
Use the track ball to move to the center of the crosshair. A value of 151 mm 1 mm
must appear in the display ( 2/Fig. 95 Page 76).
If this is not the case, the adjustment procedure must be repeated for the potentiome
ter in the ultrasound arm or the ultrasound arm must be replaced.
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Fig. 96: Phantom 2
Fig. 97: Water bubble
Checking image tilt
The isocenter (spherical echo) must be checked with every probe type and every time a
probe is replaced.
n
Check whether the isocenter phantom ( 1/Fig. 96 Page 77) is filled with water. If not,
remove the screw ( 2/Fig. 96 Page 77) and fill in water with a syringe
( 3/Fig. 96 Page 77). There may not be any air bubbles. Screw in the screw again.
Lift up the isocenter phantom.
Fill the water bladder with water (about 60 ml ) ( 1/Fig. 97 Page 77):
1.
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Fill a syringe with distilled water. Remove any air that may be trapped in the sy
ringe.
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Insert the syringe needle through one of the valves ( 2/Fig. 97 Page 77) and in
ject the contents of the syringe into the water bladder. The valve has a self-closing
membrane.
Repeat the fill operation until the water bladder is completely filled with water.
After filling, there may not be air bubbles in the water bladder. Remove any air
bubbles with the syringe.
Spread contact gel on the isocenter phantom.

Secure the water bladder ( 5/Fig. 92 Page 74) to the isocenter phantom with the
holder ( 6/Fig. 92 Page 74).
Apply coupling gel to the ultrasound probe.
Using the "image field/zoom" knob, set the value to "50" ( Fig. 98 Page 78) - lower
left in the ultrasound image.
Move the probe forward ( 3/Fig. 92 Page 74) until the crosshair is approx. in the cen
ter of the SONOLINE G20 screen.
Fig. 98: Basic settings_
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Fig. 99: Ultrasound arm_
Press the Menu button; the menu appears.
Make the following basic settings at the ultrasound unit:
Value:
Adjust using:
German
5
( Fig. 98
Page 78)
Set track ball to edge FV

(white background),
then actuate
and
English
French
Spanish
Edge
Ct
Contorno
Dyn Rng
DR
Cam Din
set the "Select" value

via the controller.
35 dB
( Fig. 98
Page 78)
Set track ball to DR

DR
(white background),
then actuate
and
set the "Select" value
via the controller.
Each activation of the "Set" key increases the value by +1. The "Select" controller allows
the value to be changed in both directions.
n
Set the slide controls all the way to the left.
Select Zoom.
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3 Startup
Button
Image reverse may not be selected.
The corresponding ultrasound probe is selected during switch-on. If there is a sec

ond ultrasound probe, select the probe with the
key.
Check whether the ultrasound arm is positioned as shown in ( Fig. 92 Page 74). If
not, position it accordingly. The long slot must be visible ( 1/Fig. 99 Page 79).
Checking the distance: Height

Fig. 100: Distance_height
But
ton
key twice ("+1" cross is not necessary for this measurement).
Using the track ball, move the measurement crosshair to the middle of the spherical
echo. If necessary, reduce the brightness with the 2 D-knobs until the spherical echo
pos. 1./( Fig. 100 Page 80) is clearly visible.
Button
key.
Use the track ball to move the "+2" cross along the longitudinal (vertical) axis to the
center of the the target cross.
Press
the
MODULARIS Variostar
key.
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The value displayed for "D2" must be between 1 and 5 mm. This is only valid for the
default values, see instructions SPL1-130.038.01... .
Press
the
key.
Checking the distance: lateral

n
Press
the
key twice ("+1" cross is not necessary for this measurement).
Using the track ball move the "+2" cross onto the center of the spherical echo.
Press
the
key.
Using the track ball move the cross into the center of the target cross.
Button
key.
If the horizontal deviation is greater than 0.5 mm from the center:

Make a note of the value of D2 (with mathematical sign):
If the display of the ball appears to the left of the target cross, the correction value
must have a negative sign (to the right it must have a plus sign). Adjustments are
made with corrections.
Adjustment and correction
Press the F6 key.
Use the track ball to select MUP.
Press the Set
Enter the password.
Select OK via the track ball.
Press the "Set" key.
Use the track ball to select the value during image inclination and increase it with
the "Set" key.
key.
German:
Bildneigung Array
French:
Basculement d'image sondes conv.
English:
Image tilt array
Spanish:
Inclinar imagen transductor curvo
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-
Set half the value of D2.

