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