Arterial Leader Catheter – Precision Access for Cardiovascular Procedures

Arterial Leader Catheter

The Arterial Leader Catheter is a thin, flexible tube used to access arteries during various cardiovascular procedures. It helps guide other medical devices into the arteries safely and accurately. This catheter is commonly used in hospitals during heart-related surgeries and diagnostic tests.

Product History

The Arterial Leader Catheter has been used in cardiology for several decades to support safe vascular access. Over the years, it has evolved with better materials and designs to reduce complications and improve performance. It became a standard tool in procedures like angioplasty and cardiac catheterization. Medical professionals now rely on it for precise arterial navigation.

Arterial Leader Catheter – Precision Access for Confident Arterial Placement

Advin Health Care manufactures high-quality Arterial Leader Catheters designed for safe and effective arterial access. These catheters are widely used in procedures like angiograms, angioplasty, and stent placements. Advin Health Care ensures each catheter is made with flexible and durable material to minimize trauma to the artery. The smooth surface and kink-resistant design enhance the ease of insertion. This product supports accurate placement and improved procedural efficiency.

Surgeries Related to Product

• Coronary Angioplasty
• Coronary Artery Bypass Grafting (CABG)
• Diagnostic Angiography
• Peripheral Artery Disease Intervention
• Carotid Artery Surgery
• Cardiac Catheterization
• Endovascular Aneurysm Repair (EVAR)

Instructions for Use

• Ensure all necessary sterile precautions are in place before starting.
• Insert the catheter gently into the selected arterial access point.
• Guide the catheter carefully under imaging assistance to reach the target location.
• Connect the catheter to the required diagnostic or therapeutic device.
• After the procedure, slowly withdraw the catheter and apply pressure to the site.

Top 10 Countries of Surgeries

• United States
• India
• China
• Germany
• Japan
• Brazil
• United Kingdom
• France
• Russia
• Italy

Advin Product Description

Advin Health Care is a prominent manufacturer of Arterial Leader Catheters, offering high-quality and dependable solutions for arterial access in cardiology procedures.

Features of Arterial Leader Catheter

• Flexible and Kink-Resistant Design
• Radiopaque Marker
• Smooth Surface Finish
• Hydrophilic Coating (Optional)
• Available in Multiple Sizes and Lengths
• Sterile and Single-Use

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+91-75037 27248 | cardiology@advinhealthcare.com | www.advinhealthcare.com

Hot Disinfectant

Hot Disinfectant solution used to sterilize dialysis machines and medical equipment. It helps kill harmful bacteria, viruses, and other microorganisms that may be present in dialysis systems. This product is commonly used in hospitals and clinics to maintain a safe and hygienic dialysis environment.

Product History

Hot Disinfectant was developed as a safer alternative to chemical-based disinfectants traditionally used in dialysis units. Over the years, it has become a preferred choice due to its effective heat-assisted sterilization process. Medical centers adopted it widely to reduce infection risks in dialysis treatment. Its use has expanded globally due to its reliability and consistent performance.

Hot Disinfectant – Intense Heat, Deep Clean for Critical Equipment

Hot Disinfectant from Advin Health Care ensures complete disinfection of dialysis equipment using heat-activated technology. It provides deep cleaning and eliminates tough microbial contaminants, making it ideal for regular dialysis maintenance. Advin Health Care manufactures this product with high-quality materials and strict safety standards. The solution is easy to apply and leaves no harmful residue. It is widely trusted by medical professionals for its effectiveness and reliability.

Surgeries Related to Product

• Hemodialysis procedures
• Peritoneal dialysis setup and maintenance
• Continuous Renal Replacement Therapy (CRRT)
• Kidney transplant pre- and post-operative dialysis sessions
• Acute dialysis treatments in ICUs

Instructions for Use

• Ensure the dialysis machine is turned off before cleaning.
• Pour the recommended amount of Hot Sterilant into the disinfection chamber.
• Activate the machine’s hot disinfection cycle as per manufacturer’s instructions.
• After the cycle, flush the system thoroughly with clean water.
• Allow the machine to cool before the next use.

Top 10 Countries of Surgeries

• United States
• India
• China
• Brazil
• Germany
• Japan
• Russia
• Mexico
• Turkey
• Indonesia

Advin Hot Disinfectant Description

Advin Health Care is a prominent manufacturer of Hot Disinfectant , providing high-quality sterilization solutions for dialysis applications across medical facilities worldwide. The product is engineered for efficient and safe disinfection of dialysis systems, meeting international safety standards.

