A unique solution to treat colorectal leakage
Case 1
Treatment of a large leakage after anterior rectal resection with TME* and creation of a J pouch.
Patient with rectal carcinoma, treated with anterior and total mesorectal resection excision and J pouch, developed a postsurgical anastomosis leakage of 20 cm depth.
Dr. Rolf Weidenhagen, Germany
Images
The leakage extends over 1/3 of the circumference and is endoscopically accessible to a depth of 20 cm. Since one sponge system is not sufficient to treat the large cavity, an additional system (sponge) is also inserted.
12 days after the start of treatment the cavity is completely cleaned of dirty fibrin coatings and covered in clean granulation tissue.
It is already possible to treat the cavity using just one sponge system.
After 21 days treatment, a clear reduction in the size of the leakage cavity has taken place. The cavity is closing with granulation tissue from its depths. The size of the sponge system is continuously decreased from one system change to the next.
After 33 days treatment only a small residual hollow is identifiable. These hollows normally heal without additional treatment.
Case 2
Patient female, 82, with rectal carcinoma and treated with anterior resection developed an anastomotic leakage 10 days after the intervention.
Dr. Rolf Weidenhagen, Germany
Videos
-
The flexible endoscope video shows the anastomosis leakage cavity.
-
The overtube is placed at the end of the cavity, prior step to inserting the Endo-SPONGE®.
-
Checking endoscopically the correct placement of the sponge.
-
24 hour assessment of the cavity. Only the area in contact with the sponge is granulated. A second sponge is needed.
-
Checking endoscopically the correct placement of the two sponges.
Images
Leakage cavity after 4 days.
Leakage cavity after 11 days.
Leakage cavity after 18 days.
Video
-
Leakage cavity after 21 days. Removal of the last sponge. Remaining cavity left to finally heal by second intention.
*TME: Total mesorectal excision