Endoluminal vacuum-assisted therapy and transanal minimally invasive surgery closure of leak following ileal pouch-anal anastomosis - a video vignette.

Abstract

Anastomotic leaks (AL) after ileal pouch procedure occur in 4-17% of cases and can lead to pelvic sepsis, stricture, delayed ileostomy closure and pouch failure [1]. Redo-pelvic surgery can be technically demanding and is associated with major postoperative morbidity in 16% of case.[2]. Weidenhagen first described the use of endoluminal vacuum-assisted therapy (E-VAT) for anastomotic leak [3]. Gardenbroek et al showed using E-VAT followed by open transanal surgical closure of the defect in patients with IPAA and AL can improve outcomes by reducing the anastomotic healing time [4].