Advanced Features:

• Performs both disinfection and decalcification in a single, efficient process
• Uses natural active ingredients including Citric Acid, Malic Acid, and Lactic Acid
• Fully biodegradable and non-toxic formulation
• Safe for both patients and medical staff

Environmentally friendly, reducing chemical waste and exposure risks

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+91-75037 27249 | dialysis@advinhealthcare.com | www.advinhealthcare.com

Heparin Sodium Injection

Heparin Sodium Injection 25000IU is a medication used to prevent and treat blood clots during dialysis procedures. It is commonly administered in hospitals to ensure smooth blood flow through the dialysis machine. This injection helps maintain the safety and effectiveness of the dialysis treatment.

Product History

Heparin has been used in medical practice since the 1930s to prevent blood clotting. Over the years, it became a vital part of dialysis procedures due to its anticoagulant properties. Heparin Sodium Injection 25000IU was developed for high-dose requirements in clinical settings. It is now widely used around the world in renal and surgical care.

Heparin Sodium Injection – Reliable Clot Prevention in Critical Care and Dialysis

Heparin Sodium Injection 25000IU by Advin Health Care is a high-strength anticoagulant used to prevent clotting in dialysis circuits. This product ensures the blood flows smoothly during dialysis, minimizing risks to the patient. Advin Health Care offers this formulation with a strong focus on quality and safety standards. The injection is suitable for adult patients undergoing hemodialysis and other extracorporeal treatments. Its reliable performance makes it a preferred choice among healthcare professionals.

Surgeries Related to Product

• Hemodialysis procedures
• Peritoneal dialysis procedures
• Kidney transplant surgeries
• Cardiovascular surgeries involving extracorporeal circulation
• Vascular access surgeries

Instructions for Use

• Inspect the vial for clarity and expiration date before use.
• Clean the injection site with antiseptic.
• Draw the prescribed dose using a sterile syringe.
• Administer the injection intravenously or as directed by the physician.
• Dispose of used syringes and vials safely.

Top 10 Countries of Surgeries

• United States
• India
• China
• Germany
• Brazil
• Japan
• United Kingdom
• Russia
• Mexico
• Turkey

Advin Heparin Sodium Injection Description

• Advin Health Care is a leading manufacturer of Heparin Sodium Injection 25000IU, providing safe and high-quality solutions for anticoagulation in dialysis and surgical care. The company ensures strict adherence to medical standards and patient safety protocols.
• Heparin Sodium Injection suppliers in India can order the medication in various strengths, each containing the active ingredient in proportionate quantities to suit different clinical needs.
• Heparin Sodium Injection is primarily used for the treatment, control, prevention, and improvement of the following medical conditions and diseases:
• Anticoagulation (prevention of blood clots)
• Additionally, Heparin Sodium Injection may be used for other medical purposes as determined by a healthcare professional.

Product History

Hemodialysis treatments have been used since the 1940s, with acid concentrate solutions evolving over time for better patient safety and treatment outcomes. Acid Concentrate (Part A) was developed to work alongside bicarbonate concentrate, providing an effective dialysis solution. Manufacturers have improved the formulation to match international quality standards. Today, it is widely used in hospitals and dialysis centers around the world.

Hemodialysis Acid Concentrate – Stable, Reliable, and Ready for Every Dialysis Session

Advin Health Care provides high-quality Hemodialysis Acid Concentrate Fluid (Part A), ensuring consistent dialysis performance and patient safety. The product contains a precise mix of electrolytes and acid components to support the dialysis process. It helps maintain proper blood chemistry during hemodialysis and assists in the removal of toxins. Advin Health Care formulates this solution under strict hygiene and safety conditions to meet global healthcare standards. The product is suitable for both acute and chronic dialysis patients.

Surgeries Related to Product

• Chronic Kidney Disease (CKD) management
• Acute Kidney Injury (AKI) treatment
• End-Stage Renal Disease (ESRD) dialysis
• Continuous Hemodialysis Procedures
• Hospital-based and outpatient dialysis sessions

Instructions for Use

• Connect the acid concentrate container securely to the dialysis machine.
• Ensure the machine is set to the proper mixing ratio as recommended.
• Do not use if the solution appears cloudy or the seal is broken.
• Monitor the patient’s vital signs and dialysate composition during treatment.
• Store the solution in a cool and dry place, away from direct sunlight.

