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LigaSure Atlas LS1020: How This Vessel Sealer Transforms Surgical Efficiency

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Surgeons and perioperative leaders are under constant pressure to shorten operative time, reduce blood loss, and safely handle more complex cases without increasing staff workload. The LigaSure Atlas LS1020 vessel sealing device sits at the center of this challenge, providing an advanced bipolar energy platform that can streamline workflows in open and laparoscopic surgery while maintaining reliable hemostasis and reproducible outcomes.

What Is the LigaSure Atlas LS1020 Vessel Sealer?

The LigaSure Atlas LS1020 is a bipolar vessel sealer and divider with a 20 cm shaft designed primarily for open procedures, often referred to as the LigaSure Atlas 20 cm tissue fusion open instrument. It features a blunt tip, straight jaws, and an integrated cutting mechanism that allows surgeons to seal and divide tissue bundles and vessels in a single step. With a seal length of about 22 mm and cut length of around 20 mm, the LS1020 is optimized to handle vessels up to 7 mm while limiting thermal spread and collateral tissue damage. This combination of tissue fusion and cutting in one device is the foundation of its impact on surgical efficiency and operating room throughput.

Core LigaSure Technology and Its Effect on Workflow

LigaSure technology uses controlled bipolar energy and real‑time feedback to fuse vessel walls and collagen, creating permanent seals with burst pressures comparable to or stronger than conventional ligation. Instead of multiple individual steps—clamping, tying sutures, cutting, and ensuring hemostasis—the LigaSure Atlas LS1020 condenses the process into one activation and one cut. This closed‑loop energy control automatically adjusts output to tissue impedance, so the device delivers only as much energy as needed to achieve a consistent seal. By minimizing guesswork and reducing the number of applications per pedicle, surgeons can move through crucial stages such as vascular control, lymphadenectomy, or adhesiolysis faster and with less instrument clutter.

Design Features of the LigaSure Atlas LS1020 That Improve Surgical Efficiency

Several specific design elements of the LigaSure Atlas LS1020 directly support surgical speed and ergonomics. The 20 cm shaft gives surgeons reach for open abdominal, pelvic, and thoracic procedures while maintaining a comfortable working distance from the field. A shaft rotation capability approaching 359 degrees allows precise jaw positioning without constant hand repositioning, which can be especially helpful in deep or narrow fields. The blunt, straight jaws with bilateral sealing surfaces provide a secure grasp on vessels and tissue bundles, reducing the risk of slippage during activation. Integrated hand switching or trigger handle control lets the surgeon activate energy without relying on a foot pedal, freeing attention and improving posture at the table. These design choices collectively reduce unnecessary motion and micro‑delays that can accumulate into significant time savings over the course of a case or a day’s schedule.

How LigaSure Atlas LS1020 Reduces Instrument Exchanges

One of the most tangible ways the LigaSure Atlas LS1020 improves surgical efficiency is by reducing instrument exchanges. Traditional techniques often require separate instruments for dissecting, grasping, sealing, clipping, cutting, and cauterizing. With LigaSure vessel sealing, the same instrument can dissect, seal, and divide, allowing surgeons to progress through steps such as mesenteric division, omental resection, or hilar control in a more continuous flow. Fewer exchanges mean less time passing instruments back and forth, fewer breaks in concentration, and reduced opportunities for contamination or dropped instruments. For scrub nurses and surgical technologists, this simplification translates to easier tray management, fewer instruments to track, and smoother coordination across different surgical specialties using the LigaSure platform.

Impact on Hemostasis, Blood Loss, and Visualization

Surgical efficiency is not only about speed but also about the quality of the field. LigaSure Atlas LS1020 excels at providing dry, bloodless planes that improve visualization for the entire team. By sealing vessels up to 7 mm with high burst pressure and minimal thermal spread, the device helps prevent persistent oozing and repeated attempts at coagulation. Strong, uniform seals lower the likelihood of intraoperative bleeding that requires additional sutures, clips, or time‑consuming hemostatic maneuvers. Better visualization allows surgeons to dissect faster, identify anatomy more clearly, and complete complex steps with fewer pauses. An organized, bloodless field also reduces stress on the assistant and scrub nurse, who can focus on anticipating needs rather than constantly suctioning and managing unexpected bleeding.

