Respect. Heal. Protect.

Endoluminal Vacuum Therapy.
Advancing Recovery With Intent.  

Discover EVT solutions with Eso‑SPONGE™ and Endo‑SPONGE™, applying continuous negative pressure for GI leak management.

Anastomotic leakage (AL) is a serious and potentially life-threatening complication following gastrointestinal surgery, strongly linked to increased morbidity and mortality. 1-6

​Endoluminal Vacuum Therapy (EVT) has emerged as an effective minimally invasive strategy to manage anastomotic leaks (AL) across both upper and lower GI tracts, with prevention in the upper GI specifically supported through the established indication of the Eso-Sponge device.

Mechanism of Action

EVT, based on Negative Pressure Wound Therapy, employs an open-pore polyurethane sponge connected to a vacuum source that applies continuous negative pressure. 

This mechanism contributes to:

  • Increased blood flow and reduced edema7
  • Promotion of granulation tissue formation and extracellular synthesis7
  • Decreased bacterial contamination and secretion8

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Eso-SPONGE™

Eso-SPONGE™ is specifically designed for upper GI perforations and for both the management and prevention of anastomotic leaks (AL). When initiated early, it supports effective infection control and contributes to shorter hospital stays and lower mortality rates.4,9-21

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Enhancing expertise

Endo-SPONGE™ targets colorectal anastomotic leaks (AL), with observed trends toward reduced hospital stay and lower rates of permanent stoma formation potentially decreasing the overall cost of AL treatment. It also supports the feasibility of ambulatory care. 22-29

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References:  

