Complete prevention of anastomotic leakage using total enteric flow diversion

Figure 1  Schematic diagram of a modified ileostomy tube with a balloon.

Figure 2 Flow diagram of the experimental pig model allocation and follow-up in the anastomotic leakage study. AL: Anastomotic leakage.

Figure 3 Intraoperative operation diagram. A: Macroscopic aspect of a descending colostomy with ligation of supplying vessels at 1 cm above the anastomotic segment. Local ischaemia at the anastomotic site was created by ligating the supplying mesocolic vessels 1 cm above the anastomotic segment; B: Leakage test: After placing the tube, the balloon was infused with water to a pressure of 20 kPa. The water mixed with methylene blue did not leak into the proximal intestine.

Figure 4 Haematoxylin and eosin staining. Histological findings in the balloon-pressed intestinal tissue on postoperative day 7, showing mild mucosal injury features, such as subepithelial space extension (magnification × 400).