Top 10 Countries of Surgeries

• United States
• India
• China
• Brazil
• Germany
• Japan
• Russia
• Mexico
• Indonesia
• Turkey

Advin Product Description

Advin Health Care is a prominent manufacturer of Hemodialysis Acid Concentrate Fluid (Part A), providing high-quality solutions for reliable and safe dialysis treatments across the globe.

Advanced Features

• Non-Pyrogenic: Designed to minimize the risk of fever and inflammation, ensuring patient safety.
• Non-Sterile: Intended for use with dialysis equipment that includes built-in sterilization and disinfection protocols.
• High Effectiveness: Formulated for optimal performance in removing toxins and maintaining electrolyte balance during dialysis.
• Precise Volume Accuracy: Manufactured with strict volume control for consistent and reliable dosing.
• Universal Machine Compatibility: Compatible with all standard dialysis machines, allowing flexible use across different clinical setups.

Product Introduction

Hemodialysis Bicarbonate Concentrate Powder (Part B) is a specially formulated powder used during hemodialysis treatments. It helps maintain the proper acid-base balance in a patient’s blood. This powder is mixed with purified water to create a dialysate solution used in dialysis machines.

Product History

The use of bicarbonate in dialysis began in the 1960s to improve patient comfort and reduce side effects. Over time, the formula has been improved to ensure better compatibility with dialysis machines and patient safety. Part B concentrates are now widely used in modern dialysis procedures across the world. This product has become a vital component of effective hemodialysis care.

Hemodialysis Bicarbonate Concentrate Powder (Part B) – High Purity Formula for Optimal Dialysate Balance

Advin Health Care offers Hemodialysis Bicarbonate Concentrate Powder (Part B) that ensures safe and effective acid-base balance during dialysis. This powder is made with high-quality ingredients to ensure patient safety and machine compatibility. Advin Health Care ensures strict quality control and adherence to international medical standards. The powder is easy to mix with purified water and forms a stable solution for dialysis. It helps in reducing metabolic acidosis and provides better dialysis outcomes for patients.

Surgeries Related to Product

• Chronic Kidney Disease (CKD) dialysis treatment
• Acute Kidney Injury (AKI) dialysis
• End-Stage Renal Disease (ESRD) management
• Pre- and post-transplant hemodialysis

Instructions for Use

• Use only as directed by the dialysis machine manufacturer.
• Mix the concentrate powder with the correct amount of purified water.
• Ensure the solution is fully dissolved before use.
• Connect the solution to the dialysis machine as required.
• Store the powder in a cool, dry place and avoid moisture exposure.

Top 10 Countries of Surgeries

• United States
• India
• China
• Brazil
• Germany
• Japan
• Mexico
• Russia
• United Kingdom
• Indonesia

Advin Hemodialysis Bicarbonate Concentrate Powder (Part B) Description

Advin Health Care is a leading manufacturer of Hemodialysis Bicarbonate Concentrate Powder (Part B), offering high-quality, clinically tested formulations designed for safe and effective dialysis treatments. The product is crafted using pharmaceutical-grade ingredients and is suitable for use with all standard dialysis machines. Advin ensures each batch meets rigorous international standards for medical safety and performance. Our powder provides stable and reliable results, making it ideal for hospitals and dialysis centers globally. Trust Advin for reliable dialysis solutions that support better patient outcomes.

Advanced Features

• Non-pyrogenic
• Non-sterile formulation
• High effectiveness
• Precise volume accuracy
• Compatible with all standard dialysis machines.

Dialysis Stainless Steel RO Plant

A Stainless Steel RO (Reverse Osmosis) Plant is a water purification system used in dialysis centers and hospitals. It removes impurities, bacteria, and harmful chemicals from water to make it safe for dialysis treatment. The stainless steel body ensures durability, hygiene, and long-lasting performance.

Product History

Reverse osmosis technology was first developed in the 1950s to produce clean drinking water. Over time, it became widely adopted in the medical field, especially in dialysis units, due to its ability to provide ultra-pure water. Stainless steel RO plants gained popularity for their strength, corrosion resistance, and easy maintenance. Today, they are a standard component in dialysis water treatment systems globally.

