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Endoscopic vacuum

Geraldine Ooi, Paul Burton, Andrew Packiyanathan, Damien Loh, Richard Chen, Kalai Shaw, Wendy Brown, Peter Nottle
BACKGROUND: Endoscopic vacuum-assisted closure (EndoVAC) therapy is a recent innovation described for use in upper gastrointestinal perforations and leaks, with reported success of 80-90%. It provides sepsis control and collapses the cavity preventing stasis, encouraging healing of the defect. Whilst promising, initial reports of this new technique have not established clear indications, feasibility and optimal technique. METHODS: We analysed all patients who underwent EndoVAC therapy between 2014 and 2016...
November 15, 2016: ANZ Journal of Surgery
K Krajinovic, S Reimer, T Kudlich, C T Germer, A Wiegering
BACKGROUND: Anastomotic leakage (AL) is one of the most common and serious complications following visceral surgery. In recent years, endoluminal vacuum therapy has dramatically changed therapeutic options for AL, but its use has been limited to areas easily accessible by endoscope. CASE PRESENTATION: We describe the first use of endoluminal vacuum therapy in the small intestine employing a combined surgical and endoscopic "rendezvous technique" in which the surgeon assists the endoscopic placement of an endoluminal vacuum therapy sponge in the jejunum by means of a pullback string...
December 2016: Surgical Case Reports
Mike G Laukoetter, Rudolf Mennigen, Philipp A Neumann, Sameer Dhayat, Gabriele Horst, Daniel Palmes, Norbert Senninger, Thorsten Vowinkel
BACKGROUND: Perforations and anastomotic leakages of the upper gastrointestinal (GI) tract cause a high morbidity and mortality rate. Only limited data exist for endoscopic vacuum therapy (EVT) in the upper GI tract. METHODS: Fifty-two patients (37 men and 15 women, ages 41-94 years) were treated (12/2011-12/2015) with EVT for anastomotic insufficiency secondary to esophagectomy or gastrectomy (n = 39), iatrogenic esophageal perforation (n = 9) and Boerhaave syndrome (n = 4)...
October 5, 2016: Surgical Endoscopy
Andreas Fischer, Robert Thimme, Ulrich T Hopt, Hans-Jürgen Richter-Schrag
Endoscopic vacuum treatment (EVT) is increasingly used in the treatment of anastomotic leakages and perforations in the upper gastrointestinal tract. However, sponges often have to be mounted individually on a gastric tube and endoscopic introduction of the latter into an infected extraluminal cavity is challenging. In order to facilitate this procedure in some anatomical situations, we developed the prototype of a new sponge for EVT called a two-side sponge (TSS).
September 2016: Endoscopy International Open
Gunnar Loske, Tobias Schorsch, Christian T Müller
No abstract text is available yet for this article.
August 8, 2016: Deutsches Ärzteblatt International
Nobuyoshi Takeshita, Khek Yu Ho
Full-thickness gastrointestinal defects such as perforation, anastomotic leak, and fistula are severe conditions caused by various types of pathologies. They are more likely to require intensive care and a long hospital stay and have high rates of morbidity and mortality. After intentional full-thickness opening of hollow organs for natural orifice transluminal endoscopic surgery, safe and secure closure is urgently required. The currently available advanced endoscopic closing techniques have a major role in the treatment of full-thickness gastrointestinal defects...
September 2016: Clinical Endoscopy
Edwin Halliday, Anant Patel, Andrew Hindmarsh, Vijay Sujendran
Endoscopic vacuum-assisted closure (VAC) is increasingly being used as a means of managing perforations or anastomotic leaks of the upper gastrointestinal (GI) tract. Published outcomes are favourable, with few mentions of complications or morbidity. We present a case in which the management of a gastric perforation with endoscopic vacuum therapy was complicated by cervical oesophageal perforation. The case highlights the risks of such endoscopic therapeutic procedures and is the first report in the literature to describe significant visceral injury during placement of a VAC device for upper GI perforation...
July 28, 2016: Journal of Surgical Case Reports
G Loske, T Schorsch
INTRODUCTION: Operative and interventional treatment of Boerhaave's syndrome include closure of the esophageal defect and drainage of the septic focus. Initial reports on the use of endoscopic vacuum therapy (EVT) of Boerhaave's syndrome are now available. This article describes the experiences gained from the clinical application in two patients using this new surgical endoscopic procedure. The current literature regarding treatment of Boerhaave's syndrome is presented. MATERIAL AND METHODS: Open-pore drainage is endoscopically placed either through the transmural defect in the extraluminal wound cavity (intracavitary EVT) or overlapping the defect into the esophageal lumen (intraluminal EVT)...
August 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Steven G Leeds, James S Burdick
BACKGROUND: Sleeve gastrectomy has become a popular weight loss procedure, but it is associated with staple line leak resulting in high morbidity and mortality. Current management options range from endoscopic techniques (predominantly stent placement) to surgical intervention. OBJECTIVE: The purpose of this study was to recognize endoluminal vacuum (E-Vac) therapy as a viable option for use in anastomotic leaks of sleeve gastrectomies. SETTING: This study took place at Baylor University Medical Center at Dallas, Texas...
January 21, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Gunnar Loske, Josef Aumiller, Frank Rucktäschel, Tobias Schorsch
No abstract text is available yet for this article.