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Quantifying Time Savings and Operating Room Throughput

Studies of LigaSure vessel sealing systems in general have demonstrated that replacing conventional clamp‑and‑tie techniques can significantly increase the number of seals performed per minute and reduce overall operative times. In bowel surgery and other major procedures, the use of advanced vessel sealing has translated into measurable reductions in operative duration, often by 10–20 minutes per case or more, depending on the extent of dissection. The LigaSure Atlas LS1020 leverages the same underlying technology, so institutions commonly observe shorter setup times for vessel ligation phases, less time spent on hemostasis troubleshooting, and smoother transitions between critical steps. Over a full day of operations, these savings can allow an extra case to be scheduled, reduce overtime, and improve on‑time case starts, all without compromising safety.

How LigaSure Atlas LS1020 Enhances Surgeon Ergonomics and Fatigue Management

Surgeon fatigue is a hidden but powerful factor in surgical efficiency and complication rates. The LigaSure Atlas LS1020, with its ergonomic handle and hand‑switching controls, is designed to reduce repetitive strain and awkward wrist positions during long cases. The ability to grasp, seal, and cut with a single instrument decreases the number of grip changes and forceful maneuvers needed to control tough vascular pedicles or scarred tissue. Less physical stress translates to more precise, consistent movements throughout the case, even toward the end of a long day. Over time, improved ergonomics can contribute to fewer musculoskeletal complaints, greater job satisfaction, and more consistent performance across the entire surgical team.

Integration with LigaSure Generators and Energy Platforms

The LigaSure Atlas LS1020 is designed to integrate with dedicated LigaSure vessel sealing generators and multi‑modality energy platforms, such as the ForceTriad energy platform and other compatible systems. This interoperability allows anesthesiology and nursing staff to standardize energy devices across operating rooms, simplifying setup, cable management, and troubleshooting. Using one generator for multiple LigaSure handpieces streamlines inventory, reduces training complexity, and ensures that surgeons can switch between instruments, such as LigaSure small jaw or laparoscopic LigaSure Atlas variants, with minimal downtime. Standardized generator interfaces and presets also help maintain consistent tissue effects across procedures and providers.

Open Versus Laparoscopic Use of the LigaSure Atlas Platform

While the LS1020 LigaSure Atlas is optimized as a 20 cm open instrument, the same design principles extend to laparoscopic LigaSure Atlas models with longer shafts. Surgical services that employ both open and minimally invasive approaches can benefit from a unified vessel sealing strategy across modalities. In open colorectal surgery, for example, the LS1020 can accelerate mesenteric division during an extended resection, while in laparoscopic hysterectomy or cholecystectomy, a longer LigaSure Atlas laparoscopic instrument can provide the same sealing performance through trocars. Maintaining a consistent energy platform and similar jaw design across open and laparoscopic instruments simplifies training and allows surgeons to adapt quickly when cases convert from minimally invasive to open or vice versa.

Safety Profile and Thermal Spread Considerations

Any energy device used for vessel sealing must balance speed and hemostasis with safety, particularly related to thermal spread and collateral tissue injury. LigaSure technology is engineered to limit lateral thermal spread and to deliver energy only until the tissue reaches its optimal sealing endpoint. The LigaSure Atlas LS1020 uses real‑time impedance monitoring to terminate energy when collagen and elastin are adequately fused. This helps protect adjacent structures such as nerves, ducts, and bowel loops when operating in tight spaces. A predictable safety profile reduces the need for cautious, incremental energy applications and allows surgeons to work at a steady pace with confidence in seal integrity.

Real‑World Clinical Applications Where LigaSure Atlas LS1020 Improves Efficiency

The LigaSure Atlas LS1020 is used across a wide range of surgical procedures where efficient hemostasis and tissue division are critical. In colorectal surgery, it can speed up mesenteric division, mobilization, and vessel ligation while maintaining control over bleeding. In gynecologic oncology, it can streamline lymph node dissection and uterine or adnexal vessel control, especially in complex pelvic dissections. In general surgery, the device is helpful for omentectomy, adhesiolysis, and management of vascular pedicles during gastrectomy or pancreatectomy. In bariatric surgery, LigaSure Atlas LS1020 can help in dividing short gastric vessels and omentum efficiently, reducing operative times in sleeve gastrectomy or gastric bypass. Each of these use cases benefits from fewer instrument changes, more reliable hemostasis, and faster progress through critical steps.

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Real User Cases and ROI: Time, Costs, and Outcomes

Hospitals that adopt LigaSure Atlas LS1020 commonly track metrics such as operative time, transfusion rates, length of stay, and readmissions to evaluate return on investment. When surgeons replace clamp‑and‑tie or clips with LigaSure vessel sealing, the per‑case cost of disposable handpieces can be offset by shorter procedures, lower anesthesia times, fewer complications, and improved operating room scheduling efficiency. For example, a modest reduction in operative time of 15 minutes per case across high‑volume procedures can add up to dozens of hours per month, enabling more surgeries to be performed with the same staffing levels. Additionally, lower blood loss and fewer postoperative complications can contribute to shorter hospital stays and better patient satisfaction, further improving financial and clinical ROI.