Dialysis Stainless Steel RO Plant – Durable Stainless Steel, Designed for Dialysis Demands

Advin Health Care offers high-performance Stainless Steel RO Plants designed for medical and dialysis applications. These systems ensure consistent delivery of pure water by removing up to 99% of contaminants. Stainless steel construction provides superior hygiene and resistance to corrosion, making it ideal for clinical settings. Advin Health Care ensures each unit meets international quality standards and supports long-term usage with low maintenance. These RO plants help improve patient safety by supplying clean water for critical treatments.

Surgeries Related to Product

• Hemodialysis procedures
• Kidney transplant preparation
• Peritoneal dialysis setup
• Chronic kidney disease treatments
• Critical care renal support procedures

Instructions for Use

• Connect the plant to the raw water supply.
• Switch on the power and let the system start filtering.
• Ensure all connections are leak-proof and secure.
• Regularly check filter indicators and pressure gauges.
• Clean and sanitize the system as recommended.

Top 10 Countries of Surgeries

• United States
• India
• China
• Brazil
• Germany
• Japan
• Russia
• United Kingdom
• Mexico
• Indonesia

Advin Dialysis Stainless Steel RO Plant Description

Advin Health Care is a prominent manufacturer of Stainless Steel RO Plants, delivering high-quality and reliable water purification systems for dialysis and hospital use. Our RO systems are designed with precision engineering, robust stainless steel construction, and advanced filtration technology to ensure safe and pure water supply. With global certifications and a commitment to excellence, Advin Health Care provides dependable support for healthcare providers worldwide.

Reverse Osmosis (RO) is one of the most reliable and widely trusted water purification technologies used in the hemodialysis process. It plays a critical role in ensuring the removal of dissolved salts, bacteria, and other impurities from water to make it safe for patient use. A standard dialysis water treatment system typically includes a sediment or pre-filter, activated carbon filter, water softener, and a reverse osmosis unit. This multi-stage purification process ensures that only ultra-pure water is used in dialysis, reducing the risk of contamination and improving patient outcomes. RO technology remains a cornerstone of safe and effective dialysis treatment.

Advanced Features

• Prevention of Bacterial Contamination
• Integrated Micron Pre-Filtration
• Built-in Membrane Cleaning System
• Fully Automated System Capabilities
• Advanced Performance Monitoring
• Low-Noise Stainless Steel Pump
• Stainless Steel Membrane Housing
• Automatic Flush Control
• Pressure and Air Relief Valve
• Stainless Steel Permeate Boosting Pumps with Standby Motors
• Bypass Facility for Control Panel, Filters, UV, and Pumps

Introducer Needle

An Introducer Needle is a medical device used to access blood vessels during cardiac and vascular procedures. It helps in the initial puncture of the vein or artery before inserting catheters or other instruments. This needle is commonly used in interventional cardiology and other minimally invasive procedures.

Product History

The Introducer Needle was developed as a safe and efficient tool to improve vascular access during medical procedures. Over the years, its design has evolved to offer better precision and reduced patient discomfort. It became a standard part of catheterization procedures worldwide. Today, Introducer Needles are used in hospitals and clinics globally.

Introducer Needle – Sharp, Smooth, and Ready for Every Insertion

The Introducer Needle from Advin Health Care is specially designed for smooth and safe vascular access. It features a sharp, beveled tip to allow clean vessel entry with minimal trauma. Advin Health Care ensures the needle is made with high-quality stainless steel for durability and reliability. This needle supports precise access in cardiac catheterization and angiographic procedures. It is a trusted tool for clinicians performing vascular interventions.

Surgeries Related to Product:

• Cardiac catheterization
• Angioplasty
• Electrophysiology procedures
• Pacemaker or ICD implantation
• Central venous catheter placement
• Peripheral angiography
• Dialysis access procedures

Instructions for Use:

• Prepare and sterilize the insertion site.
• Hold the Introducer Needle firmly and insert it at the correct angle into the blood vessel.
• Confirm blood return to ensure vessel entry.
• Insert the guidewire through the needle if needed.
• Remove the needle while leaving the guidewire in place for further access.

