Thieme ejournals endoscopy international open full text. Then, suction was applied to pull the mucosal edges into the cap. Fullthickness closure of perforation in the ileum using an ovesco otsc clip. We used a twin grasper ovesco endoscopy gmbh, tuebingen, germany as a grasping device for all the patients. The otsc twin grasper is accessible in flexible shaft length 165 cm and 220 cm. The twin grasper was used in half of the patients, according to the criterion of. Otscs figure 6a and b from ovesco endoscopy tubingen, germany are nitinol. Figure 1 overthescope clip preloaded on the scope with the twingrasper from ovesco. Accessgudid otsc twin grasper 04260206310228 the otsc twin grasper is one of the otsc application aids facilitates the approximation of gaping edges of a lesion before release of the otsc clip two jaws which can be opened separately two grasping forceps in one device working channel diameter of at least 3. After deployment of the otsc, endoscopic fullthickness colon resection was performed above the otsc under radiographic control with a standard hyperthermic snare. In a prospective human study, the clinical success rate on ovesco closure of 30 mm defect was reported as 97%. Ovesco otsc twin grasper functions the otsc twin grasper is one of the otsc application aids and facilitates the approximation of gaping edges. A 9 mm otsc was chosen for use in the esophagus and colon, and a 10 mm device was used for the stomach, duodenum and rectum. When the twin grasper was used it was inserted into the second.
Ovesco otsc over thescope clip clip from synmed for more information visit. Ovesco otsc twin grasper functions the otsc twin grasper is one of the otsc application aids and facilitates the approximation of gaping edges of a lesion before release of the otsc clip. The perforation is approximated by means of the otsc twin grasper before the clip is deployed. Endoscopic closure of duodenal perforations by using an. These videos show the components that make up the synmed supplied otsc system from ovesco. To achieve definite closure, the edges of the fistula were approximated with a twin grasper otsc twin grasper. Higham a 2015 failed endoscopic overthescope clip repair following iatrogenic colon perforation during screening colonoscopy clin case rep rev, 2015 doi. The ulcer is sucked into the cap with a loaded ovesco. Endoscopic doublegrasping forceps twingrasper could not grasp the tissue because the ulcerated area. This device is very useful to approximate, align, and center the defect edges into the otsc closure for acute perforations.
We used the atraumatic 12mm otsc 12a and the short teeth 12mm otsc 12t. Colic and gastric overthescope clip ovesco for the. Endoscopic doublegrasping forceps twin grasper could not grasp the tissue because the ulcerated area. The lesion is kept in the center of the cap and the cap is perpendicular to the wall. The otsc anchor can be used for better approximation of tissue especially when indurated e. Ftrd with a grasping forceps otsc twin grasper, ovesco and by suction. Synmed products, therapeutic, the otsc proctology brush.
Ovesco frtd system ftrd system for endoscopic fullthickness resection eftr of lesions in the colon and rectum. Download video 124mb treatment of lowergi postsurgical fistulas with the overthescope clip. In addition, an ongoing effort was made to aspirate i. Successful closure of a colon perforation via the overthescopeclip. A twin grasper with two branches which can be opening fig. Management of an ileum perforation using ovesco otsc system. Ovesco miscellaneous esutures the suture superstore. Endoscopic resection of a diverticulumarisen colonic. The otsc twin grasper is one of the otsc application aids and facilitates the approximation of gaping edges of a lesion before release of the. Then we debrided the fistula orifice with argon plasma coagulation and placed a bigger otsc clip otsc 14 t for colonoscopes using a simple olympus colonoscope, thus closing the inner ostium. We decided to close the ulcer using the overthescopeclip otsc system ovesco endoscopy ag, tubingen, germany, as regular clipping was not possible.
Multipurpose use of the overthescopeclip system bear claw in the gastrointestinal tract. Ovesco endoscopy ag, tubingen, germany figure figure5. Olympus endoscope, tokyo, japan any endoscope would be suitable as well. Endoscopic closure of gastrointestinal perforations and fistulas. The ovesco twin grasper has 2 jaws that move separately to approximate the defect edges in the applicator cap before applying suction and then deploying the clip.
