Thermoreversible injection agent for endoscopic resection.

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Use of LiftUp®

LiftUp® serves as an injection agent for endoscopic resection techniques such as ESD, EMR and POEM. It gels thermoreversibly at body temperature and forms a stable and long-lasting cushion in the submucosa. It optimally supplements the resection techniques EMR+ and ESD+.

The LiftUp®

The injection agent LiftUp® – for safe and simple1 EMR and ESD – offers many advantages:

  • Creates a durable cushion in the submucosa even after mucosa incision2
  • Time saving due to fewer post injections3
  • Separates and exposes layers and structures

 

1 Wedi, E., Ho, C.-N., Conrad, G., Weiland, T., Freidinger, S., Wehrmann, M., Meining, A., Ellenrieder, V., Gottwald, T., Schurr, MO., Hochberger, J. (2019).
Preclinical evaluation of a novel thermally sensitive co-polymer (LiftUp) for endoscopic resection.
Minim Invasive Ther Allied Technol, 28(5), 277–284. doi: 10.1080/13645706.2018.1535440

2 Wedi, E., Koehler, P., Hochberger, J., Maiss, J., Milenovic, S., Gromski, M., Ho, C.-N., Gabor, C., Baulain, U., Ellenrieder, V., Jung, C. (2019).
Endoscopic submucosal dissection with a novel high viscosity injection solution (LiftUp) in an ex vivo model: a prospective randomized study.
Endoscopy International Open, 07(05). doi: 10.1055/a-0874-1844

3 Meier, B., Wannhoff, A., Klinger, C., & Caca, K. (2019).
Novel technique for endoscopic en bloc resection (EMR+) – Evaluation in a porcine model.
World Journal of Gastroenterology, 25(28), 3764–3774. doi: 10.3748/wjg.v25.i28.3764

 

Dimensions and specifications

LiftUp® Kit

The kit contains the necessary components for the LiftUp® injection
Items per package 5 vials LiftUp® à 20 ml
10 disposable syringes(optimized for viscous injection solutions)
5 injection needles
Reference number 200.56.02

LiftUp®

Components Water, poloxamers, sodium chloride, methylene blue
Volume 20 ml
Items per package 5 vials à 20 ml
Reference number 200.56.01

Application of LiftUp®

Injection of LiftUp® into the submucosa
Execution of the endoscopic resection, e.g. EMR or ESD, as usual

Example *:

* Source: Dr. B. Meier, Hospital Ludwigsburg, Germany [ex-vivo model]

Injection into the submucosa
Positioning of snare and OTSC® Anchor or FTRD® Grasper
Elevation of the lesion and snare closure
Push-back* of the OTSC® Anchor or FTRD® Grasper while snare stays closed and subsequent resection

* Note: Anchor needles must not be captured with the snare during the push-back move. If in doubt, the anchor needles can be closed to avoid a short circuit.

Example *:

* Source: Prof. K. Caca Dr. B. Meier, Hospital Ludwigsburg, Germany [In-vivo model]

Marking of the lesion with the snare tip
Injection of LiftUp® into the submucosa
Circumferential incision with the snare tip
Elevation of the lesion with FTRD® Grasper or OTSC® Anchor and snare closure
Push-back* of the OTSC® Anchor or FTRD® Grasper while snare stays closed and subsequent resection

* Note: Anchor needles must not be captured with the snare during the push-back move. If in doubt, the anchor needles can be closed to avoid a short circuit.

Marking
Injection with LiftUp®
Circumferential incision (with AqaNife® or snare tip)
Endoscopic submucosal dissection with AqaNife®
Resection in EMR+ technique (snare, grasper and AWC®)
Marking
Injection of LiftUp®
Incision of 4⁄5 of the total circumference
Endoscopic submucosa dissection with AqaNife® and additional grasper through the AWC®

Example *:

* Source Prof. Dr. A. Meining, University Hospital Ulm, Germany [ex-vivo model]

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