Treatment of lowergi postsurgical fistulas with the over. Ovesco otsc over thescope clip clip from synmed for more information visit. Both sides of the inner ostium were grabbed with the ovesco twin grasper and the tissue was then pulled into the cap. Synmed, supplies the otsc proctology system from ovesco.
The otsc overthescope clip system from ovesco youtube. Download video 124mb treatment of lowergi postsurgical fistulas with the overthescope clip. Figure 1 overthescope clip preloaded on the scope with the twingrasper from ovesco. When the twin grasper was used it was inserted into the second. The twin grasper was used in half of the patients, according to the criterion of. Higham a 2015 failed endoscopic overthescope clip repair following iatrogenic colon perforation during screening colonoscopy clin case rep rev, 2015 doi. The company develops, manufactures and markets innovative products for the treatment of gastrointestinal disease. Olympus endoscope, tokyo, japan any endoscope would be suitable as well. Ovesco otsc twin grasper for perforation closure youtube. The stentfix otsc applicator cap is suitable for endoscope diameters of 8.
Description of a new, endoscopic technique to remove the. 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 ulcer is sucked into the cap with a loaded ovesco. The otsc twin grasper is accessible in flexible shaft length 165 cm and 220 cm. To achieve definite closure, the edges of the fistula were approximated with a twin grasper otsc twin grasper. Endoscopic closure of duodenal perforations by using an. Endoscopic closure of gi fistulae by using an overthe. In addition, an ongoing effort was made to aspirate i. The otsc twin grasper is available in flexible shaft length 165 cm and 220 cm. Otscs figure 6a and b from ovesco endoscopy tubingen, germany are nitinol. 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.
The ftrd grasper is used during endoscopic fullthickness resection with the ftrd. Thieme ejournals endoscopy international open full text. If not contraindicated, the traumatic version of the clip with sharp spikes is used. These videos show the components that make up the synmed supplied otsc system from ovesco. Ovesco system for treatment of postpolypectomy bleeding. The lesion is kept in the center of the cap and the cap is perpendicular to the wall. 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. Endoscopic doublegrasping forceps twin grasper could not grasp the tissue because the ulcerated area. The perforation is approximated by means of the otsc twin grasper before the clip is deployed. Synmed products, therapeutic, the otsc proctology brush. 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. We used a twin grasper ovesco endoscopy gmbh, tuebingen, germany as a grasping device for all the patients.
Both sides of the inner ostium were grabbed with the ovesco twin grasper. Then, suction was applied to pull the mucosal edges into the cap. Endoscopic resection of a diverticulumarisen colonic. The otsc anchor can be used for better approximation of tissue especially when indurated e. 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. Otsc closure of ileum perforation with twin grasper youtube. 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.
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 used the atraumatic 12mm otsc 12a and the short teeth 12mm otsc 12t. Set up of the system and use of the tissue application devices the twin grasper and anchor. A twin grasper with two branches which can be opening fig. Ftrd with a grasping forceps otsc twin grasper, ovesco and by suction. Endoscopic management of leaks and fistula in gastrointestinal.
Ovesco otsc overthescope clip twin grasper from synmed for more information visit. 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. Ovesco miscellaneous esutures the suture superstore. Peg closure in the second attempt pubmed central pmc. Management of an ileum perforation using ovesco otsc system. The ovesco clip was used for closure in 14 patients ranging in age from 2190. Accessories like anchor and twin grasper, which can pull the defective mucosa. The overall success rate and complications were evaluated, with a particular emphasis on patients who had. Fullthickness closure of perforation in the ileum using an ovesco otsc clip. Endoscopic closure of gastrointestinal perforations and fistulas. 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.
Ovesco endoscopy ag, tubingen, germany figure figure5. Endoscopic doublegrasping forceps twingrasper could not grasp the tissue because the ulcerated area. The ovesco endoscopy ag is a medical device company operating in the fields of flexible endoscopy and endoluminal surgery. Synmed products, diagnostic, the ftrd system from ovesco for. One hundred and one overthescopeclip applications for severe. This auxiliary device has two jaws which can be opened separately, allowing better gaping edges approximation. The overthescope clip device was directed towards the perforation, the clip was released, and the wound was closed successfully.
Multipurpose use of the overthescopeclip system bear claw in the gastrointestinal tract. Colic and gastric overthescope clip ovesco for the. Successful closure of a colon perforation via the overthescopeclip. The ftrd grasper are grasping forceps specially developed for the ftrd. 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. Pdf multipurpose use of the overthescopeclip system. Twin grasper also utilized to approximate edges of the defect and close entirely using only one clip. 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. The full wall specimen was retrieved and then processed by our inhouse pathology department. Application of endoclips and an endoloop closure technique to achieve hemostasis. A twin grasper is used if the tissue is soft but the leak is wide. 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. After deployment of the otsc, endoscopic fullthickness colon resection was performed above the otsc under radiographic control with a standard hyperthermic snare.
This device is very useful to approximate, align, and center the defect edges into the otsc closure for acute perforations. Novel overthescopeclip system for gastrotomy closure in. Endoscopic doublegrasping forceps twin grasper could not grasp the tissue because the ulcerated area was too inflamed and friable. Endoscopic closure of gastrointestinal perforations and. Peg closure in the second attempt home thieme connect.
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. 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. We decided to close the ulcer using the overthescopeclip otsc system ovesco endoscopy ag, tubingen, germany, as regular clipping was not possible. The twingrasper is generally used when the defect assumed a roundshape and only aspiration was used when ovalshape. Successful closure of the perforation could be accomplished with an otsc system and the otsc twin grasper. In a prospective human study, the clinical success rate on ovesco closure of 30 mm defect was reported as 97%. Management of perforation in sigmoid using ovesco otsc system. It facilitates both optimal grip on the target tissue and easy retrieval of the sample into the applicator cap of the ftrd. Failed endoscopic overthescope clip repair following. Ovesco otsc twin grasper functions the otsc twin grasper is one of the otsc application aids and facilitates the approximation of gaping edges. Efficacy of the ovesco clip for closure of endoscope.
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