The colonic FTRD® enables endoscopic full-thickness resection of lesions in the colon and rectum.

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Use of the colonic FTRD®

Instrument for flexible endoscopy, for full-thickness resection and diagnostic tissue acquisition through removal of suitable lesions in the colorectum.

The colonic FTRD®

The colonic FTRD® consists of an applicator cap with a ready-to-use mounted FTRD® clip, integrated HF snare and thread. Included are the thread retriever for easy retrieval of the release thread, the endoscope sleeve with fixation tapes and FTRD® hand wheel.

For application, the applicator cap is mounted on the endoscope with the snare running on the outside of the scope and the sleeve preventing entrapment of any tissue between scope and snare. By turning the hand wheel, the thread is tensioned and the clip released. Using the integrated snare, the target tissue is cut above the clip.

The size of the colonic FTRD® is suitable for endoscopes with a diameter of 11.5 - 13.2 mm and a working channel diameter of at least 3.2 mm.

The colonic FTRD® Set

The colonic FTRD® is delivered as one procedure set and consists of the following products:

  • colonic FTRD®
    - elongated OTSC® System cap (size 14) with preloaded clip and thread
    - FTRD® snare integrated into cap’s distal end
    - FTRD® hand wheel
    - thread retriever
    - endoscope sleeve with fixation tapes
  • FTRD® Marking Probe
  • FTRD® Grasper

Before purchasing and using the FTRD®, participation in a training course is mandatory.

Dimensions and specifications

Cap diameter (outside) [b] 21 mm
Cap diameter (inside) [c] 13 mm
Cap depth 23 mm
Appropriate endoscopes Endoscope diameter: 11.5 - 13.2 mm
Working channel diameter: min. 3.2 mm
Packaging unit 1 piece included in colonic FTRD® Set
Reference number of the colonic FTRD® Set (incl. FTRD® Marking Probe und FTRD® Grasper) 200.70

Important notes

The colonic FTRD® is compatible with all commercially available colonoscopes. All FTRD® products are disposable and designed for single patient use.

Application of the colonic FTRD®

Marking of the lesion with the FTRD® Marking Probe
Insert the endoscope to the resection site and adjust lesion
Grasping and mobilizing the lesion with the FTRD® Grasper (1)
Grasping and mobilizing the lesion with the FTRD® Grasper (2)
Ensure lesion is completely in the cap Fix FTRD® Grasper Apply clip
Resect tissue and retrieve specimen

Example 1*:

Procedural sequence EFTR of a recurrent sessile adenoma (non-lifting sign) in the descending colon

Marking of the lesion (with FTRD® Marking Probe) before mounting the FTRD®
Grasping of the target tissue with the FTRD® Grasper
Retrieval of target tissue into cap and fixation
Confirm that target tissue is completely within the FTRD® cap and release clip by turning the hand wheel
Closure of snare and electrical cut of tissue; retrieval of resected sample and check of resection site

* Source: Prof. K. Caca and Dr. A. Schmidt, Klinikum Ludwigsburg, Dept. of Internal Medicine, Gastroenterology, Hemato-Onkology, Diabetes and Infektious Diseases, Germany

Example 2*:

De novo resection after incomplete polypectomy in the descending colon (early carcinoma)

Status after incomplete polypectomy in the descending colon (early carcinoma)
Tissue marked with FTRD® Marking Probe
Resection site after FTRD® procedure (tissue previously marked with Indian ink)

* Source: Prof. K. Caca and Dr. A. Schmidt, Klinikum Ludwigsburg, Dept. of Internal Medicine, Gastroenterology, Hemato-Onkology, Diabetes and Infektious Diseases, Germany

Example 3*:

Resection of a relapsed adenoma (HGIEN) in the descending colon (non-lifting sign)

Relapsed adenoma in the descending colon, non-lifting sign
FTRD® resection site: all layers of the bowel wall to be identified in cross section
Full-thickness sample, approx. 2.5 cm
Histology: completely resected recurrent adenoma, HGIEN

* Source: Prof. K. Caca and Dr. A. Schmidt, Klinikum Ludwigsburg, Dept. of Internal Medicine, Gastroenterology, Hemato-Onkology, Diabetes and Infektious Diseases, Germany

Lesion with positive lateral lifting sign and central non-lifting part
Injection of solution into submucosal layer in area with positive lateral lifting sign
Resection of lateral parts with snare in piece-meal technique
Switch to FTRD® and grasp remaining non-lifting central part of lesion with FTRD® Grasper
Application of FTRD® Clip and ...
... resection of tissue with integrated snare

Animation of the Hybrid-FTRD® procedure

Example 1*:

Resection of a recurrent sigmoidal adenoma with the Hybrid-FTRD® technique – (Click here to see the corresponding clinical video)

* Source: Prof. K. Caca and Dr. B. Meier, Hospital Ludwigsburg, Germany

Example 2*:

Resection of a large cecal adenoma with the Hybrid-FTRD® technique – (Click here to see the corresponding clinical video)

* Source: Prof. K. Caca and Dr. B. Meier, Hospital Ludwigsburg, Germany

Example 3*:

Resection of an approx. 35 mm large non-lifting adenoma (LST granular type) in the sigmoid colon; Follow-up after 3 months without recurrence

* Source: Dr. M. Bauermeister, Sana Klinikum Lichtenberg Berlin, Germany

Example 4*:

Resection of an approx. 25 mm large non-lifting recurrent adenoma (LST granular type) in the upper rectum

* Source: Dr. M. Bauermeister, Sana Klinikum Lichtenberg Berlin, Germany

Schematic illustration oft he EFTR procedure of a polyp involving the appendiceal orifice.
* Source: Rogier Trompert Medical Art, www.medical-art.nl

The procedure is presented here in animated form

Clinical Example*:

* Source: Bronzwaer M, Bastiaansen B, Koens L et al. Endoscopic full-thickness resection of polyps involving the appendiceal orifice: a prospective observational case study. Endosc Int
Open 2018; 06: E1112–E1119

Clinical Video Example:

Prof. K. Shishin MD, Moscow Clinical Research Center, Russia
Click here to see the clinical video

Dr. B. Bastiaansen, UMC Amsterdam, Netherlands
Click here to see the clinical video

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