The latest news on the Exacto® cold snare…

Recently the Exacto® cold snare has featured in numbering clinical studies, while the discussion surrounding cold snare polypectomy is increasing in prevalence, meaning now more than ever there is significant clinical updates surrounding the market leading snare, find out more:

In the following video Dr. Zachary Smith utilises the Exacto® snare to safely and effectively resect a 3.5cm right colon tubulovillous adenoma…

Dr. Smith recently spoke about how he cold snares most large lesions due to the below benefits:

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Cold snaring has limited risks of post polypectomy bleeding, which saves Dr.Smiths facility an estimated $30k annually. Cold snaring saves time and additional expense by not requiring cautery equipment. – He also sleeps better at night since he doesn’t have to worry about his patient bleeding!

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Dr. Zachary Smith has an older patient population often on anticoagulants, cold snaring allows his patients go back to their normal medications and diet the next day. As opposed to cautery polypectomy where it can take up to 5 days before they return to their medication.

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Dr. Smith likes to use the Exacto® cold snare as it maintains its shape and performs well after many cuts, as shown in the above case.

For further clinical studies beyond Dr. Smith’s support on cold snare polypectomy, check out the below…

“Cold snare endoscopic resection of nonpedunculated colorectal polyps larger than 10 mm” is a systematic review and pooled-analysis published, by GIE, of 8 studies with 522 polyps ≥10mm, that reported no delayed bleeding or perforations.

The review states “added benefits of cold snaring may be both the cost, and shorter time for resection, because of the lack of need for an electrocautery machine and lower need for prophylactic hemostatic clip placement.”

Article Abstract of 2019 systematic review

Below is a recent article by Dr. Akira Horiuchi, published by GIE. Dr. Horiuchi is based in Japan and a Key Opinion Leader with a GI focus on cold snare polypectomy.

This study sought to determine the optimal technique for CSP where Exacto® was utilized to resect 216 subcentimeter polyps in 90 patients. Complete resection rate was achieved in 90% of all polyps and 95% for polyp resection sites measuring ≧7 mm, with no delayed bleeding.

Optimal technique for cold snare polypectomy

The above study by Dr. Akira Horiuchi, using Exacto®, aims to determine the optimal technique for CSP, here are the highlighted tips:

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Position the snare at 5 to 6 o’clock

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The “push and cut” technique – angle the endoscope into the colon wall and pushing the snare forward

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Additional margin of tissue was resected around the polyp

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Complete resection rate was determined by evaluating neoplastic tissue on the margins

The study concluded that “A CSP technique that creates a ≧7 mm mucosal defect using a dedicated cold snare resulted in the complete removal of non-pedunculated colorectal polyps 4-10 mm in diameter.”

More information on Exacto® can be found here:

Exacto® cold snare!

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