Role of the Scrub Nurse and OR Team in Maximizing Efficiency with LigaSure Atlas LS1020

The full efficiency benefit of LigaSure Atlas LS1020 is realized when the entire operating room team understands how to set up, handle, and troubleshoot the device. Scrub nurses can prepare and test the LigaSure handpiece and generator parameters before incision, ensuring that activation is ready as soon as the surgeon needs it. Circulating nurses and surgical technologists can standardize their workflows and checklists around LigaSure systems, minimizing delays associated with missing accessories or incorrect settings. By integrating the device into preference cards and team briefings, OR leaders can eliminate variability and build predictable workflows that take advantage of rapid vessel sealing and reduced instrument complexity.

Market Trends: Energy‑Based Vessel Sealing and Surgical Efficiency

Globally, the shift toward energy‑based vessel sealing devices continues to accelerate as hospitals seek technologies that boost throughput and support minimally invasive surgery. Market reports on advanced bipolar and ultrasonic devices note consistent growth driven by rising procedure volumes, aging populations, and pressure to lower complication rates. LigaSure systems, including the LigaSure Atlas LS1020, are widely adopted in general surgery, gynecology, urology, bariatric surgery, and thoracic surgery, signaling a strong preference for platforms that combine sealing strength with minimal thermal spread. As reimbursement models increasingly emphasize value and outcomes, devices that demonstrably reduce operative time and complications are becoming central to perioperative strategy and capital purchasing decisions.

At one point in this evolving landscape, ALLWILL is redefining B2B medical aesthetics by focusing on innovation, trust, and efficiency, and their model highlights how data‑driven vendor management and refurbishment can lower total cost of ownership. By connecting practitioners with vetted technicians and optimizing inventory and trade‑up programs, ALLWILL demonstrates how thoughtful equipment lifecycle management can mirror the same efficiency gains that devices like LigaSure Atlas LS1020 bring into the operating room.

Top LigaSure Atlas LS1020 and Related Vessel Sealing Products

Product Name Key Advantages Ratings (Clinical/Usability) Typical Use Cases
LigaSure Atlas LS1020 20 cm Open Instrument Blunt tip vessel sealer and divider, 20 cm shaft, strong seals up to 7 mm, hand‑switching control High clinical reliability, high ease of use Open general surgery, colorectal, gynecologic oncology, bariatric, hepatobiliary
Laparoscopic LigaSure Atlas 37 cm Longer shaft for minimally invasive access, similar sealing performance, compatible with LigaSure generators High laparoscopic ergonomics, strong seals Laparoscopic hysterectomy, cholecystectomy, bariatric surgery, colorectal laparoscopy
LigaSure Small Jaw Open Instrument Smaller curved jaw for precise dissection in confined spaces, strong hemostasis High precision, excellent in tight anatomy Thyroidectomy, head and neck surgery, limited access open procedures
LigaSure Impact Instrument Larger jaw and longer shaft suited for bariatric and open abdominal procedures High efficiency in large tissue bundles Abdominoplasty, large bowel resections, omentectomy, massive‑weight‑loss surgery
LigaSure Maryland Jaw Laparoscopic Maryland‑style dissector tip with integrated sealing and cutting Combines fine dissection with sealing Advanced laparoscopic dissections around critical vasculature and ducts

Competitor Comparison Matrix: LigaSure Atlas LS1020 vs Other Vessel Sealing Solutions

Feature LigaSure Atlas LS1020 Typical Ultrasonic Shears Conventional Clamp‑and‑Tie Clip Appliers
Vessel sealing capability Seals vessels up to 7 mm with bipolar tissue fusion Effective on smaller vessels and tissue bundles, may require additional clips for larger vessels No intrinsic sealing, relies on sutures Closes vessels with mechanical clips only
Thermal spread Limited, controlled by real‑time feedback Can vary depending on power and technique Minimal from energy, but tissue manipulation trauma can be higher Minimal thermal spread, but no energy sealing
Steps per vessel Grasp, seal, cut in one instrument Often dissect, coagulate, cut, sometimes add clips Clamp, tie, cut, verify hemostasis Place clip, cut, verify hemostasis
Instrument exchanges Reduced due to multifunctional design Moderately reduced versus clamp‑and‑tie High, requires multiple tools Moderate, still needs scissors or scalpel
Operative time impact Frequently shortens operative time in major procedures Improves time vs traditional methods, especially in minimally invasive surgery Often longest due to multiple steps Intermediate, can be slower than advanced energy
Learning curve Moderate, with intuitive jaw design and generator presets Moderate, requires understanding of tissue effects and activation Long but familiar to most surgeons Short for clip placement but can be technique‑sensitive
Cost profile Higher per case device cost, balanced by time and outcome gains Similar or higher per case cost depending on brand and settings Lower disposable cost, higher OR time and potentially higher complication cost Lower device cost, variable efficiency
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Training, Credentialing, and Protocol Development

