Colorectal Surgery

Can you lower your rate of return to the operating room or hospital due to complications?
 
At Ethicon our goal is to provide products and support that help to improve patient outcomes.  In pre-clinical testing Ethicon products have been shown to outperform the competitor for these risk factors that are common considerations in colorectal procedures.

Improving outcomes in open colorectal surgery and minimally invasive colorectal surgery

The Ethicon Colorectal Portfolio

At Ethicon, we are the market leader in products supporting colorectal surgeries.2  We offer the most comprehensive portfolio to support surgeon’s colorectal surgery needs.3

ethicon product portfolio

Videos

Supporting Documentation

References

 

* Benchtop testing in porcine tissue ≤30mmHg (26mmHg average pressure experienced during intra-operative leak test), comparing Ethicon ECHELON CIRCULAR™ Powered Stapler CDH25P to Medtronic DST Series™ EEA™ Stapler EEA2535 (p<0.001) and preclinical perfusion model, in which perfusion was not significantly different between devices.

**Impact of the Novel Powered Circular Stapler on Risk of Anastomotic Leakage in Colorectal Anastomosis. A Propensity Score-Matched Study. [ECHELON CIRCULAR 1.7% (1/60) vs. manual circular 11.8% (14/119), p=0.022]

1. de Jonge SW, Atema JJ, Solomkin JS, Boermeester MA. Meta-analysis and trial sequential analysis of triclosan-coated sutures for the prevention of surgical site infection. Brit J Surg. 2017;ePub-DOI: 10.1002/bjs.10445

2. Ethicon 2017 procedure spotlight data

3. Comparing product lines of major manufacturers

4. Benchtop testing in porcine colon compared the rate of staple line leak failure at ≤30mmHg, compared Ethicon CDH29P/CS40B/CR40B to Ethicon CDH29A/CS40B/CR40B, n=30 ea p=0.029. Leak rate at ≤30mmHg was selected based on a preclinical study that measured the intraluminal pressure associated with an intra-operative leak test by surgeons (n=31). Average selected pressure was 26 +/-1.8 mmHg.

5. Risk factors for leaks include the following:tissue trauma and astaple line with unevencompression. Benchtop testing on porcine colon comparing mean mucosal capture of 46.3% (n=30) for Echelon Contour to 74.46% (n=30) for Contour (p<0.05). Finite element‐based computational simulations (FEA) on simulated porcine tissue measuring tissue compression after approximation and staple formation, comparing average standard deviation of 5.481 for 2D staples to 5.109 for 3D staples (n=37, p<0.05).

6. Unique curved head design gives low pelvic access and enhanced visibility of anatomic structures

7. Preclinical test of distal tip bleeding in thick porcine mesentery base; ENSEAL® vs. Impact-LF4318 (p=0.001).

8. System components include ECHELON FLEX™ Powered Plus Stapler and ECHELON™ ENDOPATH Reloads with Gripping Surface Technology

9. 21 RCTs, 6462 patients, 95% CI: (14, 40%), P < 0.001. All triclosan-coated sutures in these RCTs were Ethicon Plus Antibacterial Sutures (Monocryl Plus, Vicryl Plus and PDS Plus), barbed sutures were not included.

10. ENSEAL® devices tested in a benchtop study on 5-7mm porcine carotid arteries. With NSLG2C35A devices, median burst pressures were 51% higher for vessels sealed at a 90° angle compared to vessels sealed at a 45° angle (p=0.0007). With NSLG2S35A devices, mean burst pressures were 29% higher for vessels sealed at a 90° angle compared to vessels sealed at a 45° angle (p=0.001).

11. Based on benchtop metrology and porcine comparative studies vs. legacy HARMONIC® and LigaSure™ Maryland devices.

12. Benchtop testing in porcine colon ranging in width from 28mm to 36mm, and in thickness from 1.5mm to 2.5mm. Mean tissue slippage GST45 with Blue reload (1.69mm), Tri-Staple45 with Purple reload (2.12mm), p=0.022.

13. Market share data compiled from Decision Resources Group.

14. Compared to Harmonic ACE+7 Shears

SURGICEL Essential Product Information
•    INDICATIONS
SURGICEL® Absorbable Hemostat (oxidized regenerated cellulose) is used adjunctively in surgical procedures to assist in the control of capillary, venous, and small arterial hemorrhage when ligation or other conventional methods of control are impractical or ineffective. SURGICEL® ORIGINAL, SURGICEL® FIBRILLAR™, SURGICEL® NU-KNIT®, and SURGICEL® SNoW™ Absorbable Hemostats can be cut to size for use in endoscopic procedures.

•    PRECAUTIONS
Use only as much SURGICEL® Absorbable Hemostat as is necessary for hemostasis, holding it firmly in place until bleeding stops. Remove any excess before surgical closure in order to facilitate absorption and minimize the possibility of foreign body reaction.
In urological procedures, minimal amounts of SURGICEL® Absorbable Hemostat should be used and care must be exercised to prevent plugging of the urethra, ureter, or a catheter by dislodged portions of the product. 
Since absorption of SURGICEL® Absorbable Hemostat could be prevented in chemically cauterized areas, its use should not be preceded by application of silver nitrate or any other escharotic chemicals.
If SURGICEL® Absorbable Hemostat is used temporarily to line the cavity of large open wounds, it should be placed so as not to overlap the skin edges. It should also be removed from open wounds by forceps or by irrigation with sterile water or saline solution after bleeding has stopped.
Precautions should be taken in otorhinolaryngologic surgery to assure that none of the material is aspirated by the patient.  (Examples: controlling hemorrhage after tonsillectomy and controlling epistaxis.)
Care should be taken not to apply SURGICEL® Absorbable Hemostat too tightly when it is used as a wrap during vascular surgery (see Adverse Reactions section of the complete product package insert).

•    ADVERSE EVENTS 
“Encapsulation” of fluid and foreign body reactions have been reported. 

There have been reports of stenotic effect when SURGICEL® Absorbable Hemostat has been applied as a wrap during vascular surgery. 

Paralysis and nerve damage have been reported when SURGICEL® Absorbable Hemostat was used around, in, or in proximity to foramina in bone, areas of bony confine, the spinal cord, and/or the optic nerve and chiasm. 

Blindness has been reported in connection with surgical repair of a lacerated left frontal lobe when SURGICEL® Absorbable Hemostat was placed in the anterior cranial fossa. 

Possible prolongation of drainage in cholecystectomies and difficulty passing urine per urethra after prostatectomy have been reported. 

For more information, please consult your doctor or for product quality and technical questions, call 1-800-795-0012.  For complete product information including indications, contraindications, warnings, precautions, and adverse reactions, please reference the individual product package inserts.  


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