Clinical Outcomes & Patient Safety, Innovation & Emerging Technology, Sustainability in Healthcare
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Anastomotic leak is the most feared complication in colorectal surgery. In 2008, a new treatment modality was introduced, which consists of endoscopic placement of a vacuum sponge into the abscess cavity, connected to a negative pressure device, referred to as endoscopic vacuum therapy. A recent meta-analysis has reported an anastomotic healing rate as high as 85%. Moreover, there is a complementary new concept defined as early surgical closure, which consists of a re-approximation of the bowel edges of the defect. Evidence is still required, but the surgical community believes that the addition of early surgical closure may improve outcomes further. In this SOC we will review the current status of the endoscopic vacuum therapy for colorectal anastomotic leak, together with early surgical closure.
Published
Jul 2022
Dr. Frasson gives a demonstration of how to use the Endo-Sponge kit, unboxing all the items and showing its indications, tips and tricks. In low colorectal anastomoses, an anuscope is usually enough to place the device. For higher anastomoses an endoscopic tube is needed. The abscessual cavity must be cleaned before placing the endo-sponge. Lubricant is needed, as well as a push-up tube, to insert the sponge in the abscessual cavity. A Y-shape connexion is used to establish the vacuum in the cavity through the drain tube. Two sponges can be connected to the vacuum if needed. The sponge can also be removed under endoscopic vision by using a saline solution to separate it from the tissues. Endo-sponge therapy should be maintained until the abscessual cavity is healed.
Published
Apr 2019
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