What is SpotⓇ Ex?

Expanded indications support adoption of guidelines1
Expedite localisation at follow-up procedures2
Extra efficiency from new features
- 1ESGE Clinical Guideline. Colorectal polypectomy and endoscopic mucosal resection (EMR). 2017.
- 2Easier identification at follow-up procedures as compared to no tattoo.
Expanded Indications Support Adoption of Guidelines
Spot Ex is the only endoscopic tattoo indicated for clinical surveillance and surgical localisation1.
- 1Spot Ex Indication. Instructions For Use. G46-006 Rev02. April 2018.

Tattoos are Society Recommended

A sterile and biocompatible pre-packaged suspension …(Spot) has been developed…and this has enhanced the accessibility, ease of use, and safety of the procedure." 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
Long-term Visibility of Endoscopic Tattoos Using Sterile Carbon Suspension in a Pre-filled Syringe
Jackson FW. Long-term Visibility of Endoscopic Tattoos Using Sterile Carbon Suspension in a Pre-filled Syringe. AM Gastroenterol 2017; 112:S1-S45
Spot Ex is long lasting1, enabling patient follow-up for 36 months.
In 31 follow-up exams of patients previously tattooed with Spot, 100% were visible – up to 10 years later.2
- 1Spot Ex Indication. Instructions For Use. G46-006 Rev02. April 2018.
- 2Cano A, et al. Durability analysis of an endoscopic marker for the identification of locations in the colon. SEED. Toledo, Spain. 2017
Spot Ex is Used for Both Clinical Surveillance and Surgical Localisation
Use this protocol to confirm when to tattoo for each.
Common Clinical Uses of Endoscopic Tattoos for Surgical Localisation and Clinical Surveillance

Surgery
- Laparoscopic localisation
- 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.