Endo-SPONGE® endoluminal vacuum therapy in lower GI tract staple line failure

Anatomy Perioperative management Technique Complications Evidence Total Video

Content

Endo-SPONGE® – Set
Baseline situation
Removing the sponge
Flexible endoscopy and sizing the wound cavity
Inserting the overtube
Sponge placement principle
Inserting the sponge with overtube and pusher
Releasing the sponge and checking its position
Connecting to the bottle
Final outcome

Authors

Date

date of publication: 14.12.2014

Endo-SPONGE® – Set

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Baseline situation

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The baseline situation is as follows:
There is a colonic J-pouch with colonic pouch-anal anastomosis. At the blind end of the pouch, suture line failure has resulted in a greasy largish wound cavity.
Removing the sponge

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The wound presented in step 1 was treated with an Endo-SPONGE®, which now needs to be replaced.
First, check the sponge position with an endoscope. Then disconnect the system from the vacuum by disconnecting the drainage tube and setting the suction to zero. Now disconnect the draining tube at the Y-connector. After opening the application set, remove the syringe and dilator to irrigate the sponge. Insert the dilator into the tube and attach the syringe. Irrigate the sponge by instilling physiological saline or, as in this example, simethicone, a liquid defoamer, and pull.