Prof. Andre Jan Louis D'Hoore

Department of Abdominal Surgery, University Clinics Gasthuisberg, Belgium

Department of Surgery, Kaplan Medical Center, Israel

Department of Surgical Science, University Hospital Uppsala, Sweden

Prof. Micha Rabau

Department of Surgury, The Tel Aviv Sourasky Medical Center, Israel

Prof. Anthony J. Senagore

Michigan State University and Spectrum Health System, MI, USA

Dr. Hagit Tulchinsky

Department of Surgery, The Tel Aviv Sourasky Medical Center, Israel

What the ColonRing™ is

The ColonRing™ is a medical device that helps your colon heal after colon surgery. Your surgeon places the ColonRing™ so that it reconnects the two parts of your colon after your surgery. Inside your body, the ColonRing™ applies gentle pressure to the sections of your colon until they completely and naturally grow back together. This usually takes about 7 to 10 days. After healing is complete, the ColonRing™ is expelled from your body, leaving healthy tissue and no foregin body within your bowel lumen.

ColonRing™ Natural Healing after Colorectal Surgery

• What is BioDynamix™ Anastomosis?
• What are the advantages of the ColonRing™?
• What is the alternative?
• Has the ColonRing™ been well tested?
• Will I feel the ring when it is expelled?
  
  

What is BioDynamix™ Anastomosis?

Anastomosis is the surgical connection of two parts of a hollow organ, such as the colon. The technology used in the ColonRing™ is called BioDynamix™ Anastomosis because it encourages natural, biologic healing and because it is dynamic, or active, in applying the gentle pressure needed for healing. 
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What are the advantages of the ColonRing™?

The ColonRing™ offers important benefits compared to other methods of repairing the colon. It preserves the widest possible opening in the colon following surgery. It helps prevent scar tissue and it exits your body after healing is complete, leaving nothing behind in the bowel lumen.
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What is the alternative?

Before the ColonRing,™ surgeons usually reconnected the colon using surgical staples. They stay in the body permanently. In addition, the colon often becomes narrower at the area that has been stapled.
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Has the ColonRing™ been well tested?

The safety and effectiveness in the ColonRing™ have been shown in clinical trials and in use by surgeons around the world. The ColonRing™ has been used in patients in North America, Europe, Israel, South Africa and China, and has been shown to be safe and effective. 
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Will I feel the ring when it is expelled?

In clinical trials and regular use, surgeons report that very few patients even notice the ring when it leaves their body. Of those who do, none have reported discomfort.
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The ColonRing™ does not eliminate the complications associated with the surgery or the anastomosis, which may include leakage, stricture, bleeding, septic complications, extra-colonic complications and others, which are the same to those reported with other methods (e.g. staplers).

NiTi Surgical Solutions is a medical device company. As such, the company cannot provide any personal medical advice or guidance. Please talk to your physician, colorectal surgeon or general surgeon about whether the ColonRing™ is right for you.

To find out more about NiTi™ Surgical Solutions, our unique technology and product portfolio, or for information on surgeons using our products, please contact niti@nitisurgical.com.

For more information about BioDynamix™ Anastomosis please refer to the Technology Overview page. 
Read more on conditions relating to the colon, rectum and anus at the American Society of Colon and Rectal Cancer web-site. 

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Risk Factors and Outcomes for Anastomotic Leakage in Colorectal Surgery: A Single-Institution Analysis of 1576 Patients.
Boccola MA, Buettner PG, Rozen WM, Siu SK, Stevenson AR, Stitz R, Ho YH.
World J Surg. 2010 Oct 23. [Epub ahead of print]
PMID: 20972678 [PubMed - as supplied by publisher]

CONCLUSION: In this prospective study, advanced tumour stage, distal site, and need for postoperative blood transfusion were associated with increased rates of anastomotic leakage. In addition to their high risk of immediate postoperative morbidity and mortality, both localized and generalized leaks had similarly negative impacts on overall, cancer-related, and disease-free survival.


Real-time Intraoperative Detection of Tissue Hypoxia in Gastrointestinal Surgery by Wireless Pulse Oximetry.
Servais EL, Rizk NP, Oliveira L, Rusch VW, Bikson M, Adusumilli PS.
Surg Endosc. 2010 Oct 23. [Epub ahead of print]
PMID: 20972585 [PubMed - as supplied by publisher]

CONCLUSIONS: We have constructed, validated, and successfully tested a novel wireless pulse oximeter capable of detecting intraoperative tissue hypoxia in open or endoscopic surgery. This device will aid surgeons in detecting anastomotic vascular compromise and facilitate choosing an ideal site for bowel anastomosis by targeting well-perfused tissue with optimal healing capacity.


