The Nakao Snare™ Line was invented in order to address the problem of the lost polyp syndrome. Colonic polyps, precursors to colon cancer, are removed during a colonoscopic procedure.  Resected with a cautery snare, they often roll into the colon necessitating a polyp search in order to retrieve the specimen for pathologic evaluation. The rate of lost polyps is 10-15% in the best of hands, a problem that is quite concerning: the treatment for a cancerous polyp differs significantly from that of a benign one.  It is therefore crucial for the patient that every polyp be retrieved. Because it is so important to examine every polyp for cancer cells, the physician must often engage in a difficult and time-consuming polyp chase. The additional time spent in search of the lost polyp adds to the procedure increases risk and patient discomfort. In the worst case the polyp is never found, and the prognosis and proper management of the patient remain uncertain.

The Nakao Snare Line, to be distributed by ConMed Endoscopic Technologies beginning May 2006, will offer three different snares designed to address the “lost polyp syndrome”. The Nakao Snare I is a double lumen snare, which houses a regular cautery snare in one lumen and a retrieval basket in another.  The cautery snare is used to resect the polyp in the usual fashion. After the polyp is severed, without removing the catheter from the working channel of the endoscope a second snare with net is used to retrieve the specimen. The retrieving net is specially designed to slide up and down the snare, gently cradling the delicate specimen so that it may be delivered unharmed to the pathologist.

The Nakao Cautery Retrieval Snare cuts and retrieves the polyp in the same maneuver. This device combines two loops constructed in a coplanar configuration.  The same delicate net described above is attached to the lager of the two loops, while the smaller, inner loop constitutes the cutting wire.  The polyp is captured, cautery is performed and the severed polyp falls into the net. Thus, both cutting and retrieval occur simultaneously, eliminating the polyp chase altogether.

The Nakao retrieval Net is a retrieval net utilizing the delicate pouch specially tethered to the inner wall of the catheter to enable its sliding up and down the snare for proper positioning around the specimen.  The Nakao Green Net is utilized in cases wherein a very large polyp is resected in several segments.  The segmental resection is performed with a cutting snare, leaving behind a number of pieces which are then harvested with the retrieval net.

The cutting snares may come in a thin mono-filament used for the smaller polyps, and for cold polypectomy (polypectomy without cautery), and retrieval nets come in small, medium and large sizes.

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