Applications of endoscopic vacuum therapy in the upper gastrointestinal tract

Figure 1 Intracavitary endoscopic vacuum therapy for an anastomotic leak after Ivor-Lewis esophagectomy. A: 10 mm wide Anastomotic leak; B: 6 cm deep cavity with necrotic tissue, debris, and fibrin; C: Intracavitary positioning of an EsoSponge (a nasojejunal feeding tube is visible inside the lumen to the right); D: Downsizing of the defect after the first endoscopic vacuum therapy (EVT) session; E: Clean cavity with healthy granular tissue after the first EVT session; F: Healed anastomotic leak after 4 EVT sessions.

Figure 2 Endoscopic vacuum therapy materials. A: The necessary materials for a handmade endoscopic vacuum therapy (EVT) sponge: Suture, scissors, needleholder, drain and polyurethane sponge; B: The components of the EsoSponge System: EVT sponge, pusher and overtube; C: A comparison of a handmade EVT sponge (left) and an EsoSponge (right).

Figure 3 Open-pore film drainage. A: The open-pore film drainage (OFD) system; B: Intraluminal application of OFD in the duodenum after a resection related perforation (clips are visible at the resection site).

Figure 4 VAC-Stent (MICRO-TECH Europe GmbH, Düsseldorf, Germany). A: The VAC-Stent system; B: The VAC-stent in place in the esophagus.