Advertisement

Techniques in Coloproctology

, Volume 22, Issue 3, pp 231–233 | Cite as

Different approaches for Endo-SPONGE® insertion to treat rectal anastomotic leaks

  • Ephraim Katz
  • Ian White
  • Baruch Shpitz
  • Ronen Ghinea
  • Shmuel Avital
Trick of the Trade

Introduction

Rectal anastomotic leaks may present in different degrees of severity. Significant leaks are life-threatening events and may lead to a permanent stoma [1].

The treatment goal in such cases is sepsis control and an attempt to preserve the rectal anastomosis.

Vacuum-assisted closure (VAC) devices have been shown to accelerate wound healing by increasing local blood flow, reducing bacterial load, and stimulating growth of granulation tissue [2]. The Endo-SPONGE® system (B. Braun, Melsungen, Hessen, Germany) was designed on the same principles to specifically treat rectal anastomotic leaks and was first introduced in 2008 [3].

This vacuum-assisted device consists of a sponge inserted endoscopically through the dehiscence site into the para-anastomotic space and connected to a small container which exerts a constant suction at 120 psi.

Preliminary promising results in the treatment of para-anastomotic abscesses following anastomotic leakage lead to a wider use of this device...

Notes

Compliance with ethical statements

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the hospital ethical review board.

Informed consent

Informed consent was exempted due to the retrospective nature of this report.

References

  1. 1.
    Caulfield H, Hyman NH (2013) Anastomotic leak after low anterior resection: a spectrum of clinical entities. JAMA Surg 148(2):177–182CrossRefPubMedGoogle Scholar
  2. 2.
    Argenta LC, Morykwas MJ (1997) Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 38(6):563–576CrossRefPubMedGoogle Scholar
  3. 3.
    Weidenhagen R, Gruetzner KU, Wiecken T, Spelsberg F, Jauch KW (2008) Endoscopic vacuum-assisted closure of anastomotic leakage following anterior resection of the rectum: a new method. Surg Endosc 1818–1825:7Google Scholar
  4. 4.
    Strangio G, Zullo A, Ferrara EC et al (2015) Endo-sponge therapy for management of anastomotic leakages after colorectal surgery: a case series and review of literature. Dig Liver Dis 47(6):465–469CrossRefPubMedGoogle Scholar
  5. 5.
    Kuehn F, Janisch F, Schwandner F et al (2016) Endoscopic vacuum therapy in colorectal surgery. J Gastrointest Surg 2:328–334CrossRefGoogle Scholar
  6. 6.
    Borstlap WAA, Musters GD, Stassen LPS et al (2018) Vacuum-assisted early transanal closure of leaking low colorectal anastomoses: the CLEAN study. Surg Endosc 32(1):315–327CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Ephraim Katz
    • 1
    • 2
  • Ian White
    • 1
    • 2
  • Baruch Shpitz
    • 1
    • 2
  • Ronen Ghinea
    • 1
    • 2
  • Shmuel Avital
    • 1
    • 2
  1. 1.Department of Surgery BMeir Medical CenterKfar SabaIsrael
  2. 2.Sackler Faculty of MedicineTel-Aviv UniversityTel-AvivIsrael

Personalised recommendations