Top 10 Countries of Surgeries:

• United States
• China
• India
• Germany
• Japan
• Brazil
• United Kingdom
• Russia
• France
• Italy

Advin Product Description:

Advin Health Care is a prominent manufacturer of Introducer Needles, offering reliable and precise products for vascular access in cardiology procedures. Their Introducer Needles are designed for easy handling and high performance in both routine and complex cases. These needles are made from superior materials and meet international standards to ensure safe patient care in hospitals and clinics.

Key Features of Introducer Needle

• Sharp, Beveled Tip
• Sterile and Single-Use
• Various Gauge Sizes
• Compatible with Guide wires
• Blunt or Safety Stylet Options

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+91-75037 27248 | cardiology@advinhealthcare.com | www.advinhealthcare.com

Transseptal Needle

The Transseptal Needle is a specialized medical instrument used in cardiology procedures. It helps doctors safely access the left atrium of the heart by puncturing the septum between the heart’s chambers. This needle is essential for many heart surgeries and diagnostic interventions.

Product History

The Transseptal Needle was developed to improve the safety and accuracy of heart procedures that require access to the left atrium. Over time, its design has evolved to increase precision and reduce complications during surgery. Today, it is a standard tool used in hospitals worldwide for cardiac interventions. The needle has helped advance minimally invasive heart treatments.

Transseptal Needle – Trusted Tool for Accurate Interatrial Access

Advin Health Care produces high-quality Transseptal Needles designed for precision and safety. The product from Advin Health Care is crafted to assist cardiologists in gaining reliable access to the heart’s left atrium with minimal risk. It features a sharp, durable tip that ensures smooth penetration of the septal wall. This needle is compatible with various catheter systems and supports a wide range of cardiac procedures. It offers consistent performance and helps reduce procedure time and patient discomfort.

Surgeries Related to Product

The Transseptal Needle is commonly used in:

• Atrial fibrillation ablation
• Mitral valve repair or replacement
• Left atrial pressure measurement
• Left atrial appendage closure
• Pulmonary vein isolation procedures

Instructions for Use

• Prepare the needle and catheter system according to hospital protocols.
• Insert the needle into the introducer sheath carefully.
• Position the needle tip against the interatrial septum under imaging guidance.
• Apply gentle pressure to puncture the septum and access the left atrium.
• Confirm proper needle placement before proceeding with catheter insertion.

Top 10 Countries of Surgeries

• United States
• Germany
• Japan
• France
• United Kingdom
• Canada
• South Korea
• Australia
• Italy
• Brazil

Advin Product Description

Advin Health Care is a leading manufacturer of Transseptal Needles, providing advanced solutions for cardiology procedures. Their products ensure precision, safety, and reliability during critical heart surgeries.

Features of Transseptal Needle

• Tapered Tip: Precisely shaped for smooth and safe puncture of the interatrial septum.
• Ergonomic Designed Handle: Provides a comfortable and secure grip, improving control during delicate procedures.
• High-Grade Medical Materials: Made from premium stainless steel and biocompatible materials to ensure strength, durability, and safety.
• Sterile Packaging: Delivered sterile and ready for immediate use in surgical environments.
• Single-Use: Reduces infection risk and ensures high safety standards.
• Consistent Performance: Trusted for use in various transseptal cardiac procedures.

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+91-75037 27248 | cardiology@advinhealthcare.com | www.advinhealthcare.com

What is a Polyp Trap?

A Polyp Trap is a medical device used during endoscopic procedures to collect tissue specimens, such as polyps, without interrupting suction. It is installed in-line between the suction channel and waste container. The device helps in safely capturing polyps for further examination or testing.

Product History

Polyp Traps were developed to address the challenge of retrieving small tissue specimens during gastrointestinal procedures. Earlier, medical staff had to manually extract polyps from waste, which increased the risk of tissue loss and contamination. Over time, innovations like removable chambers and clear labelling were added to improve accuracy and specimen handling. Today, Polyp Traps are commonly used across various hospitals and endoscopy units worldwide.

Polyp Trap – Designed for Easy, Accurate Polyp Capture

Polyp Traps by Advin Health Care are reliable, single-use devices designed to collect and store tissue samples during colonoscopy and endoscopy procedures. These traps eliminate the need for manual retrieval of specimens, ensuring patient safety and better infection control. The large, numbered chambers allow for accurate identification and safe transfer of tissue samples. Advin Health Care designs these devices with ease-of-use and efficiency in mind, meeting the standards of modern gastrointestinal diagnostics. This product reduces the chances of losing small or delicate tissue during retrieval.

