Intracolonic bypass by an intraluminal tube

Abstract

The most important cause of morbidity and mortality in colonic resection remains anastomotic leakage and, to this end, temporary stomas, with their own incidence of mortality or morbidity, are often created. Problems associated with both anastomosis and stoma can be prevented with the use of an internal bypass tube. This tube is implanted in the proximal colon above the proposed anastomotic site, then passed distally to the rectal ampulla, following which, the proximal and distal colonic segments are anastomosed. The fecal stream and gastrointestinal secretions are thereby prevented from coming in contact with the anastomotic site. The tube is expelled spontaneously after a varying time. The anastomoses in the experimental animals were subjected to maximal stress. Additionally, large dehiscences and induced fecal peritonitis were purposefully created in some animals. Results demonstrated that the intracolonic bypass tube prevents leakage even from gross dehiscences and that these dehiscences progress to complete healing. The experimental study leading to its clinical adaptation is presented.