The gastroduodenal FTRD® enables endoscopic full-thickness resection in the stomach and duodenum.

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Use of the gastroduodenal FTRD®

A smaller FTRD® System for endoscopic full-thickness or deep wall resection (especially in the stomach) and diagnostic tissue acquisition in the stomach and duodenum.

The gastroduodenal FTRD® can be used for:

  • not pretreated non-lifting adenoma
  • non-lifting recurrent adenoma
  • small subepithelial tumors
  • early carcinoma

The gastroduodenal FTRD®

The gastroduodenal FTRD® consists of an application cap with a ready-to-use mounted FTRD® clip, integrated HF snare and thread, thread retriever, the endoscope sleeve with fixation tapes and FTRD® hand wheel.

For an easier and safer introduction of the system into the upper GI-tract (passage of esophagus and pylorus) the gastroduodenal FTRD® Set is delivered with an insertion balloon and guide wire.

For application, the application 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 gastroduodenal FTRD® is suitable for endoscopes with a diameter of 10.5 – 12.0 mm and a working channel diameter of at least 3.7 mm.

The gastroduodenal FTRD® Set

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

  • gastroduodenal FTRD®
    – gastroduodenal FTRD® cap with preloaded clip and thread
    – snare integrated into cap’s distal end
    – FTRD® hand wheel
    – thread retriever
    – endoscope sleeve with fixation tapes
  • FTRD® Marking Probe
  • FTRD® Grasper
  • insertion balloon
  • guide wire

For a better mobilization of the tissue in case of submucosal findings (especially in the stomach) an Anchor is available as a separate item (not included in the procedure set).

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

Dimensions and specifications

Cap diameter (outside) 19.5 mm
Cap depth 23 mm
Appropriate endoscopes Endoscop diameter: 10.5 – 12.0 mm
Working channel diameter: min. 3.7 mm
Packaging unit 1 piece included in gastroduodenal FTRD® Set
Reference number of gastroduodenal FTRD® Set (incl. FTRD® Grasper, FTRD® Marking Probe, guide wire and insertion balloon) 200.72

Important notes

The gastroduodenal FTRD® can be used with endoscopes with an outer diameter between 10.5 – 12.0 mm and a working channel diameter of at least 3.7 mm. All FTRD® products are disposable and designed for single patient use.

Application of the gastroduodenal FTRD®

For an easier insertion, the use of a bite block (size 20 or larger) is recommended
Step 1: FTRD® cap is positioned in front of the narrow section of the upper esophageal entrance
Step 2: The insertion balloon is inserted using a guide wire and is slid out of the FTRD® application cap up to the marking
Step 3: Insertion balloon is filled with air (approx. 20 ml)
Step 4: gastroduodenal FTRD® is then carefully slid forward until narrow section is passed.
Step 5: After passage of esophagus deflate balloon completely and withdraw into working channel. Proceed accordingly for passage of pylorus.
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
Marking of the lesion with the FTRD® Marking Probe
Insert the endoscope to the resection site and adjust lesion
Position Anchor on lesion (establish contact with tissue) and extend needles
Position Anchor on lesion (establish contact with tissue) and extend needles
Ensure lesion is completely in the cap, fix Anchor, Apply clip
Resect tissue and retrieve specimen

Example *:

EFTR of a GIST in the stomach with the gastroduodenal FTRD®

* Source: Dr. A. Schmidt, Department of Internal Medicine II, Gastroenterology, Hepatology, Endocrinology and Infectiology, University Medical Center Freiburg

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

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