Surgeries Where Polyp Trap is Commonly Used

• Colonoscopy
• Upper GI Endoscopy
• Flexible Sigmoidoscopy
• Polypectomy procedures
• Biopsy retrieval in gastrointestinal surgeries

Basic Instructions for Use

1. Connect the Polyp Trap in-line with the suction tubing during the procedure.
2. Ensure the removable chambers are securely placed before starting.
3. Activate suction and begin the endoscopic retrieval process.
4. After the procedure, remove the trap and seal the chambers for specimen analysis.
5. Dispose of the single-use trap following hospital guidelines.

Benefits of Using a Polyp Trap

Polyp Traps reduce the risk of tissue contamination and improve specimen management. They help streamline the diagnostic process by making retrieval easy and minimizing handling errors. Single-use models also reduce the risk of infection. Their numbered compartments simplify post-procedure analysis. These benefits contribute to higher procedural safety and diagnostic accuracy.

Advin Polyp Trap Description

Advin Health Care is a prominent manufacturer of Polyp Trap, offering advanced and user-friendly designs for accurate tissue collection during endoscopic procedures. Their Polyp Trap devices are crafted to reduce manual intervention, ensure accurate specimen labeling, and maintain high hygiene standards, supporting better diagnostic outcomes.

Key Points

• Prevents tissue loss
• No manual retrieval needed
• Easy, accurate specimen transfer
• Single-use to avoid cross-contamination

Esophageal Balloon Dilator

The Esophageal Balloon Dilator is a medical tool used to gently stretch narrow or blocked areas of the esophagus. It is most commonly used in procedures to treat esophageal strictures. This device helps improve swallowing and overall patient comfort during treatment.

A Brief Look at the History

Balloon dilation of the esophagus began gaining popularity in the 1980s as a safer, less traumatic alternative to traditional bougie dilation methods. Over time, the technique has evolved with advancements in material design and inflation control. Modern devices like the Esophageal Balloon Dilator offer precise positioning and controlled expansion. These improvements have made the procedure more efficient and patient-friendly.

Esophageal Balloon Dilator – Smooth, Precise Dilation for Optimal Patient Comfort

The Esophageal Balloon Dilator by Advin Health Care is designed with patient safety and clinical efficiency in mind. It offers smooth finishing and accurate positioning, reducing trauma during dilation. The device is sterile, single-use, and individually packed, ensuring hygienic and hassle-free handling. Balloon dilation is a common and essential procedure in the management of esophageal strictures and blockages. Advin Health Care ensures a reliable and easy-to-navigate design that meets modern clinical needs.

Common Surgeries Using Esophageal Balloon Dilator

• Endoscopic Esophageal Dilation Procedures
• Treatment of Esophageal Strictures
• Achalasia Management
• Post-surgical Esophageal Narrowing
• Caustic Injury Repair

Basic Instructions for Use

• Carefully remove the Esophageal Balloon Dilator from its sterile packaging.
• Connect it to the inflation system as per clinical setup.
• Insert the dilator under endoscopic guidance into the esophagus.
• Inflate the balloon slowly at the targeted stricture point.
• Maintain inflation as per clinical protocol, then deflate and gently remove.

Countries with the Highest Number of Esophageal Dilation Surgeries

• United States
• India
• China
• Germany
• Brazil

Advantages of Balloon Dilation Over Traditional Methods

Balloon dilation offers controlled, targeted expansion, reducing the risk of perforation compared to older bougie methods. Its minimally invasive approach ensures less discomfort and faster recovery for patients. The procedure can also be repeated with ease when needed.

Advin Esophageal Balloon Dilator Description

Advin Health Care is a prominent manufacturer of Esophageal Balloon Dilator, offering a product that is sterile, smooth, and designed for accurate dilation during endoscopic procedures. The dilator is crafted to assist gastroenterologists in performing precise and effective esophageal treatments with enhanced safety and ease.

Key Features

• Easy to guide and position
• Accurate targeting during use
• Supports up to 10 ATM pressure
• Smooth, patient-friendly surface
• Sterile and for one-time use
• Individually sealed packaging