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slide the extact bracket onto the scope with the arrow pointing upwards wrap the blue strap above the scope channel and secure to the bracket pin insert the extact device with pre-loaded helix tack and scope liner into the scope channel ensure the biopsy cap is open and the scope is straight fully seat the scope liner funnel into the biopsy cap remove the extact backer card from the device catheter by folding the tab towards the helix tacks position the backer card with the number two proximal and attach by inserting both side tabs pull on the red scope liner clamp to release ensure the handle slider is in the reset position labeled r and the push catheter is in the initial locked position maneuver the scope to the target site recommended helix tac placement is approximately 5 to 10 millimeters from the defect margin verify position before fully driving into tissue while applying forward pressure to the catheter drive the helix tack by slowly pulling the handle slider to the d positio