Application aid for easier mobilization of tissue, even in cases of indurated tissue

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Use of the OTSC® Anchor

The OTSC® Anchor improves the mobilization of tissue even in difficult conditions such as indurated tissue (e.g. fistulas, ulcer base). Conventional graspers tend to slip off the tissue; the Nitinol® anchor needles, on the other hand, spread out in the tissue so that it can be grasped more easily. The OTSC® Anchor enables precise alignment between the tissue and the application cap, making it easier to adjust lesions, for example when treating bleeding.

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

Working length
[cm]		 Max. diameter Ø
[mm]		 Needle width
[mm]		 Stitch depth
[mm]		 Ref.No.
OTSC® Anchor 165 2.4 12 4 200.10
OTSC® Anchor 220tt 220 2.4 9 2–2,5 200.11

Anwendung des OTSC® Anchor

In case of fibrotic or hard tissue (e.g. callous ulcers) or tangential application, the OTSC® Anchor can be valuable in precisely aligning the 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.

OTSC®neo is also suitable for closing gastrointestinal fistulas (e.g. anorectal, rectovaginal fistulas). The OTSC® Anchor can be used as an application aid to facilitate mobilization of the fistula orifice into the cap. Freshening/debridement of the tissue at the fistula and in the fistula tract, e.g. with the Fistula Brush or APC, can improve healing after closure with the OTSC®neo clip.

Targeting of the fistula opening and application of the OTSC® Anchor in fistula opening.
Positioning of the cap and light pulling of the tissue.
Mobilization of the tip of the OTSC® Anchor shaft into cap; anchor spikes may remain external.
Clip application and release of the 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

The optimized fistula closure using a mucosal incision can show good treatment results in otherwise refractory fistulas. Preparing the tissue by making a circular incision in the mucosa prior to closure with the OTSC®neo Clip can lead to reduced tissue tension around the fistula opening and more effective tissue compression by the clip. The fistula tract should also be freshened up, e.g. with the Fistula Brush or APC, to improve healing.

Mucosal incision (circular; not too deep, because of perforation risk) around the fistula opening with the AqaNife® (Ø ~ 15 mm)
Targeting of the fistula opening and application of the OTSC® Anchor in fistula opening.
Positioning of the cap and light pulling of the tissue.
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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