GUIDE SHEATH SYSTEMCreated to Help Improve Bronchoscopic Diagnosis

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DEVICES FOR ACCURATE ACCESS AND THE EFFICIENT SAMPLING OF LESIONS

Advance the guide sheath as close as

possible to the lesion. The radiopaque

tip is clearly visible under X-ray.

Optional 5. Use the Guiding Device (A)

to Navigate Through Bifurcations

1. Move the ultrasonic probe together

with the guide sheath when using

the ultrasonic probe.

2. Use the ultrasonic image to precisely

position the guide sheath tip at the

centre of the lesion.

With the guiding device inserted into

the guide sheath, use the rotatable

bending tip of the guiding device to

navigate through difficult bifurcations.

The guiding device is visible under

X-ray.

4. Advance the Guide Sheath Under Fluoroscopy

Optional6. Use the Ultrasonic Probe (B)

for Precise Targeting

1. Once the guide sheath tip reaches

the target position, fix the guide

sheath stopper at the endoscope’s

channel port so that the sheath

remains in place.

2. Once you have used the guiding

device or an ultrasonic probe,

retrieve the device while leaving the

guide sheath at the target site.

7. Position the Guide Sheath at the Target Site

8. Sampling with Biopsy Forceps

Guide Sheath 2.0 mm / 2.6 mm Ultrasonic Probe Biopsy Forceps 2.0 mm / 2.6 mm Cytology Brush 2.0 mm / 2.6 mmStopper 2.0 mm / 2.6 mm

SG-200C/SG-201C

· Supports repeated approach of

sampling devices

· Radiopaque tip allows excellent

visibility and positioning under

fluoroscopy

UM-S20-17S UM-S20-20R/UM-S30-20R

· A lesion can be accurately identified

with ultrasound

· The guide sheath can be precisely

positioned

· Positions the guide sheath on the

endoscope’s channel port

· Defines protrusion of EndoTherapy

devices from the guide sheath

within the target site

FB-233D/FB-231D

· Precisely engineered large-volume

fenestrated cups safely allow high

yield

BC-204D-2010/BC-202D-2010

· Metal tip guarantees perfect

visibility under fluoroscopy

· Fine micro bristles proved to collect

more cells, supporting better

diagnosis

Different devices can be inserted and

removed from the guide sheath

repeatedly, increasing the effectiveness

of the procedure with increased yield.

Biopsies and cytologies can repeatedly

be taken.

9. Changing Sampling Devices

Guiding Device

CC-6DR-1

· The bending and rotating

mechanism enables the guiding

device to access airways at difficult

bifurcations

1. Prepare the Guide Sheath

1. Insert the endoscope into the

bronchus.

2. Advance the endoscope as far as

possible into the targeted area

of the lung.

1. Attach a stopper to all devices.

2. Insert the devices into the guide

sheath and adjust the stoppers so

that the distal end of the devices

slightly extends from the guide

sheath.

2. Insert the Bronchoscope 3. Insert the Guide Sheath

Insert the guide sheath into the endo-

scope with an EndoTherapy device/

ultrasonic probe.

Alternative devices:

A) Guiding device B) Ultrasonic probe

C) Biopsy forceps D) Cytology brush

THE CONVENIENT GUIDE SHEATH TECHNIQUE

Accessing peripheral pulmonary lesions remains a challenge with bronchoscopy. The innovative

GuideSheathKit helps to improve the diagnosis of lung lesions.

The guide sheath is advanced and positioned at the centre of a solitary pulmonary nodule under X-ray or with ultrasonic

guidance. Once positioned at the target site, the guide sheath acts like an extended working channel allowing safe and

repeated access to the lesion for taking biopsies and cytology brushing.

Every kit contains the following instruments:

· Guide sheath

· Biopsy forceps

· Cytology brush (only in K-201/K-203)

· A set of dedicated stoppers

Optional devices:

· Guiding device

· Ultrasonic miniature probe

Biopsy forceps

Guide sheath

Adjust

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8. Sampling with a Cytology Brush

Repeatedly insert the cytology brush

until the adjusted stopper touches the

grip of the guide sheath. This ensures

sampling within the target site.

Repeatedly insert the biopsy forceps

until the adjusted stopper touches the

grip of the guide sheath. This ensures

sampling within the target site.

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GUIDE SHEATH SYSTEM

GuideSheathKit Model Name K-201 K-203

Minimum Channel Diameter 2.0 mm 2.6 mm

Guide Sheath SG-200C SG-201C

Specification Radiopaque distal tip for clear visibility under X-ray

Biopsy Forceps FB-233D FB-231D

Specification Oval, fenestrated cups Oval, fenestrated cups, swinging type

Cytology Brush BC-204D-2010 BC-202D-2010

Specification Brush diameter Ø 2 mm, brush length 10 mm

EndoTherapy (ET) Stopper 3 pcs (white) 2 pcs (grey) + 1 pc. (white)

Ultrasound (US) Stopper 1 pc. (white) 1 pc. (grey)

GuideSheathKit Model Name K-202 K-204

Minimum Channel Diameter 2.0 mm 2.6 mm

Guide Sheath SG-200C SG-201C

Specification Radiopaque distal tip for clear visibility under X-ray

Biopsy Forceps FB-233D FB-231D

Specification Oval, fenestrated cups Oval, fenestrated cups, swinging type

EndoTherapy (ET) Stopper 3 pcs (white) 2 pcs (grey) + 1 pc. (white)

Ultrasound (US) Stopper 1 pc. (white) 1 pc. (grey)

Guiding Device Model Name CC-6DR-1

Minimum Channel Diameter 2.0 mm

Specification Rotatable, bendable tip (double-joint type), reusable

Compatible GuideSheathKit K-201,-202,-203,-204

Ultrasonic Probe Model Name UM-S20-17S UM-S20-20R UM-S30-20R

Minimum Channel Diameter 2.0 mm 2.2 mm 2.2 mm

Scanning Frequency 20 MHz 20 MHz 30 MHz

Compatible GuideSheathKit K-201,-202 (2.0 mm) K-203,-204 (2.6 mm) K-203,-204 (2.6 mm)

EASY AND REPEATED ACCESS TO SOLITARY PULMONARY NODULES

Minimally Invasive

Using the GuideSheathKit for endobronchial sampling in the peripheral area of the lung is a less invasive

technique than percutaneous or surgical sampling methods.

Multiple Sampling for Improved Bronchoscopic Diagnosis

By placing the distal tip of the guide sheath at the target site, physicians can repeatedly take biopsies and

cytology specimens at the same site. Multiple sampling and the combination of different sampling methods

help to increase yield and diagnostic success.

Reliable and Fast Access with Less Radiation

Once the guide sheath is positioned, fast and reliable access to the lesion is possible. There is no further need

to spend additional time relocating the target site under fluoroscopy. By using an ultrasonic probe, the detection

of the centre of the lesion becomes even more precise.

References: Kurimoto N, et al.: Endobronchial ultrasonography using a guide sheath increases the ability to diagnose peripheral pulmonarylesions endoscopically. Chest 2004; 126: 959–965Eberhardt R, et al.: Ultrasound-guided transbronchial biopsy of solitary pulmonary nodules less than 20 mm. ERJ 2009; 34: 1284–1287

Devices to Diagnose Pulmonary Nodules

Optional support devices

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Specifications, design, and accessories are subject to change without any notice or obligation on the part of the manufacturer.

Postbox 10 49 08, 20034 Hamburg, GermanyWendenstrasse 14–18, 20097 Hamburg, GermanyPhone: +49 40 23773-0, Fax: +49 40 233765www.olympus-europa.com

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