• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2024 Scientific Session Call For Abstracts
      • 2024 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Endoluminal protection of colorectal anastomosis using a temporary non invasive bypass in pigs

Charam Khosrovani, MD. Clinique Fonvert

Aims: Anastomotic leakage (AL) and its complication remain the main concern following colorectal surgery. A defunctioning ostomy is commonly used to protect patients but is fraught with its own complications. This study examined the feasibility, safety, usefulness of Colovac, an anastomosis protection device, alleviating the need for ostomies. Colovac consists of a flexible bypass sheath placed in the colon lumen and intended to prevent extravasation of intracolonic content in case of dehiscence. The sheath is anchored using a stent and a vacuum system, sucking the colonic wall against the device.

Methods: Between 2016 and 2017, 22 12-week-old female pigs underwent low-anterior resection and circular-double-stapled anastomosis in an end-to-end technique. Once the anastomosis was created, Colovac was inserted endoluminally through the anus and the stent delivered and expanded 10 cm proximal to the anastomosis using a dedicated introducer. The sheath and vacuum-tube were deployed distally through the anastomosis and the anal orifice, with the vacuum-tube connected to a Redon vial, providing constant aspiration during the implantation period. All animals were sacrificed on a maximum of 14th-day post-surgery, after endoscopic removal of the device if no prior natural expulsion occurred. The anastomotic and stent implantation regions were examined for signs of abnormalities or impaired healing by histology.

Results: Surgical implantation of Colovac was technically successful in all cases, with immediate stent deployment and effective aspiration, requiring no more than 5-minutes additional time. During the implantation period, none of the animals died nor developed clinically relevant disease due to AL or intra-abdominal infection. One animal died of ischemia unrelated to the Colovac. Migration occurred in the 7 first animals, leading to a natural expulsion between D+3 and D+11. Absence of migration was achieved for 13 of the 14 following animals by reinforcing the connection of the aspiration tube and implementing a low-residue-diet during the entire implantation period. One animal had premature migration of the device due to an inadvertent disconnection of the vacuum system. Endoscopic retrieval was achieved in all cases. Macroscopic examination of the abdominal cavity showed no AL, intra-abdominal abscess, fistulas, nor necrosis. Microscopic examination showed signs of inflammation at the stent implantation site without abscess nor infection. All anastomotic lines appeared normal.

Conclusion: This study indicates an easy, safe use of Colovac in animals. Feasibility was achieved for insertion and removal. Anastomotic complications were absent. Preliminary efficacy is encouraging, arguing for a careful clinical evaluation in humans currently under preparation.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86217

Program Number: S057

Presentation Session: Instrumentation / Devices / Technologies Session

Presentation Type: Podium

47

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2018 abstract archive

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064
1-310-437-0544
sagesweb@sages.org
Monday - Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons