Open-pore drainage film-based vacuum stent for intraluminal endoscopic negative pressure therapy of the esophagus

Open-pore polyurethane foam drainage is used for endoscopic negative pressure therapy of the esophagus [1]. The vacuum stent (VacStent GI; Micro Tech, Nanjing, China) is coated with a voluminous polyurethane foam [2].

An alternative drainage material for endoscopic negative pressure therapy is a very thin, open-pore, double-layer, transparent drainage film [3] [4] [5]. The volume of material is minimal, and it can be used to produce very narrow, open-pore film drainage devices with diameters of 4–6 mm [1].

This report describes in detail how a novel alternative vacuum stent can be manufactured using the open-pore, double-layer film. Placement of the film in an over-the-scope technique is demonstrated on an anatomical model.

The equipment and material required include a strip of the film (Suprasorb CNP Drainage Film; Lohmann & Rauscher, Rengsdorf, Germany), a covered esophageal stent (e.g. partially covered Hanarostent Esophageal Stent; M.I. Tech, Pyeongtaek, South Korea), drainage tube (Argyle Ventrol Duodenal Tube 12 Fr/Ch; Covidien, Dublin, Ireland), and suture (Mersilene; Ethicon, Raritan, New Jersey, USA) ([Fig. 1]).

Fig. 1 Materials required for creation of an open-pore, double-layer film-covered vacuum stent. oF, open-pore drainage film (Suprasorb CNP Drainage Film; Lohmann & Rauscher, Rengsdorf, Germany); ST, covered stent; Su, suture; T, drainage tube.

The stent is removed from the delivery device. The middle covered part is wrapped with a strip of open-pore drainage film ([Fig. 2] a). The drainage film is sutured ([Fig. 2] b). The distal end of the drainage tube is inserted between the outside of the stent and the film sleeve ([Fig. 2] c). The drainage tube is fixed to the proximal end of the stent with a suture. The drainage film is secured to the stent with sutures. The newly created vacuum stent is then ready for use ([Fig. 2] d, [Video 1]).

Fig. 2 Creation of the vacuum stent. a The middle covered part of the stent is wrapped in the drainage film. b The drainage film is fixed with a suture. c The drainage tube is inserted between the drainage film and the outside of the covered part of the stent. d The newly created vacuum stent.

Creation of a vacuum stent, using open-pore, double-layer, transparent drainage film, and over-the-scope placement.Video 1

No special delivery device is required. The vacuum stent can be inserted using an over-the-scope method ([Video 1]). The distal end of an endoscope is introduced into the stent. The string loop at the distal end of the stent is grasped and fixed with a grasping forceps. Then, the drainage tube (proximal end of the stent) is pulled. This stretches the stent and secures it over the endoscope. The introduction of the stent and placement in the correct location is carried out under continuous endoscopic view. After oro-nasal conversion of the drainage tube, vacuum is applied with an electronic pump.

With the open-pore, double-layer, transparent drainage film, any covered esophageal stent can be converted into a vacuum stent. The vacuum can be applied over the entire surface of the film coating. As the film is very thin, its application around the stent changes the design of the stent only slightly.

Endoscopy_UCTN_Code_TTT_1AO_2AI

Publication History

Article published online:
03 April 2025

• References

• 1 Loske G. Endoscopic negative pressure therapy of the upper gastrointestinal tract. Chirurg 2019; 90: 1-6
• 2 Chon SH, Scherdel J, Rieck I. et al. A new hybrid stent using endoscopic vacuum therapy in treating esophageal leaks: a prospective single-center experience of its safety and feasibility with mid-term follow-up. Dis Esophagus 2022; 35: doab067
• 3 Loske G, Schorsch T, Rucktaeschel F. et al. Open-pore film drainage (OFD): a new multipurpose tool for endoscopic negative pressure therapy (ENPT). Endosc Int Open 2018; 6: E865-E871
• 4 Kouladouros K, Wichmann D, Loske G. The role of open-pore film drainage systems in endoscopic vacuum therapy: current status and review of the literature. Visc Med 2024; 39: 177-183
• 5 Richter F, Conrad C, Hoffmann J. et al. Endoluminal vacuum therapy using a new “fistula sponge” in treating defects of the upper gastrointestinal tract – a comparative, retrospective cohort study. Medicina 2024; 60: 1105