2016: Endoscopy
Gunnar Loske, Tobias Schorsch, Olaf Gobrecht, Eckhard Martens, Frank Rucktäschel
No abstract text is available yet for this article.
2016: Endoscopy
Jae J Hwang, Yeon S Jeong, Young S Park, Hyuk Yoon, Cheol M Shin, Nayoung Kim, Dong H Lee
The aim of the present study was to evaluate the more effective therapy for the postsurgical gastroesophageal leakage by a head-to-head comparison of endoscopic vacuum therapy (EVT) and endoscopic stent implantation with self-expandable metal stent (E-SEMS). In this hospital-based, retrospective, observative study, the patients were classified into 2 groups. Those treated with EVT were assigned to the EVT group (n = 7), and those treated with E-SMS were assigned to the E-SEMS group (n = 11). We evaluated the clinical characteristics and treatment outcomes between the 2 groups...
April 2016: Medicine (Baltimore)
Hyo Chul Youn, Se Hwan Kwon
It has been reported that intrathoracic esophageal leakages occur at a rate of 4%-17% after Ivor-Lewis esophagectomy. There has been no consensus on a specific treatment for the post-operative anastomotic leakage. Recently, endoscopic vacuum-assisted closure (E-VAC) has been introduced as a novel treatment for the post-operative anastomotic leakage. We herein report the case of a patient with early perforation of the gastric conduit followed by late esophagogastric anastomotic leakage who was successfully treated with early surgical repair and subsequent E-VAC...
April 13, 2016: Annals of Thoracic and Cardiovascular Surgery
X W Wu, J A Ren, J S Li
Intestinal fistulas are severe complications after abdominal surgical procedures. The endoscopic therapy makes it possible to close fistulas without surgical interventions. When patients achieved stabilization and had no signs of systemic sepsis or inflammation, these therapies could be conducted, which included endoscopic vacuum therapy, fibrin glue sealing, stents, fistula plug, suture, and Over The Scope Clip (OTSC). Various techniques may be combined. Endoscopy vacuum therapy could be applied to control systemic inflammation and prevent continuing septic contamination by active drainage...
March 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Nicolas A Villa, Manuel Berzosa, Michael B Wallace, Isaac Raijman
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has become a fundamental tool in obtaining cytopathological diagnosis of pancreatic tumors. When sampling solid lesions of the pancreas, the endosonographer can use two suction techniques to enhance tissue acquisition; the dry and the wet suction techniques. The standard dry suction technique relies on applying negative pressure suction on the proximal end of the needle after the stylet is removed with a pre-vacuum syringe. The wet suction technique relies on pre-flushing the needle with saline to replace the column of air with fluid followed by aspiration the proximal end by using a prefilled syringe with saline...
January 2016: Endoscopic Ultrasound
Oliver Möschler, Christoph Nies, Michael K Mueller
BACKGROUND AND STUDY AIMS: Injuries to the esophageal wall, such as perforations and anastomotic leaks, are serious complications of surgical and endoscopic interventions. Since 2006, a new treatment has been introduced, in the form of endoscopically placed vacuum sponge therapy. PATIENTS AND METHODS: Between April 2012 and October 2014, 10 patients (5 men and 5 women) aged 57 to 94 years were treated at our institution using endoscopic vacuum therapy (EVT) in the upper gastrointestinal tract...
December 2015: Endoscopy International Open
Gunnar Loske, Tobias Schorsch, Christian Dahm, Eckhard Martens, Christian Müller
BACKGROUND AND STUDY AIMS: Endoscopic Vacuum Therapy (EVT) has been reported as a novel treatment option for esophageal leakage. We present our results in the treatment of iatrogenic perforation with EVT in a case series of 10 patients. PATIENTS AND METHODS: An open pore polyurethane drainage was placed either intracavitary through the perforation defect or intraluminal covering the defect zone. Application of vacuum suction with an electronic device (continuous negative pressure, -125 mmHg) resulted in defect closure and internal drainage...
December 2015: Endoscopy International Open
Gunnar Loske, Frank Rucktäschel, Tobias Schorsch, Vera van Ackeren, Bettina Stark, Christian T Müller
No abstract text is available yet for this article.
January 2015: Endoscopy
Florian Kuehn, Leif Schiffmann, Florian Janisch, Frank Schwandner, Guido Alsfasser, Michael Gock, Ernst Klar
INTRODUCTION: Intraluminal therapy used in the gastrointestinal (GI) tract was first shown for anastomotic leaks after rectal resection. Since a few years vacuum sponge therapy is increasingly being recognized as a new promising method for repairing upper GI defects of different etiology. The principles of vacuum-assisted closure (VAC) therapy remain the same no matter of localization: Continuous or intermittent suction and drainage decrease bacterial contamination, secretion, and local edema...
February 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jens Rassweiler, Marie-Claire Rassweiler, Jan Klein
PURPOSE OF REVIEW: New developments of retrograde intrarenal and percutaneous endoscopic surgery for nephrolithiasis have significantly enhanced the indications of endourology compared to extracorporeal shock wave lithotripsy. We want to review the most significant new technologies RECENT FINDINGS: New technology to access the renal collecting system includes marker-based tracking with iPAD, laser-guided puncture on (Uro)Dyna-CT, electromagnetic tracking (only experimental), and optical tracking for ultrasound-guided puncture...
January 2016: Current Opinion in Urology
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