EXACTO™ Cold Snare

Product Overview

Clinically proven to achieve a significantly high complete resection rate, the EXACTO Cold Snare offers control and placement for a precise, clean cut. The 9mm wide EXACTO Cold Snare supports the cold snare polypectomy technique and can resect various polyps of multiple sizes (small, diminutive, and large).

The EXACTO - MUNDO Cold Snare is a 14mm wide dedicated cold snare offering an 89% larger snare area than the market-leading cold snare (Data on file at STERIS). This larger cold snare offers an option for piecemeal cold snare polypectomy or cold EMR of large polyps. The larger surface area reduces the number of resections needed when performing CSP on large polyps, potentially improving the efficiency and effectiveness of the procedure.¹

Our portfolio of polypectomy snares offers a wide range of colonoscopy snares and eliminates the risks associated with electrocautery. The EXACTO Cold Snare and EXACTO – MUNDO Cold Snare are colonoscopy snares intended to be used without diathermic energy for the endoscopic resection of polyp tissue in the gastrointestinal tract.

How does the EXACTO endoscopy snare portfolio affect patient flow and outcomes?

The EXACTO Cold Snare, introduced in 2010:

• Achieves higher complete resection rates for diminutive and small colorectal polyps (≤ 10 mm) compared to traditional snares (91% vs. 79%)²
• Achieves a resection rate as high as 83% for flat or pedunculated polyps of 8-10 mm in diameter compared to 45% with traditional snares²
• Achieves higher complete endoscopic excision in patients with colorectal polyps of 3 to 7mm compared to traditional snares (90.2% vs 73.3)³
• Reduces withdrawal time, and procedural time, compared to hot snare polypectomy (27.6 min vs 35.7 min)⁴
• Reduces the rate of injured arteries in submucosal layer compared to traditional snares (3.1% vs 6.7%)³
• Provides superior resection ability, requiring less force and featuring a stiffer sheath and loop wire compared to the Captivator cold, Snare Master Plus, and Micro Tech cold snares⁵
• Reduces slippage on the mucosal surface with its 1 x 7 wire design, featuring finer grooves and a larger contact area, outperforming the Captivator cold braided wire⁵
• Is more effective for cold resection than traditional snares, leading to more cutting than tearing through the mucosa or stalk³
• Provides reliable transection due to its thin wire and stiff catheter as reported by Dr. David G. Hewett in a 2015 GIE editorial⁶
  • “There are several design features of the EXACTO™ snare that may form the basis of its superior performance. In my experience with this snare, the combination of a thin wire and stiff catheter produces reliable tissue transection, often with audible feedback as the snare handle snaps closed on cutting. Traditional snares have softer catheters that typically buckle on full closure of the snare wire, without tissue transection.”⁶

How does the EXACTO - MUNDO Cold Snare affect patient flow and outcomes?

The larger EXACTO - MUNDO colonoscopy snare:

• Offers an option for en bloc or piecemeal cold snare polypectomy or cold EMR of large polyps
• Addresses the concerns with the risk of incomplete resection (RIR) when using cold snaring for larger polyp by reducing the number of resections needed¹
• Offers a 14 mm snare loop which is 44% wider and offers 43% more surface than the EXACTO Cold Snare (DATA ON FILE at STERIS)
• This larger surface area reduces the number of resections needed when performing CSP on larger polyps, improving the efficiency and effectiveness of the procedure

Why the EXACTO Cold Snare portfolio?

• The thin wire design (0.012 inch / 0.30mm) enables a clean cut while maintaining its shape and stiffness
• Provides a balance between stiffness and flexibility due to its thin (0.012”/0.30mm), seven-braided wire configuration
• Offers a stiff catheter that aids in placement, supports tissue transection, and decreases buckling
• Reduces polyp “fly away” from the resection site, making it possible to collect specimens for pathology
• The EXACTO Cold Snare features a shield shape design that maximizes its width for control and placement during cold snare polypectomy
• The EXACTO – MUNDO Cold Snare option offers a 14mm wide dedicated snare loop for more tissue removal with fewer snare resections

FAQs

What is the difference between hot and cold snare polypectomy?

During a colonoscopy, a polypectomy may be performed to completely remove a polyp, or a sample of the polyp tissue may be biopsied for further examination. Clinicians typically use two techniques to remove polyps – cold snare polypectomy or hot snare polypectomy. The choice of which technique and tool to use depends on the size of the polyp being removed and the physician’s technique preference. During cold snare polypectomy, an endoscopic snare such as the EXACTO Cold Snare or EXACTO – MUNDO Cold Snare is looped around the polyp and closed until the polyp is removed. The key difference between hot snare polypectomy and cold snare polypectomy is the addition of electrocautery to aid in polyp removal.

When do you use a cold snare?

Clinical evidence and guidelines support cold snare polypectomy by strong recommendation and high-quality evidence for the removal of diminutive (≤5 mm) and small (6-9mm) lesions due to high complete resection rates, efficiency in technique, and safety profile. As guidelines and practices move towards endoscopic procedures over surgery, polypectomy snaring and endoscopic mucosal resection are trending to resect larger, more complicated lesions. Cold snare polypectomy decreases risks such as injury to submucosal arteries, delayed bleeding, and perforation associated with other polypectomy techniques.

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