To fully realize the efficiency benefits of the LigaSure Atlas LS1020, hospitals often implement structured training and credentialing programs. Surgeons may participate in workshops or proctorships that focus on seal quality, activation timing, and appropriate tissue selection for LigaSure vessel sealing. Nursing education covers generator setup, error codes, and safe handling of the handpiece on the sterile field. Institutions that develop clear protocols—such as standardizing LigaSure use in specific steps of colorectal or gynecologic procedures—tend to see faster adoption curves and more consistent time savings across departments. This alignment between clinical leadership, education teams, and supply chain further enhances the overall impact of the device on surgical efficiency.

Future Trends in Vessel Sealing and the Role of LigaSure Atlas LS1020

The future of vessel sealing technology is moving toward smarter, more connected systems that integrate data analytics, real‑time feedback, and possibly robotic platforms. Devices such as LigaSure Atlas LS1020 already embody intelligent energy delivery and tissue response monitoring, and this is likely to expand with more detailed feedback on seal quality and tissue type. As robotic surgery continues to grow, surgeons may expect similar bipolar vessel sealing capabilities through robotic instruments, while open and laparoscopic cases continue to rely on advanced handpieces. Hospitals will increasingly focus on device ecosystems that share generators, interfaces, and training requirements to reduce complexity. In this landscape, proven workhorses like the LigaSure Atlas LS1020, with a strong safety record and broad procedure coverage, will remain central to strategies aimed at improving surgical efficiency, standardizing care, and optimizing operating room resources.

Practical Steps to Leverage LigaSure Atlas LS1020 for Better Efficiency

Surgical services looking to improve operating room efficiency with LigaSure Atlas LS1020 can start by identifying high‑volume procedures where blood loss and vessel ligation consume substantial time. Updating preference cards to include the LS1020 as the default vessel sealer in these cases and tracking operative times before and after adoption can quickly reveal its impact. Involving surgeons, anesthesiologists, and nursing leadership in device evaluation ensures that clinical, ergonomic, and economic factors are all considered. By combining robust training, standard protocols, and thoughtful case selection, hospitals can translate the technological strengths of LigaSure Atlas LS1020 into real‑world gains in speed, safety, and patient outcomes.

Three‑Level Conversion Funnel CTA: Awareness, Evaluation, Action

For teams beginning to explore advanced vessel sealing, the first step is building awareness of how devices like LigaSure Atlas LS1020 affect operative time, blood loss, and workflow compared with historical techniques. Once awareness is established, evaluation should focus on pilot cases, surgeon feedback, and quantitative data on operative metrics to determine whether broader adoption is justified. Finally, when the case for LigaSure Atlas LS1020 is clear, organizations can move to action by standardizing protocols, aligning procurement strategies, and embedding vessel sealing best practices into ongoing training so that every case benefits from the efficiency and reliability the device offers.

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(e) Notice and Inspection. The limited warranties contained in this Section 8 are made on condition that immediate written notice of any noncompliance with the Equipment’s and/or the Service’s warranty be given to MRP, and provided that MRP’s inspection reveals that Buyer’s claim is valid under the terms of such warranty.

