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

Staple line failure is the most significant complication after deep anterior rectal resection.
. Because of the immediate proximity of the sphincter to the anastomosis, there is a permanent backup of infected secretions and gas into the intestinal lumen.
Once staple line failure has occurred, primary extraperitoneal inflammation develops in the vicinity of the anastomosis, localized in the lesser pelvis. If inflammation remains localized and endoscopy demonstrates a cavity, Endo-SPONGE® endoluminal vacuum therapy can be employed.
This requires a functioning protective ileostomy, usually fashioned during the initial procedure.

• Generalized peritonitis
• No wound cavity on endoscopy
• Intraperitoneal wound cavity, with the walls of the cavity being formed by loops of small intestine. Otherwise, intraperitoneal localized perforations can also be managed with the sponge.

The open pores of the polyurethane sponge distribute the suction evenly over all tissue in contact with the sponge surface. This results in:

• Continuous drainage without secretion buildup
• Debridement with rapid cleansing of the wound
• Improved granulation
• Continuous mechanical wound cavity diminution
• Infection control