AqaNife

Monopolar electrosurgical instrument for dissection with flushing and reinjection possibility using flexible endoscopes To AqaNife
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Description

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Use of the AqaNife

Instrument for flexible endoscopy for dissection of tissue e.g. in endoscopic submucosal dissection (ESD) and for haemostasis during this prodecure.

The AqaNife

The AqaNife is a monopolar electrosurgical instrument for dissection using flexible endoscopes with a working channel diameter of minimum 2.8 mm. It is a fixed (short) dissection knife and provides the following advantages:

  • precise marking of tissue
  • defined fixed position of the needle, no back pushing by tissue contact
  • straight needle for flexibility of dissection angle
  • ceramic cap as a stopper and a protector
  • reinjection without instrument change, flushing function

Available needle lengths: 1.5 mm | 2.0 mm | 2.5 mm | 3.0 mm

Measurements and specifications

Slider (A) for feeding forward (1) and retracting (2) the dissection electrode
HF connector (3 mm) (B)
Flexible shaft with irrigation channel (C)Shaft length: 220 cm
Straight HF knife (needle-shaped electrode) for dissection and coagulation of tissue (D)Needle lengths: 1.5 mm | 2.0 mm | 2.5 mm | 3.0 mm
Irrigation connection (E)
Appropriate working channel diameterFrom 2.8 mm
Packaging unit1 piece
Article number200.53.01 − 04

Application of the AqaNife

Clinical procedure: ESD+

Endoscopic submucosa dissection with AqaNife and additional grasper through the AWC

EXAMPLE*:

*Source Prof. Dr. A. Meining & Dr. B. Walter, University hospital Ulm (clinical case example)

Clinical procedure: ESD

Endoscopic Submucosal Dissection consists of several steps. The first step is usually the placement of coagulation marks around the lesion with a safety margin. This facilitates identification of the resection margin during the procedure. The AqaNife can be used for this step.

The next step is submucosal liquid injection to lift the mucosa from the muscular layer. Then follows the incision of the mucosa and the subsequent RF-dissection of the submucosal space with the tip of the AqaNife.

Lost fluid, occurring during dissection over time, can be replaced without instrument change by gently inserting the tip of the Aqanife into the submucosa and fluid injection.

Besides the AqaNife also the Coag Dissector can be used for tissue dissection. As in surgical dissection, the specially shaped jaws of the instrument can be applied to gently spread the tissue and bluntly dissect the submucosal space. Also bleeding can be stopped, applying the Coag Dissector as a coagulation grasper.

Clinical procedure: OPIMIZED 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*:

*Source: Meining A. et al. (2015) Erfolgreicher Verschluss einer großen ösophago-bronchialen Fistel durch mukosale Inzision vor OTSC-Clip-Platzierung. Endoskopie heute. Doi: 10.1055/s-0035-1545049.

 

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