        9.  DISCLAIMERS; NO OTHER WARRANTY. EXCEPT TO THE EXTENT AS PROVIDED IN SECTION 8(c)(i)(D), BUYER ACKNOWLEDGES THAT MRP IS NOT BOUND BY ANY WARRANTY THAT MAY BE SET FORTH IN A MANUFACTURER’S WRITTEN MATERIALS THAT WOULD HAVE APPLIED HAD BUYER PURCHASED THE EQUIPMENT DIRECTLY FROM THE MANUFACTURER IN ITS UNUSED STATE. BUYER ACKNOWLEDGES THAT BUYER HAS NOT RELIED UPON ANY WARRANTY OTHER THAN AS SET FORTH IN THIS AGREEMENT. IN ADDITION, BUYER ALSO HEREBY ACKNOWLEDGES AND AGREES THAT ANY ORAL OR WRITTEN STATEMENTS CONCERNING USE AND REGULATION OF MEDICAL DEVICES SOLD BY MRP ARE AND SHALL BE CONSTRUED AS FOR INFORMATIONAL PURPOSES ONLY AND WITHOUT WARRANTY OR ASSURANCE BY MRP AS TO THEIR ACCURACY OR VALIDITY. MRP ALSO HEREBY DISCLAIMS ANY AND ALL WARRANTIES REGARDING OTHER MEDICAL CARE OR HELP, INCLUDING THE SELECTION OF AESTHETIC AND MEDICAL PROCEDURES AND PRODUCTS FOR, OR CARE OF, PATIENTS. THE LIMITED WARRANTIES OF THIS AGREEMENT, IF APPLICABLE TO ANY EQUIPMENT OR SERVICE FURNISHED UNDER THIS AGREEMENT, CONSTITUTE THE ONLY WARRANTIES MADE WITH RESPECT TO THE EQUIPMENT AND/OR SERVICE AND ANY DEFECT, DEFICIENCY OR NONCONFORMITY. TO THE EXTENT PERMITTED BY LAW, SUCH WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES, EXPRESS OR IMPLIED BY LAW, COURSE OF DEALING, COURSE OF PERFORMANCE, USAGE OF TRADE OR OTHERWISE, INCLUDING, BUT NOT LIMITED TO, ANY EXPRESS OR IMPLIED WARRANTY OF MERCHANTABILITY, TITLE, NONINFRINGEMENT OR FITNESS FOR A PARTICULAR PURPOSE.

        10.  LIMITATION OF LIABILITY. NOTWITHSTANDING ANYTHING TO THE CONTRARY IN THIS AGREEMENT, UNDER NO CIRCUMSTANCES SHALL MRP BE LIABLE FOR ANY INDIRECT, PUNITIVE, INCIDENTAL, CONSEQUENTIAL, EXEMPLARY OR SPECIAL DAMAGES, ARISING FROM, RELATED TO OR CAUSED, DIRECTLY OR INDIRECTLY, WHETHER FORESEEABLE OR NOT, BY THE EQUIPMENT AND/OR THE SERVICES, THE USE OR INABILITY TO USE THE EQUIPMENT, THE RESULTS GENERATED FROM THE EQUIPMENT AND/OR THE SERVICES, THIS AGREEMENT, ANY OTHER ACT OR OMISSION OF MRP, OR BASED UPON ANY OTHER LEGAL THEORY. IN NO EVENT SHALL MRP BE LIABLE FOR ANY LOSSES OF REVENUE, USE, BUSINESS OPPORTUNITY, PROFIT, SAVINGS OR ANY OTHER DAMAGES DUE TO ANY CAUSE WHATSOEVER, EVEN IF MRP OR ITS AGENTS HAS BEEN ADVISED OF THE POSSIBILITY THEREOF. THE FOREGOING IS A SEPARATE, ESSENTIAL TERM OF THIS AGREEMENT, AND SHALL BE EFFECTIVE UPON THE FAILURE OF ANY REMEDY, EXCLUSIVE OR NOT. IN NO EVENT WILL MRP’S TOTAL LIABILITY UNDER THIS AGREEMENT EXCEED THE PURCHASE PRICE ACTUALLY PAID TO MRP BY BUYER FOR THE EQUIPMENT AND/OR THE SERVICES GIVING RISE TO THE CLAIM FOR WHICH DAMAGES ARE BEING SOUGHT. NO SUIT OR ACTION MAY BE BROUGHT BY BUYER, ITS SHAREHOLDERS, DIRECTORS, MANAGERS, EMPLOYEES OR AGENTS FOR ANY BREACH OF THIS AGREEMENT MORE THAN ONE (1) YEAR AFTER THE ACCRUAL OF SUCH CAUSE OF ACTION. IT IS AGREED THAT MRP’S LIABILITY IS SO LIMITED. WITHOUT LIMITING THE GENERALITY OF THE FOREGOING, BUYER ASSUMES ALL RISK AND LIABILITY FOR THE RESULTS OBTAINED BY THE USE OF ANY EQUIPMENT IN THE PRACTICE OF ANY PROCESS, WHETHER IN TERMS OF OPERATING COSTS, GENERAL EFFECTIVENESS, SUCCESS OR FAILURE, AND REGARDLESS OF ANY ORAL OR WRITTEN STATEMENTS MADE BY MRP, BY WAY OF TECHNICAL ADVICE OR OTHERWISE, RELATED TO THE USE OF THE EQUIPMENT.

