Perioperative management - Endoluminal Vacuum Therapy with the Endo-SPONGE® for the Treatment of Anastomotic Insufficiency of the Lower GI Tract

The most significant complication after deep anterior rectal resection is anastomotic leakage.
Due to the sphincter located in close proximity to the anastomosis, there is a constant backflow of infected secretions and gas into the intestinal lumen.
Following the occurrence of anastomotic leakage, inflammation primarily develops extraperitoneally in the area of the anastomosis, localized in the small pelvis. If the inflammation remains localized and a cavity can be visualized endoscopically, endoluminal vacuum therapy with the Endo-SPONGE® is applied.
A prerequisite is a functioning protective ileostomy, which is usually created during the initial procedure.

• generalized peritonitis
• no cavity amenable to colonoscopic visualization
• intraperitoneal location of the wound cavity, if the wall of the cavity is formed by loops of the small intestine. Otherwise, the intraperitoneally covered perforation can also be treated with the sponge

Through the open pores of the polyurethane sponge, the suction is evenly distributed across the entire tissue in contact with the surface of the sponge. This achieves:

• continuous drainage without secretion stasis,
• debridement with rapid cleansing of the wound cavity,
• stimulation of granulation,
• constant mechanical reduction of the wound cavity,
• infection control.