Medical electrical device for fragmentation of OTSC® and FTRD® clips.
Use of the remOVE DC Impulse
The remOVE DC Impulse is a medical electrical device which allows the fragmentation of OTSC® and FTRD® clips in the digestive tract when used in combination with a remOVE DC Cutter Set.
The remOVE DC Impulse
The remOVE DC Impulse generates a bipolar current pulse. This DC pulse is applied onto the OTSC®/FTRD® clip via the DC Cutter instrument resulting in localized melting and cutting of the clip. The clip is grasped with the DC Cutter instrument preferably at the thinnest parts.
The remOVE DC Impulse is designed to ensure that a direct pulse can only be generated when sufficient contact with a segment of the clip is established. Sufficient contact is indicated through an acoustic signal.
Dimensions and specifications
B) Foot-activated switch with connector cable
C) DC cord in order to connect the remOVE DC Cutter
D) Power cord
|Initial charging||ca. 10 min|
|One-time duration of the impulse during activation||max. 65 ms|
|Interval between activations||≥ 6 s|
|Items per package||1|
Application of the remOVE DC Impulse
Installation of the remOVE DC Impulse
- Place the device on a stable surface in sufficient distance to the wall, ensuring that the device can immediately be disconnected from the power supply if necessary.
- Connect the power cord to the remOVE DC Impulse and connect the power cord to the power supply.
- Connect the foot-activated switch and the DC cord to the remOVE DC Impulse.
- Connect the remOVE DC Cutter to the DC cord. In order to connect the remOVE DC Cutter with the DC cord, align the two markings (red and white dot) on both devices in such a way that the white dot on the plug of the remOVE DC Cutter and the red dot on the plug of the DC cord are opposite to each other.
- Activate the remOVE DC Impulse by pressing the ON/OFF switch. The ON/OFF switch lights up to indicate that the device is activated. The status display indicates the charge of the remOVE DC Impulse through green flashing LEDs.
Successful completion of charging cycle is indicated through three short acoustic signals in quick succession. The status display indicates operational readiness through emitting constant green light from all eight LEDs.
As soon as all eight green LEDs are constantly on, the remOVE DC Impulse is ready for use.
Application of the remOVE DC Cutter
Step 1: Introduce the remOVE DC Cutter through working channel and establish contact with the clip. When a continuous acoustic signal occurs, press the foot-activated switch once in order to cut the clip. Repeat the procedure at a point of the clip opposite of the first cut.
Step 2: Make sure by endoscopic visualization that fragmentation of the clip at two spots has been successfully accomplished.
Step 3: Mount the remOVE SecureCap onto the endoscope tip. Use the remOVE Grasper to pull the clip fragments into the remOVE SecureCap and remove it from the patient’s body.
Before application the endoscope has to be protected using the remOVE Shield.
Clip removal with AWC®
Clip removal with DC Cutter and an additional grasper through the AWC®
*Source: Prof. Dr. Marc O. Schurr, Ovesco Endoscopy AG, Tuebingen, Germany [In-vivo model]
Situation after endoscopic full-thickness resection with the FTRD® System in sigma. Clip removal for monitoring.
FTRD® clip in the sigmoid colon
remOVE DC Cutter is positioned at the clip bow
The clip bow is effectively cut
The clip is cut at a point opposite of the first cut
Extraction of a clip fragment by using the remOVE Grasper and the remOVE SecureCap
Extracted clip fragments
*Source: Prof. Dr. K. Caca und Dr. A. Schmidt, Klinikum Ludwigsburg, Dept. of Internal Medicine, Gastroenterology, Hämato-Oncology, Diabetes and Infectous Diseases, Germany