Example : D2 = -1.2 mm Enter: -06.
Example : D2 = +1.2 mm Enter: +06.
Press
Save Button.
Check the deviation; if white area is not in the center of the isocenter, repeat the
procedure.
Also check the central position of the spherical echo to the target cross
with the probe turned 90.

If the tolerance is not maintained, check the screw connections between the shock wave
head and US holder and probe and the probe sleeve. If the holder is damaged it must be
replaced. The focus phantom must also be checked and replaced if damaged.
n
After the adjustment check the US arm at the second installation position of the
shock wave head. ( 7/Fig. 92 Page 74) . For each probe, check whether the adjust
ment in this position is also OK. Do not make any change to the image tilt adjust
ment.
Following the check, store the parts in the appropriate transport cases.
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Startup 3
3.6 MUT MODULARIS

The endoscopy trolley will be started up by the corresponding supplier.
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3.7 Final Work Steps

See the chapter ( Final Work Steps / Page 87).
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Retrofitting MODULARIS Uro (old table) 4
4.1 Retrofitting MODULARIS Uro (old table)
The retrofit must be performed if a MODULARIS Variostar is to be used with an existing

Modularis Uro table (serial number < 1358). In this case, a new table control, material
number 5666099, must be installed.
The retrofit enables a second, lower table position, which is required for the application
"Variostar in overtable position".
If the MODULARIS Uro is included in the delivery volume of the Variostar, this work has
already been performed at the factory.
4.1.1
Scope of the retrofit

Replacing the electronics box ( 1/Fig. 101 Page 86)
NOTICE
Electrical voltage!
Disconnect the MODULARIS Uro from line voltage prior to working on the ta
ble.
4.1.2
Replacing the electronics box

NOTICE
Risk of injury!
2 people are required to turn over the table.
Use a wooden block or cloth to prevent the table from scratching.
Remove the table extensions.
Remove the cover.
If possible, move the table into Litho position and transversely, so that the accessory
rail will be on the floor when the table is turned over.
Turn the table over.
Disconnect the cable connector from the electronics box.
Remove the electronics box ( 1/Fig. 101 Page 86).
Install the new electronics box.
Connect the cable connector to the new electronics box ( 2/Fig. 101 Page 86).
Reinstall all covers.
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4 Retrofitting MODULARIS Uro (old table)

Fig. 101: Electronics box
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Final Work Steps 5
5.1 Customer and country-specific settings

5.1.1
Setting the system clock (if necessary)

n
Switch MODULARIS Variostar ON.
Set the service switch in M13/D3/S2 to position 2 (service on).
Select "service" on the control panel and then "set clock".
Select the corresponding item and change the setting.
Set the service switch in M13/D3/S2 to position 1 (service off).
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5 Final Work Steps
5.2 Backup and error memory

n
When the start-up is complete, perform a backup and then erase the error memory
(e:show error log) (see Service Instructions).
Delete the therapy data (t:show therapy data).
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Final Work Steps 5
5.3 Remaining work

n
Connect and secure the protective conductors to all the covers.
Measure the protective conductor resistance.
Measurement
device:
Ground wire meter
Measured value: max. 0.2 ohms
(Ensure compliance with country-specific

regulations.)
(Current 10 A, voltage drop max. 2 V)
Measurement
procedure:
Measure between all conductive parts of the system that can be

touched and the ground wire bus rail in the generator.
Conditions:
Ground wire resistance max. 0.2 Ohm
Reduce the contact resistance (e.g. tighten the screws)
If necessary, increase the diameter of the protective conductor.
Cleaning the MODULARIS Variostar:

