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Description
OTSC® application aid for better approximation of tissue especially when indurated.
Use of the OTSC® Anchor
The OTSC® Anchor can be used for better approximation of tissue especially when indurated (e.g. fistulae, chronic ulcer). It also facilitates targeting of lesions, e.g. in the treatment of hemorrhage, the OTSC® Anchor allows precise alignment between the target tissue and the applicator cap.
Dimensions and specifications
The OTSC® Anchor is available in two versions and lengths:
- The OTSC® Anchor has a flexible shaft length of 165 cm
- The OTSC® Anchor 220 tt has a flexible shaft length of 220 cm and is especially for thin tissue
| OTSC® Anchor | OTSC® Anchor 220tt | |
|---|---|---|
 |  | |
| Needle width | 12 mm | 9 mm |
| Stich depth | 4 mm | 2 – 2.5 mm |
| Length | 165 cm | 220 cm |
| Appropriate endoscope | working channel diameter of minimum 2.8 mm to be used alone or 3.2 mm with the OTSC® System Set. | working channel diameter of minimum 2.8 mm to be used alone or 3.2 mm with the OTSC® System Set. |
| Items per package | 1 | 1 |
| Reference number | 200.10 | 200.11 |
Application
Hemostasis with anchor technique
In cases of fibrotic or hard tissue (e.g. callous ulcers) or tangential application, the OTSC® Anchor can be valuable in precisely aligning target tissue with the cap opening and keeping it fixed during clip release. It may not always be possible to manipulate fibrotic tissue fully inside the cap. However, it is sufficient to pull the tissue firmly to the rim of the cap with the OTSC® Anchor, then apply the clip. The clip “jumps” slightly forward upon release and grasps the tissue in front of the cap.
Position the OTSC® Anchor and fix the tissue
Align the OTSC® cap to the lesion by pulling the anchor and advancing the endoscope
Mobilize the tip of the OTSC® Anchor shaft into the cap; anchor spikes may remain external; release the OTSC® clip
After clip application, detach the OTSC® Anchor from the tissue
Fistula closure
Target fistula opening, position the OTSC® Anchor and fix tissue
Align OTSC® cap to the fistula opening by pulling the anchor and advancing endoscope
Mobilize tip of OTSC® Anchor shaft into cap; anchor spikes may remain external
Apply clip; release OTSC® Anchor from tissue
Example*:
Closure of persistent PEG-fistula using the OTSC® Anchor
*Source: Dr. Thomas Kratt, Interventional Endoscopy, Klinik für Allgemeine, Viszeral- und Transplantationschirurgie, University Hospital Tuebingen, Germany
Optimized fistula closure
Mucosal incision (circular; not too deep, because of perforation risk) around the fistula opening with the AqaNife® (Ø ~ 15 mm)
Positioning of the clip in the incision line
Clip application and closure of the fistula
Example*:
Closure of a large esophago-bronchial fistula through mucosal incision prior to OTSC® placement
*Source: Meining A. et al. (2015) Erfolgreicher Verschluss einer großen ösophago-bronchialen Fistel durch mukosale Inzision vor OTSC-Klipp-Platzierung. Endoskopie heute. Doi: 10.1055/s-0035-1545049.
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