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In a 69-year-old male, endoscopic vacuum therapy reduced the fistulising orifice size, but complete closure was achieved using four “Z”-pattern helix tacks secured by a cinch device. Six-week follow-up confirmed successful closure.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/a-helix-tacking-system-for-the-management-of-colonic-anastomotic-dehiscence-after-a-laparoscopic-left-colectomy/459167/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/a-helix-tacking-system-for-the-management-of-colonic-anastomotic-dehiscence-after-a-laparoscopic-left-colectomy/459167.png","ImageObject",300,407,{"name":42,"@type":43},"moss~","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",7,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What is anastomotic dehiscence (AD) in this article?","Question",{"text":63,"@type":64},"AD is defined as separation of sutures occurring within 30 days after colectomy. The article links leakage to serious complications such as pelvic abscess, peritonitis, or sepsis.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the patient’s AD initially managed?",{"text":68,"@type":64},"The patient initially received endoluminal vacuum therapy (EVT). EVT reduced the fistulising orifice size from about 15 mm to about 10 mm within 2 weeks.",{"name":70,"@type":61,"acceptedAnswer":71},"How did the helix tacking system achieve complete closure?",{"text":72,"@type":64},"Complete closure was achieved by placing four helix tacks around the defect in a “Z” pattern, pulling the thread attached to the tacks, and securing the suture with a cinch device to lock the suture and cut the thread.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},459167,1790755325,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":55,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":80,"read_time":97,"preview_page_count":4},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Article published online: 2026-01-08  \nA helix tacking system for the management of colonic anastomotic dehiscence, after a laparoscopic left colectomy  \nThe endoscopic helix tacking system is increasingly used to treat mucosal defects, particularly following endoscopic submucosal dissection or endoscopic mucosal resection [1] . Here, we aim to demonstrate the feasibility of using thistacking system to manage an anastomotic dehiscence (AD) after oncologic laparoscopic left colectomy. AD is defined as the separation of sutures occurring within 30 days after colectomy [2] . When dehiscence leads to bowel leakage, it can result in pelvic abscesses, peritonitis, or sepsis [3] . The current standard of care includes a diverting colostomy orileostomy along with the drainage of the surgical site infection. In recent years, however, minimally invasive endoscopic approaches, such as endoluminal vacuum therapy (EVT), have shown effectiveness in managing colonic dehiscence [2]. We present the case of a 69-year-old male patient who underwent laparoscopic left colectomy with an end-to-end colorectal anastomosis, performed 18cm from the anal margin, to treat colonicadenocarcinoma. Within 2 months, he developed an AD affecting approximately a quarter of the anastomosis (approximately 15mm), connected to a small cavity measuring 15–20mm in diameter. The patient initially received EVT, which reduced the orifice size from 15 to 10mm within 2 weeks. However, complete closure of the fistulising orifice was ultimately achieved with the use of an endoscopic helix tacking system. Closure was accomplished by placing four tacks around the defect in a “Z” pattern ( ▶ Fig. 1 and ▶ Fig.2a), pulling the thread attached to the tacks, and securing the suture with a cinch device to lock the suture and cut the thread ( ▶ Fig.2b) . Six-week follow-up confirmed successful endoscopic closure using X-MAN  \n▶Fig. 1 Schematic illustration of the helix tacking system showing a sequential deployment of four helix tacks around a mucosal lesion: a Placement of four tacks around the defect in a“Z” pattern. b Transmural section of a mucosal defect showing the deployment of helix tacks around a mucosal lesion. A, adventitia; M, mucosa; Mm, muscularis mucosa; Mp, muscularis propria; SM, submucosa.  \n▶Fig.2 a Closure was accomplished by placing four tacks around the defect in a “Z” pattern. b Securing the suture with a cinch device to lock the suture and cut the thread. c Follow-up at 6 weeks confirmed successful endoscopic closure using the X-MAN (heliX tacking system for the Management of colonic ANastomotic dehiscence) .  \nVandenDriessche Vincent et al. A helix tacking… Endoscopy 2026; 58: E5–E6 | © 2026. The Author(s) . E5  \nVideo 1 A helix tacking system for the management of colonic anastomotic dehiscence after a laparoscopic left colectomy.  \n(heliX tacking system for the Management of colonic ANastomotic dehiscence; ▶Fig.2c) . This case demonstrates the safe and effective management of post-colectomy anastomotic dehiscence using the X-MAN ( ▶Video 1) .  \nEndoscopy_UCTN_Code_TTT_ 1AQ_ 2AK  \nContributors ʼ Statement  \n\n| Vincent VandenDriessche: Visualization, Writing – original draft, Writing – review & editing. Eda Kaya: Writing – original draft, Writing – review & editing. Patrick Yengue: Supervision. Maxence Lefebvre: Supervision.\u003Cbr>Conflict of Interest |\n| --- |\n| The authors declare that they have no conflict of interest.\u003Cbr>The authors |\n| Vincent VandenDriessche1, Eda Kaya1, Patrick Yengue1, Maxence Lefebvre1\u003Cbr>1 Department of Gastroenterology, Centre Hospitalier de Wallonie Picarde, Tournai, Belgium\u003Cbr>Corresponding author |\n\nVincent VandenDriessche  \nDepartment of Gastroenterology, Centre Hospitalier de Wallonie Picarde, 9 Avenue Delmée, 7500 Tournai, Belgium [vincent.vdd@gmail.com](vincent.vdd@gmail.com)  \nReferences  \n[1] Mohapatra S, Fukami N. Follow-up outcomes of mucosal defect closures after endoscopic resection using a helix tacking system and endoc","cbCaikOVil0g6wJG","https://ap.wps.com/l/cbCaikOVil0g6wJG","pdf",2349645,"English","# Case and rationale\n## Definition and complications of AD\n## Standard care and minimally invasive options\n# Index case\n## Patient background and AD development\n## EVT response and transition to helix tacking\n# Technique and results\n## Deployment of four tacks in a “Z” pattern\n## Cinch device securing and follow-up outcome\n# References and authorship","[{\"question\":\"What is anastomotic dehiscence (AD) in this article?\",\"answer\":\"AD is defined as separation of sutures occurring within 30 days after colectomy. The article links leakage to serious complications such as pelvic abscess, peritonitis, or sepsis.\"},{\"question\":\"How was the patient’s AD initially managed?\",\"answer\":\"The patient initially received endoluminal vacuum therapy (EVT). EVT reduced the fistulising orifice size from about 15 mm to about 10 mm within 2 weeks.\"},{\"question\":\"How did the helix tacking system achieve complete closure?\",\"answer\":\"Complete closure was achieved by placing four helix tacks around the defect in a “Z” pattern, pulling the thread attached to the tacks, and securing the suture with a cinch device to lock the suture and cut the thread.\"}]","A helix tacking system for the management of colonic anastomotic dehiscence, after a laparoscopic left colectomy | PDF"]