For information on cleaning the system, refer to the chapter on "Cleaning/Disinfect
ing" in the operating instructions.
The manufacturer of this product requires information and the legislature demands
proofs that a product delivered free of defects from the factory continues to possess
the required and certified quality properties on installation and start-up. It is therefore
absolutely necessary that the installation report with the installation and start-up data
is sent without delay after completion of the work to the address stated on the instal
lation report. The report is available in the system binder.
File the fax for the release for operation in the system binder. If the C-arm unit is not
from Siemens, include the dimension protocol from the PG.
NOTICE
Fill out the protocols.
After completing all adjustments and measurements, the responsible service
engineer should confirm that all the values have been correctly measured and
recorded in the measurement protocols by signing his name and the date
(system, generator and IQ measurement protocol).
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90
6 Changes to previous version
New warning label, chapter "Installation"

New D3 in chapter "Startup"
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List of Hazard IDs 7

There are no Hazard IDs in this document.
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- Restricted - All documents may

only be used by authorized person
nel for rendering services on Sie
mens Healthcare Products. Any
document in electronic form may
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Print No.: SPL1-130.814.20.03.02 | Replaces: SPL1-130.814.20.02.02

Doc. Gen. Date: 02.08 | Language: English
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MODULARIS Installation and Start Up

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MODULARIS Variostar

Installation and Startup

Answers for life.

Document Version / Disclaimer / Copyright

Notes and symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Retrofitting MODULARIS Uro (old table)

3.3.9 Triggering shock waves with ECG (optional) . . . . . . . . . . . . . . . .

Retrofitting MODULARIS Uro (old table) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Final Work Steps

Customer and country-specific settings . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Changes to previous version

List of Hazard IDs

1.1 Notes and symbols

Bei einer unmittelbar drohenden Gefahr, die bei Nichtvermeidung

Indicates when there is an immediate danger that leads to death

Indicates a risk of danger that may lead to death or serious physi

Bei einer Gefahr, die bei Nichtvermeidung zu einer leichten oder

Bei einer Gefahr, die bei Nichtvermeidung zu einem uner

Ist als Tipp zu verstehen. Der Anwender muss diese Anweisung

1.2 Safety information

General safety information (in existing documents)

The product-specific safety information in these instructions,

General electrical safety information

If an uninterruptible power supply (UPS) is installed in the system, the voltage

Radiation safety information

Use available radiation protection devices.

Release radiation for as short a time as possible.

1.3 Important Notes Regarding Startup

Applicability and regulations for regional companies

1.4 Overview of MODULARIS Variostar

1.5 Required technical documents

Start-up, release for operation

Troubleshooting Instructions for MODULARIS Variostar SPL1-130.840.20..

**LITHOSTAR MODULARIS Variostar adaptation

MODULARIS Uro Plus operating instructions

MODULARIS Variostar operating instructions

C-arm unit operating instructions

MODULARIS Uro Service Instructions

* Only in combination with a non-Siemens C-arm unit.

1.6 Required Tools and Test Equipment

Standard installation tools

Service PC, refer to intranet, service laptop for CSEs

Internal line resistance meter

Protective conductor testing device

DVM, e.g.. Fluke 187

Bender safety meter

Approx. 10 liters of sterile water

SIREMOBIL and monitor trolley

MODULARIS Uro Plus

Unpacking MODULARIS Variostar

Do not use the phantom as a handle.

Remove the packaging above the unit.

Fig. 4: Transport pallet

Appropriately dispose of the packaging according to the country-specific regulations.

Adapt the power cord to the country-specific requirements, if required. If necessary,

Fig. 6: Docking securing_4

Fig. 8: Docking securing_3

The docking bridge can be positioned horizontally via Allen screws

Move the shock wave head to the UT (undertable) therapy position.

Fig. 9: Docking unit 2

Move Variostar in, to a distance of approx. 20 mm ( 2/Fig. 9 Page 19).

Fig. 11: Lower part_

Fig. 13: Block

Fig. 15: Block_mounted