        11.  BUYER’S REPRESENTATIONS AND WARRANTIES. Buyer represents and warrants to MRP that: (a) Buyer is duly organized, validly existing, and in good standing in the jurisdiction of Buyer’s formation; (b) Buyer is duly qualified to do business and is in good standing in every jurisdiction in which such qualification is required; (c) Buyer has the full right, power, and authority to enter into this Agreement and to perform Buyer’s obligations under this Agreement; (d) the execution of this Agreement by the person whose signature is set forth at the end hereof has been duly authorized by all necessary corporate action of Buyer; (e) when executed and delivered by each of MRP and Buyer, this Agreement will constitute the legal, valid and binding obligation of Buyer, enforceable against Buyer in accordance with its terms; (f) Buyer is in compliance with all applicable laws relating to this Agreement, the Equipment and the operation of Buyer’s business; (g) Buyer is not insolvent and is paying all of its debts as they become due; and (h) all financial information that Buyer has provided to MRP is true and accurate and fairly represents Buyer’s financial condition.

        12. PROPRIETARY RIGHTS.

(a) Ownership. No sale shall be construed as granting to Buyer any license or other right in, or to, any of MRP’s (i) patents; (ii) trademarks; (iii) internet domain names, whether or not trademarks, registered by any authorized private registrar or governmental authority, web addresses, web pages, websites and URLs; (iv) works of authorship, expressions, designs and design registrations, whether or not copyrightable, including copyrights and copyrightable works, software and firmware, technical data, data files, and databases and other specifications and documentation; (v) trade secrets; (vi) environmental or other testing applicable to the Equipment and/or the Services; and (vii) industrial and other intellectual property rights, and all rights, interests, and protections that are associated with, equivalent or similar to, or required for the exercise of, any of the foregoing, however arising, in each case whether registered or unregistered and including all registrations and applications for, and renewals or extensions of, such rights or forms of protection pursuant to the laws of any jurisdiction throughout in any part of the world (collectively, the “Intellectual Property Rights”).

(b) Prohibited Acts. Buyer shall not (i) take any action that might interfere with any of MRP’s rights in or to Intellectual Property Rights, including MRP’s ownership or exercise thereof; (ii) challenge any right, title, or interest of MRP in or to the Intellectual Property Rights; (iii) make any claim or take any action adverse to MRP’s ownership of the Intellectual Property Rights; (iv) register or apply for registrations, anywhere in the world, for MRP’s trademarks or any other trademark that is similar to MRP’s trademarks or that incorporates MRP’s trademarks in whole or in confusingly similar part; (v) use any mark, anywhere that is confusingly

similar to MRP’s trademarks in whole or in confusingly similar part; (vi) engage in any action that tends to disparage, dilute the value of or reflect negatively on the Equipment and/or the Services or any of MRP’s trademarks; (vii) misappropriate any of MRP’s trademarks for use as a domain name without prior written consent from MRP; or (viii) alter, obscure or remove any of MRP’s trademarks, or trademark or copyright notices or any other proprietary rights notices placed on the

Equipment, marketing materials or other materials that MRP may provide.

        13.  CONFIDENTIAL INFORMATION. Without the prior written consent of MRP,Buyer, directly or indirectly, shall not disclose (and will direct its directors, shareholders, employees and agents not to disclose) any Confidential Information. The term “Confidential Information” means any information of or relating to MRP or the Equipment and/or the Services not generally known to the public (other than as a result of disclosure in violation of this Agreement) in spoken, printed, electronic or any other form or medium, including, but not limited to, business processes, practices, methods, policies, plans, publications, documents, research, operations, services, strategies, techniques, agreements, contracts, transactions, potential transactions, know-how, trade secrets, databases, manuals, records, supplier information, financial information, accounting information, legal information, marketing information, pricing information, payroll information, personnel information, and supplier lists.

        14.  NON-SOLICITATION. Buyer agrees not to solicit or hire any personnel of MRP involved with the delivery of the Services during the provision of such Services and for twelve (12) months after the completion of such Services; provided, however, that Buyer may hire individuals employed by MRP who, without other solicitation, respond to advertisements or solicitations aimed at the general public.

        15.  EQUITABLE REMEDIES. Buyer acknowledges and agrees that (a) a breach or threatened breach by Buyer of any of its obligations under Sections 13 or 14 would give rise to irreparable harm to MRP for which monetary damages would not be an adequate remedy and (b) in the event of a breach or a threatened breach by Buyer of any such obligations, MRP shall, in addition to any and all other rights and remedies that may be available to MRP at law, at equity, or otherwise in respect of such breach, be entitled to equitable relief, including a temporary restraining order, an injunction, specific performance, and any other relief that may be available from a court of competent jurisdiction, without any requirement to post a bond or other security, and without any requirement to prove actual damages or that monetary damages will not afford an adequate remedy. Buyer agrees that Buyer will not oppose or otherwise challenge the appropriateness of equitable relief or the entry by a court of competent jurisdiction of an order granting equitable relief, in either case, consistent with the terms of this Section 15.

