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


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