Ovesco otsc overthescope clip twin grasper from synmed for more information visit. Both sides of the inner ostium were grabbed with the ovesco twin grasper. Ovesco otsc twin grasper for perforation closure youtube. Otsc closure of ileum perforation with twin grasper youtube. After advancement of the endoscope into the stomach and identification of the perforation, the twin grasper ovesco endoscopy ag was introduced through the working channel of the endoscope and was carefully advanced toward the perforated side. Peg closure in the second attempt home thieme connect. The ovesco endoscopy ag is a medical device company operating in the fields of flexible endoscopy and endoluminal surgery. A twin grasper is used if the tissue is soft but the leak is wide. Novel overthescopeclip system for gastrotomy closure in.
The ftrd grasper is used during endoscopic fullthickness resection with the ftrd. The overthescope clip device was directed towards the perforation, the clip was released, and the wound was closed successfully. The otsc twin grasper is available in flexible shaft length 165 cm and 220 cm. It facilitates both optimal grip on the target tissue and easy retrieval of the sample into the applicator cap of the ftrd.
The otsc system represents a new class of endoscopic clips providing significantly more strength and better tissue capture compared to conventional clips delivered through the working channel of the flexible endoscope. Description of a new, endoscopic technique to remove the. The overall success rate and complications were evaluated, with a particular emphasis on patients who had. The ovesco clip was used for closure in 14 patients ranging in age from 2190. Synmed products, diagnostic, the ftrd system from ovesco for. The ovesco twin grasper has two jaws that move separately to approximate the edges of the duodenotomy into the cap before applying suction and then deploying the clip fig. Endoscopic management of leaks and fistula in gastrointestinal. If not contraindicated, the traumatic version of the clip with sharp spikes is used. Treatment of lowergi postsurgical fistulas with the over. Twin grasper also utilized to approximate edges of the defect and close entirely using only one clip. Efficacy of the ovesco clip for closure of endoscope. Endoscopic doublegrasping forceps twin grasper could not grasp the tissue because the ulcerated area was too inflamed and friable. Successful closure of the perforation could be accomplished with an otsc system and the otsc twin grasper. Peg closure in the second attempt pubmed central pmc.
The otsc overthescope clip system from ovesco youtube. The otsc overthescope clip system from ovesco the otsc overthescope clip system from ovesco represents a new class of endoscopic clips for the treatment of gastrointestinal hemorrhage and. Synmed, supplies the otsc proctology system from ovesco. The stentfix otsc applicator cap is suitable for endoscope diameters of 8. The ftrd grasper are grasping forceps specially developed for the ftrd. Ovesco system for treatment of postpolypectomy bleeding. The otsc twin grasper is one of the otsc application aids and facilitates the approximation of gaping edges of a lesion before release of the otsc clip. Both sides of the inner ostium were grabbed with the ovesco twin grasper and the tissue was then pulled into the cap. The mean time to close the duodenotomy was defined as the time from insertion of the twin grasper into the working channel to final withdrawal of the instrument. The company develops, manufactures and markets innovative products for the treatment of gastrointestinal disease. Pdf multipurpose use of the overthescopeclip system. Application of endoclips and an endoloop closure technique to achieve hemostasis. Failed endoscopic overthescope clip repair following. We are a liquidator of sutures and other surgical items from ethicon, covidien autosuture, synthes, stryker, arthrex and are able to pass our savings on to you.
Endoscopic closure of gi fistulae by using an overthe. Accessories like anchor and twin grasper, which can pull the defective mucosa. Our study demonstrates that all perforations with the size range from 10 to 15 mm can be successfully closed by one ovesco clip, and only the 40 mm perforation failed to be closed by one ovesco clip. Set up of the system and use of the tissue application devices the twin grasper and anchor. Endoscopic closure of gastrointestinal perforations and. One hundred and one overthescopeclip applications for severe. This auxiliary device has two jaws which can be opened separately, allowing better gaping edges approximation.