1. Holscher AH, Vallbohmer D, Brabende J. The prevention and management of perioperative complications. Best Pract Res Clin Gastroenterol. 2006;20(5):907-23.
2. Schaheen L, Blackmon SH, Nason KS, Optimal approach to the management of intrathoracic esophageal leak following esophagectomy: a systematic review. Am J Surg, 2014. 208(4): p. 536-43.
3 .Blencowe NS, Strong S, McNair AG, Brookes ST, Crosby T, Griffin SM, Blazeby JM. Reporting of short-term clinical outcomes after esophagectomy: a systematic review. Ann Surg, 2012 Apr;255(4):658-66.
4. Morell B, Murray F, Vetter D, Bueter M, Gubler C. Endoscopic vacuum therapy (EVT) for early infradiaphragmal leakage after bariatric surgery-outcomes of six consecutive cases in a single institution. Langenbecks Arch Surg. 2019 Feb;404(1):115-21.
5. Milito G, Lisi G. Endoluminal Vacuum Therapy as treatment for anastomotic colorrectal leakage. Surg Technol Int. 2017;10(30):125-30.
6. Shalaby M, Emile S, Elfeki H, Sakr A, Wexner SD, Sileri P. Systematic review of endoluminal vacuum-assisted therapy as salvage treatment for rectal anastomotic leakage. BJS open. 2018;3(2):153-60.
7. Schintler MV. Negative pressure therapy: theory and practice. Diabetes Metab Res Rev. 2012 Feb;28 Suppl 1:72-7.
8. Kuehn F, Janisch F, Schwandner F, Alsfasser G, Schiffmann L, Gock M, Klar E. Endoscopic Vacuum Therapy in Colorectal Surgery. J Gastrointest Surg. 2016 Feb;20(2):328-34
9. Kuehn F, Schiffmann L, Janisch F, Schwandner F, Alsfasser G, Gock M, Klar E. Surgical Endoscopic Vacuum Therapy for Defects of the Upper Gastrointestinal Tract. J Gastrointest Surg. 2016 Feb;20(2):237-43.
10. Heits N, Bernsmeier A, Reichert B, Hauser C, Hendricks A, Seifert D, Richter F, Schafmayer C, Ellrichmann M, Schniewind B, Hampe J, Becker T, Egberts JH. Long-term quality of life after endovac-therapy in anastomotic leakages after esophagectomy. J Thorac Dis. 2018 Jan;10(1):228-40.
11. Gubler C, Vetter D, Schmidt HM, Müller PC, Morell B, Raptis D, Gutschow CA. Preemptive endoluminal vacuum therapy to reduce anastomotic leakage after esophagectomy: a game-changing approach? Dis Esophagus. 2019 Jul 1;32(7):doy126.
12. Bludau M, Fuchs HF, Herbold T, Maus MKH, Alakus H, Popp F, Leers JM, Bruns CJ, Hölscher AH, Schröder W, Chon SH. Results of endoscopic vacuum-assisted closure device for treatment of upper GI leaks. Surg Endosc. 2018 Apr;32(4):1906-14.
13. Valli PV, Mertens JC, Kröger A, Gubler C, Gutschow C, Schneider PM, Bauerfeind P. Stent-over-sponge (SOS): a novel technique complementing endosponge therapy for foregut leaks and perforations. Endoscopy. 2018 Feb;50(2):148-53.
14. Alakkari A, Sood R, Everett SM, Rembacken BJ, Hayden J, Sarela A, Mohammed N. First UK experience of endoscopic vacuum therapy for the management of oesophageal perforations and postoperative leaks. Frontline Gastroenterol. 2019 Apr;10(2):200-203.
15. Chon SH, Toex U, Plum PS, Fuchs C, Kleinert R, Bruns C, Goeser T. Successful closure of a gastropulmonary fistula after esophagectomy using the Apollo Overstitch and endoscopic vacuum therapy. Endoscopy. 2018 Jul;50(7):E149-50.
16. Herbold T, Chon SH, Grimminger P, Maus MKH, Schmidt H, Fuchs H, Brinkmann S, Bludau M, Gutschow C, Schröder W, Hölscher AH, Leers JM. Endoscopic Treatment of Transesophageal Echocardiography-Induced Esophageal Perforation. J Laparoendosc Adv Surg Tech A. 2018 Apr;28(4):422-28.
17. Loske G. Endoscopic negative pressure therapy of the upper gastrointestinal tract. Chirurg. 2019 Jan;90 (Suppl 1):1-6.
18. Loske G, Müller CT. Tips and tricks for endoscopic negative pressure therapy. Chirurg. 2019 Jan;90:(Suppl 1):7-17.
19. Comellas E, Bellomo FJ, Rosales I, Del Castillo LF, Sánchez R, Turón P, Oller S. On the feasibility of the computational modelling of the endoluminal vacuum-assisted closure of an oesophageal anastomotic leakage. R Soc Open Sci. 2018 Feb 7;5(2):171289.
20. Schniewind B, Schafmayer C, Voehrs G, Egberts J, von Schoenfels W, Rose T, Kurdow R, Arlt A, Ellrichmann M, Jürgensen C, Schreiber S, Becker T, Hampe J. Endoscopic endoluminal vacuum therapy is superior to other regimens in managing anastomotic leakage after esophagectomy: a comparative retrospective study. Surg Endosc. 2013 Oct;27(10):3883-90.
21. Glatz T, Fischer A, Hoeppner J, Thimme R, Walker C, Richter-Schrag HJ. Vacuum sponge therapy using the pull-through technique via a percutaneous endoscopic gastrostomy to treat iatrogenic duodenal perforation. Endoscopy. 2015;47 Suppl 1:E567-8.
22. Milito G, Lisi G. Endoluminal Vacuum Therapy as treatment for anastomotic colorrectal leakage. Surg Technol Int. 2017;10(30):125-30.
23. Shalaby M, Emile S, Elfeki H, Sakr A, Wexner SD, Sileri P. Systematic review of endoluminal vacuum-assisted therapy as salvage treatment for rectal anastomotic leakage. BJS open. 2018;3(2):153-60.
24. Jimenez-Rodriguez RM, Araujo-Miguez A, Sobrino-Rodriguez S, Heller F, Díaz-Pavon JM, Bozada-García JM, de la Portilla F. A new perspective on vacuum-assisted closure for the treatment of anastomotic leak following low anterior resection for rectal cancer, is it worthy? Surg Innov. 2018;25(4):350-6.
25. Weidenhagen R, Gruetzner KU, Wiecken T, Spelsberg F, Jauch KW. Endoluminal vacuum therapy for the treatment of anastomotic leakage after anterior rectal resection. Rozhl Chir. 2008;87(8):397-402.
26. Nerup N, Johansen JL, Alkhefagie GAA, Maina P, Jensen KH. Promising results after endoscopic vacuum treatment of anastomotic leakage following resection of rectal cancer with ileostomy. Dan Med J. 2013;60(4):A4604.
27. Arezzo A, Verra M, Passera R, Bullano A, Rapetti, Morino M. Long-term efficacy of endoscopic vacuum therapy for the treatment of colorectal anastomotic leaks. Dig Liver Dis. 2015;47(4):342-5.
28. Riss S, Stift A, Meier M, Haiden E, Grünberger T, Bergmann M. Endo-Sponge assisted treatment of anastomotic leakage following colorectal surgery. Colorectal Dis. 2010;12(7):104-8.
29. Weidenhagen R, Gruetzner KU, Wiecken T, Spelsberg F, Jauch KW. Endoscopic vacuum-assisted closure of anatomotic leakage following anterior resection of the rectum: a new method. Surg Endosc. 2008;22(8):1818-25.

 

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