        16.  INDEMNIFICATION. Buyer agrees to indemnify, defend and hold harmless MRP and its directors, shareholders, employees and agents (collectively, “MRP Indemnitees”) against any liability, damage, loss or expense incurred by or imposed in connection with any claims, suits, actions, demands or judgments arising out of (a) any breach or non-fulfillment of any representation, warranty or covenant set forth in this Agreement by Buyer or its directors, managers, employees or agents (collectively, “Buyer’s Agents”); (b) any negligent act or omission or willful misconduct of Buyer or Buyer’s Agents in connection with this Agreement; (c) any bodily injury, death of any person or damage to real or tangible personal property caused by Buyer or Buyer’s Agents, including the use of unauthorized parts in or service of the Equipment; (d) any failure by Buyer or Buyer’s Agents to comply with any applicable laws; (e) any fraud or other intentional acts by Buyer or Buyer’s Agents; and (f) the use or operation of the Equipment, including, without limitation, any medical and/or surgical procedures performed by Buyer, and any of Buyer’s Agents, using the Equipment unless said damages are determined by a court of competence jurisdiction to be solely by the gross negligence of MRP or solely as result of a breach by MRP of the limited warranties contained herein.

        17.  DEFAULTS; REMEDIES. Notwithstanding anything herein to the contrary, should Buyer fail to pay for the order or any other amount, in whole or in part, when due or perform its other obligations under this Agreement or as otherwise mutually agreed in writing between Buyer and MRP (each, a “Default”), then MRP may take any and all actions available under law or equity to collect said amounts with a ten (10) day prior written notice, including, but not limited to, enforcing its security interest, accelerating the payment of and declaring immediately due and payable any unpaid balance of the order, referral to outside collection agencies and/or commencement of legal action. MRP’s rights shall be cumulative, and it shall not be required to have attempted to realize upon to the Equipment before taking any other collection actions. MRP may require that Buyer assemble and return any or all of the Equipment to MRP and, in the event Buyer fails to return such Equipment peaceably, enter upon the premises where such Equipment is located, with or without legal process, and repossess such Equipment. Upon a Default, Buyer agrees to pay upon MRP’s demand: (i) all costs and expenses incurred by MRP or its assignee in connection with the enforcement of any remedies, including all expenses incurred in connection with the return, sale, release or other disposition of the Equipment, including attorneys’ fees and other costs incurred by MRP or its assignee in enforcing or defending its rights and remedies under this Agreement and any other written agreement between Buyer and MRP.

        18.  COMPLIANCE WITH LAWS. Buyer shall (a) carry out the transactions contemplated by this sale and deal with the Equipment in conformity with all applicable laws, rules and regulations of all government authorities, including, without limitation, export laws, (b) obtain all permits and licenses required in connection with the purchase, shipment, installation or use of the Equipment, and (c) be solely responsible to fully understand and comply with laws, rules and regulations. Any information provided is as a convenience only.

        19.  FURTHER ASSURANCES. Upon MRP’s reasonable request, Buyer shall, at its sole cost and expense, execute and deliver all such further documents and instruments, and take all such further acts, necessary to give full effect to this Agreement.

        20.  ASSIGNMENT; SUCCESSORS AND ASSIGNS. Buyer cannot delegate any duties nor assign any rights or claims under this Agreement without MRP’s prior written consent, and any such attempt or assignment shall be void. In the event that Buyer finances its acquisition of any Equipment with a third party, Buyer may direct MRP to transfer title of such Equipment to such third-party financing company, with all remaining terms and conditions of this Agreement remaining in full force and effect. This Agreement is binding on and inures to the benefit of the parties to this Agreement and their respective permitted successors and permitted assigns.

        21.  NO THIRD-PARTY BENEFICIARIES. Subject to Section 16, this Agreement benefits solely the parties to this Agreement and their respective permitted successors and assigns, and nothing in this Agreement, express or implied, confers on any other person any legal or equitable right, benefit, or remedy of any nature whatsoever under or by reason of this Agreement.

        22.  GOVERNING LAW; VENUE. The application of the UN Convention on Contracts for the International Sale of Goods is expressly excluded. The parties agree that any and all claims, demands, disagreements, controversies or disputes arising out of or relating to this Agreement and any agreement or document delivered in connection herewith (collectively, “Claims”) shall be governed by and construed in accordance with the laws of the State of Utah and adjudicated exclusively in the state and federal courts located in or nearest to Summit County, Utah, which courts shall have the sole and exclusive jurisdiction and venue for adjudication of all Claims. The parties hereby agree upon, consent and stipulate to the jurisdiction and venue of the aforementioned courts for the adjudication of all Claims, to the exclusion of all other courts, forums and venues whatsoever.

