Pre-emptive EVT is a further development of endoscopic negative pressure therapy. It can be used beneficially to protect various anastomoses. The intraluminal version of the therapy is used. For intraluminal EVT the open-pored drain is placed in the lumen of the intestinum. Both open-pored foam and film drains can be used.  You will find here some examples of application and initial descriptions.


Pre-emptive ENPT in Esophagus after Ivor-Lewis Esophagoectomy

Since 2017, we have been using a double lumen open pore drain (dOFD) with simultaneous enteral feeding channel for preemptive negative pressure therapy during Ivor Lewis esophagectomy. With this new drainage device, we completely empty the stomach immediately after suturing the anastomosis.

 

Our goal is to drain the aggressive digestive secretions of reflux to avoid disturbances of anastomosis healing.

 

 

Pre‑emptive active drainage of reflux (PARD) in Ivor‑Lewis oesophagectomy with negative pressure and simultaneous enteral nutrition using a double‑lumen open‑pore film drain (dOFD)

Loske GMüller J, Schulze W, Riefel B, Müller CT. Pre-emptive active drainage of reflux (PARD) in Ivor-Lewis oesophagectomy with negative pressure and simultaneous enteral nutrition using a double-lumen open-pore film drain (dOFD). Surg Endosc. 2022 Jan 1. doi: 10.1007/s00464-021-08933-w. Epub ahead of print. PMID: 34973079.


Schematic representation of the method of pre-emptive active reflux drainage (PARD) in Ivor-Lewis esophagectomy from a presentation at the MIC Symposium Hamburg in November 2021.



We use this double-lumen open-pore film drain (dOFD) for PARD in Ivor-Lewis Esophagoectomy.


Making of a double-lumen open-pore film drain (dOFD) for pre-emptive active reflux drainage (PARD) with simultanous enteral feeding in cases of Ivor-Lewis esophagoectomy is demonstrated in video.

Video demonstrates the making of a double-lumen open-pore drain (dOFD) for pre-emptive reflux drainage after Ivor-Lewis esophagectomy. The drainage allows active aspiration of post-operative reflux (PARD) with simultaneous enteral feeding via an integrated feeding tube in the vulnerable early operative phase. PARD with open-pore drainage serves to prevent postoperative anastomotic insufficiency and increases patient safety during this high-risk surgery.

Das Video demonstriert die Herstellung einer doppellumigen offenporigen Drainage (dOFD) für die pre-emptive Refluxdrainage nach Ivor-Lewis Ösophagusresektion. Die Drainage ermöglicht die aktive Absaugung des postoperativen Refluxes (PARD) bei gleichzeitiger enteraler Ernährung über eine integrierte Ernährungssonde in der vulnerablen frühoperativen Phase. Die PARD mit offenporigen Drainage dient der Vermeidung der postoperativen Anastomoseninsuffizienz und erhöht die Patientensicherheit bei dieser Hochrisikooperation.




Prevention of reflux after esophagectomy with endoscopic negative pressure therapy using a new double-lumen open-pore film drainage with an intestinal feeding tube

Loske G, Schorsch T, Müller CT. Prevention of reflux after esophagectomy with endoscopic negative pressure therapy using a new double-lumen open-pore film drainage with an intestinal feeding tube. Endoscopy. 2017 Dec;49(12):E294-E295. doi: 10.1055/s-0043-118211. Epub 2017 Sep 19. PMID: 28926851.

Material for construction of an double-lumen openpore film drainage (OFD): Trilumina-tube (Fresenius), openpore film (L&R, CNP-Drainagefilm), suture.
Material for construction of an double-lumen openpore film drainage (OFD): Trilumina-tube (Fresenius), openpore film (L&R, CNP-Drainagefilm), suture.


First Report of Intraluminal Endoscopic Negative Pressure Therapy (ENPT) for Anastomotic Prophylaxis in a Case of Tubular Resection of Cervial Esophagus

.Loske G, Schorsch T, Muller CT. First Report of Intraluminal Endoscopic Negative Pressure Therapy (ENPT) for Anastomotic Prophylaxis in a Case of Tubular Resection of Cervical Esophagus. Clin Surg. 2017; 2: 1500


Intraluminal endoscopic vacuum therapy in a case of ischemia of the blind end of the jejunal loop after Roux-en-Y gastrectomy

Loske G, Schorsch T, Schmidt-Seithe H, Müller C. Intraluminal endoscopic vacuum therapy in a case of ischemia of the blind end of the jejunal loop after Roux-en-Y gastrectomy. Endoscopy. 2014;46 Suppl 1 UCTN:E575-6. doi: 10.1055/s-0034-1390913. Epub 2014 Nov 21. PMID: 25415175.

Grasping the openpore foam with a polyp-grasper
Grasping the openpore foam with a polyp-grasper