Case Studies

These case studies are presented only as examples and should not be considered as medical advice for any specific patient.

Laparoscopic Colostomy Reversal

90% Stenosis of Left Circumflex Artery

56 Year-Old Female Presents With:

  • Colostomy following Hartmann’s procedure for an obstruction of the sigmoid colon
  • Successful tumor resection; adenocarcinoma was invasive to the subserosa, but lymph nodes were benign and surgical margins were clear
  • Request for colostomy reversal for restoration of intestinal continuity approximately three months following completion of chemotherapy (nine months after initial surgery)

Colorectal Anastomosis/Reinforcement

  • An endorectal bougie facilitated identification of the rectal stump which was dissected free of adhesions (Image A)
  • The colostomy was dissected free of the skin and reintroduced into the abdominal cavity
  • Following reintroduction of the proximal end of the colon into the abdomen, it was prepared for anastomosis via circular stapler
  • To prevent potential leakage, fibrin sealant was applied to the colorectal anastomosis (Image B) for reinforcement

Why TISSEEL [Fibrin Sealant]?

  • Proven efficacy in preventing leakage from colonic anastomosis following the reversal of temporary colostomies1
  • In a single-center, prospective, open-label randomized trial (118 patients: 58 patients standard of care; 60 patients standard of care plus an earlier formulation of TISSEEL), TISSEEL was shown to be effective:
    • For sealing colonic anastomoses
    • For reducing the incidence of anastomotic complications following the reversal of temporary colostomies (p=0.0406)1

Selected Important Risk Information for TISSEEL [Fibrin Sealant]

  • Do not inject TISSEEL directly into the circulatory system or into highly vascularized tissue; thromboembolic events can occur1
  • Do not use in individuals with a known hypersensitivity to aprotinin1
  • Apply TISSEEL as a thin layer by dripping or spraying using cannula or spray set1
  • Do not use for the treatment of severe or brisk arterial or venous bleeding1