        23.  NON-DISPARAGEMENT. Buyer shall not disparage MRP or MRP’s trademarks, websites, products or services, or display any such items in a derogatory or negative manner on any website or in any public forum or press release.

        24.  NOTICES. Any notice, demand, or communication required, permitted or desired to be given hereunder shall be deemed effectively given when personally delivered, when sent by electronic means, when received by overnight courier, or when mailed by prepaid, certified or registered mail, return receipt requested, addressed to the other party at its address set forth on the Quote or to such other address that the receiving party may designate from time to time in accordance with this Section 25.

        25.  PUBLIC ANNOUNCEMENTS. Unless otherwise stated herein, neither party shall issue a press release or otherwise advertise, make a public statement or disclose to any third-party information pertaining to the relationship arising under this Agreement, the existence or terms of this Agreement, the underlying transactions between MRP and Buyer or agent for Buyer or refer to the other party in relation to this Agreement without the other party’s prior written approval.

        26.  ENTIRE AGREEMENT; ADDITIONAL OR INCONSISTENT TERMS. Subject to Section 32, this Agreement constitutes the sole and entire agreement between the parties hereto relating to the subject matter hereof, and any unincorporated representation, affirmation of fact, course of prior dealings, promise or condition in connection therewith, or usage of the trade, shall not be binding on either party. Terms and conditions set forth which differ from, conflict with or are not included in this Agreement shall not be part of any agreement between MRP and Buyer unless both parties specifically accept such terms and conditions in writing.

        27.  WAIVER. No waiver under this Agreement is effective unless it is in writing and signed by the party waiving its right. Any waiver authorized on one occasion is effective only in that instance and only for the purpose stated and does not operate as a waiver on any future occasion. None of the following constitutes a waiver or estoppel of any right, remedy, power, privilege or condition arising from this Agreement: any failure or delay in exercising any right, remedy, power or privilege or in enforcing any condition under this Agreement; or any act, omission or course of dealing between the parties.

        28.  SURVIVAL. Subject to the limitations and other provisions of this Agreement, the representations and warranties of Buyer contained herein shall survive the expiration or earlier termination of this Agreement for a period of twelve (12) months after such expiration o termination and (b) this Section 29 and Sections 10, 12, 13, 14, 15, 16, 17, 21, 22, 23, 24, 26, and 32 of this Agreement, as well as any other provision that, in order to give proper effect to its intent, should survive such expiration or termination, shall survive the expiration or earlier termination of this Agreement. All other provisions of this Agreement shall not survive the expiration or earlier termination of this Agreement.

        29.  RELATIONSHIP OF PARTIES. Nothing in this Agreement creates any agency, joint venture, partnership or other form of joint enterprise, employment or fiduciary relationship between the parties. Neither party has any express or implied right or authority to assume or create any obligations on behalf of or in the name of the other party or to bind the other party to any contract, agreement or undertaking with any third party.

        30.  HEADINGS. The headings in this Agreement are for reference only and do not affect the interpretation of this Agreement.

        31.  ORDER OF PRECEDENCE. In the event of conflict between the Quote, a written agreement by MRP, and these Terms, the order of priority shall be: (1) the written

agreement by MRP, if only if executed by an MRP Officer, (2) the Quote and (3) these Terms, and only to the extent of the direct conflict. Notwithstanding the foregoing, MRP shall not be bound by, and specifically objects to, any terms, conditions or other provisions, both written and oral, which are different from, in addition to or inconsistent with the provisions of this Agreement which are set forth in any purchase order, receipt, acceptance, confirmation, correspondence or otherwise of, or by, Buyer. Fulfillment of Buyer’s order shall not constitute acceptance of any of Buyer’s terms and conditions and does not serve to modify or amend the terms and conditions contained herein.

        32.  SEVERABILITY. If any part of this Agreement is held to be void, illegal or unenforceable, then it shall be deemed to be severed from this Agreement and the remaining provisions shall continue in full force and effect; provided, however, that if any fundamental term or provision of this Agreement is held to be void, illegal or unenforceable, the remainder of this Agreement shall be unenforceable. Upon a determination that any term or provision is void, illegal or unenforceable, the parties shall negotiate in good faith to modify this Agreement to effect the original intent of the parties as closely as possible in order that the transactions contemplated hereby be consummated as originally contemplated to the greatest extent possible.