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What is SpotⓇ Ex?

Expanded Indications | Expedite Localization | Exceedingly Cost Effective

Expanded indications support adoption of guidelines1

Expedite localization at follow-up procedures2

Exceedingly cost effective3

  • 1ESGE Clinical Guideline. Colorectal polypectomy and endoscopic mucosal resection (EMR). 2017.
  • 2Easier identification at follow-up procedures as compared to no tattoo.
  • 3CMS 2018 National Payment for Tissues Marking (CPT 45381)

Expanded Indications Support Adoption of Guidelines

Spot Ex is the only endoscopic tattoo indicated for clinical surveillance and surgical localization1.

Read the Spot Ex Indications
Spot® Ex tube and syringe
  • 1Spot Ex Indication. Instructions for Use. G45-006 Rev03. May 2018.

Tattoos are Society Recommended

“Colonoscopic tattooing is performed to enable future identification, at colonoscopy or surgery, of malignant lesions (proven or suspected), polypectomy, EMR, or ESD sites, difficult-to-detect polyps, or dysplastic areas. All such lesions, other than those definitely located in the cecum, adjacent to the ileocecal valve, or in the low rectum, should be tattooed.”1
  • 1Ferlitsch M, Moss A, Hassan C, et al. Colorectal polypectomy and endoscopic mucosal resection (EMR): ESGE Clinical Guideline. 2017.

Society Guidelines Recommend Tattooing for Clinical Surveillance

Read the Guidelines

Spot Ex is permanent1, enabling a lifetime of follow-up procedures.

In 121 follow-up exams of patients previously tattooed with Spot, 100% were visible – up to 11 years later.2

  • 1Spot Ex Indication. Instructions for Use. G45-006 Rev03. May 2018.
  • 2Jackson FW. Long-Term Visibility of Endoscopic Tattoos Using Sterile Carbon Suspension In A Prefilled Syringe. Am J Gastroenterol 2017; 112:S1–S45

Spot Ex is Used for Both Clinical Surveillance and Surgical Localization

Use this protocol to confirm when to tattoo for each.

Review the Protocol

Common Clinical Uses of Endoscopic Tattoos for Surgical Localization and Clinical Surveillance

Surgery

  • Laparoscopic localization
  • Faster surgeries1 with lower risk of wrong site resection2

Large Polyp

  • Risk of unknown dysplasia <2mm from biopsy margin
  • Referring to therapeutic endoscopist or surgery

EMR or ESD

  • Piecemeal endoscopic mucosal resection (PEMR)
  • Follow-up to monitor recurrence of residual

Difficult-to-Detect Polyps

  • Sessile serrated adenomas
  • Proximal side of folds
  • Transverse colon with few landmarks
  • 1Arteaga-Gonzalez I, et. al., The use of preoperative endoscopic tattooing in laparoscopic colorectal cancer surgery for endoscopically advanced tumors: a prospective comparative clinical study. World J Surg. 2006. 30(4):605–611.
  • 2Acuna SA, et. al., Preoperative localization of colorectal cancer: a systematic review and meta-analysis. Surg. Endosc. 2017; 31:2366-2379.