[Diagnosis and Definition of Anastomotic Leakage from the Radiologist's Perspective.]
Bundy BD, Kauczor HU, Grenacher L.
Chirurg. 2010 Oct 23. [Epub ahead of print] German.
PMID: 20967532 [PubMed - as supplied by publisher]

CONCLUSIONS: Anastomotic leakage is a typical complication in gastrointestinal surgery. The frequency of occurrence and symptoms depend on the location of the intervention in the gastrointestinal tract. Consensus definitions have been published for bile leakage, pancreatic fistulas and colorectal leakage but there is still no overall standard classification for anastomotic leakage after surgical intervention in the gastrointestinal tract. Hence, there are also no standard guidelines for a diagnostic algorithm. Radiological techniques for the diagnosis of an anastomotic leakage include sonography, X-ray, fluoroscopy and computed tomography (CT). Percutaneous transhepatic cholangiography (PTC) could be helpful for the diagnosis of a leakage of a biliary enteric anastomosis. Magnetic resonance imaging (MRI) plays a subordinate role in the diagnosis of anastomotic leakage.


The Ladies Trial: Laparoscopic Peritoneal Lavage or Resection for Purulent Peritonitis and Hartmann's Procedure or Resection with Primary Anastomosis for Purulent or Faecal Peritonitis in Perforated Diverticulitis (NTR2037).
Swank H.A., Vermeulen J, Lange J.F., Mulder I.M., van der Hoeven J.A., Stassen L.P., Crolla R.M., Sosef M.N., Nienhuijs S.W., Bosker R.J., Boom M.J., Kruyt P.M., Swank D.J., Steup W.H., de Graaf E.J., Weidema W.F., Pierik R.E., Prins H.A., Stockmann H.B., Tollenaar R.A., van Wagensveld B.A., Coene P.P., Slooter G.D., Consten E.C., van Duyn E.B., Gerhards M.F., Hoofwijk A.G., Karsten T.M., Neijenhuis P.A., Blanken-Peeters C.F., Cense H.A., Mannaerts G.H., Bruin S.C., Eijsbouts Q.A., Wiezer M.J., Hazebroek E.J., van Geloven A.A., Maring J.K., d'Hoore A., Kartheuser A., Remue C., van Grevenstein W.M., Konsten J.L., van der Peet D.L., Govaert M.J., Engel A.F., Reitsma J.B., Bemelman W.A., 3d TD.
BMC Surg. 2010 Oct 18;10(1):29. [Epub ahead of print]
PMID: 20955571 [PubMed - as supplied by publisher] Free Article

DISCUSSION The Ladies trial is a nationwide multicentre randomised trial on perforated diverticulitis that will provide evidence on the merits of laparoscopic lavage and drainage for purulent generalised peritonitis and on the optimal resectional strategy for both purulent and faecal generalised peritonitis.

Single Incision Laparoscopic Total Colectomy and Proctocolectomy for Benign Disease - Initial Experience.
Leblanc F, Makhija R, Champagne B.J., Delaney C.P.
Colorectal Dis. 2010 Oct 19. doi: 10.1111/j.1463-1318.2010.02448.x. [Epub ahead of print]
PMID: 20955513 [PubMed - as supplied by publisher]

CONCLUSION: Single incision laparoscopic total colectomy or proctocolectomy is feasible for benign disease in selected patients.


Ghost Ileostomy: Real and Potential Advantages.
Miccini M, Amore Bonapasta S, Gregori M, Barillari P, Tocchi A.
Am J Surg. 2010 Oct;200(4):e55-7.
PMID: 20887836 [PubMed - indexed for MEDLINE]

CONCLUSIONS: We describe a simple technique (ghost ileostomy) to combine all the advantages of a disposable ileostomy without entailing its complications in patients submitted to low rectal resection.


A Clinical Risk Score to Predict 3-, 5- and 10-year Survival in Patients Undergoing Surgery for Dukes B Colorectal Cancer.
McMillan D.C., McArdle C.S., Morrison D.S.
Br J Cancer. 2010 Sep 28;103(7):970-4. Epub 2010 Aug 31.
PMID: 20808311 [PubMed - indexed for MEDLINE]

CONCLUSION: The results of this study, in a mature cohort, introduce a new simple clinical risk score for patients undergoing surgery for Dukes B colon cancer. This provides a solid foundation for the examination of the impact of additional factors and treatment on prediction of 3-, 5- and 10-year cancer-specific survival.


Influence of Anastomotic Leakage on Oncological Outcome in Patients with Rectal Cancer.
Park I.J.
J Gastrointest Surg. 2010 Jul;14(7):1190-6. Epub 2010 Jan 22. Review.
PMID: 20094811 [PubMed - indexed for MEDLINE]

OUTCOME: The rates of anastomotic leakage are reported to range between 0.6% and 17.4%, depending on the definitions used. Here, we review the available information on anastomotic leakage and its association with oncological outcome.

Updated October 26, 2010