Innovations combined into KIT solutions to optimize the anastomosis.

Ethicon continually partners with healthcare professionals to improve survival rates and quality of life for colorectal cancer patients.

Research

Holistic Colorectal Solution

Education

InnovationPartnering with Ethicon:Reducing the risk factorsof Anastomotic Leaks

Colorectal cancer is the 2nd deadliest cancer in the EU, accounting for > 214,000 deaths.1

Partnering with surgeons on multiple fronts to reduce anastomotic leaks

For over 130 years, Ethicon has been dedicated to caring for patients by developing treatment approaches that address critical disease states.

Ethicon educated over 6,000 surgeons across EMEA in 2017 alone.* Colorectal-specific courses are focused on expanding surgeons’ technical skillset in areas related to anastomotic leaks, such as laparoscopic surgery and advanced procedural skills.

As part of Johnson & Johnson, Ethicon draws upon the breadth, scope, and resources of the world’s most comprehensive healthcare company to shape the future of colorectal surgery. For example, Ethicon has a partnership with the European Society of Coloproctology (ESCP) to better understand & reduce anastomotic leaks by researching real world data in EMEA on the drivers of leaks, and offering educational programs that could address the main causes of leaks.

Innovation

Education

Research

on colorectal cancer was € 13.1 billion,

10% of the total cost of cancer.3

Annual expenditure In Europe there are

700,000 colorectal resections a year2

The consequences are enormous, leaks reduce

5 years overall survival to as little as 33.3 %.5

In addition, anastomotic leaks increase direct

healthcare costs by up to € 35,000 per patient.6

Anastomotic leaks are the most devastating challenge to colorectal surgeons, occuring in up to

8.5% of cases.4

* As per Johnson & Johnson internal tracking of educational event registrations as of January 2018

Comprehensive Portfolio of Solutions: Optimizing Outcomes in Colorectal SurgeryEthicon offers a comprehensive portfolio that enables you to deliver optimized outcomes at every critical step of your colorectal procedure.

ENSEAL™ X1 Large Jaw seals vessels securely7 †, had minimal lateral thermal spread8 ‡, and offers an ergonomic design

CONTOUR™ is designed for controlled compression and less tissue movement10

The Ethicon Linear Cutter (NTLC55 & NTLC75) featuring 3-D staples is designed for more uniform tissue compression to reduce the risk of leaks or bleeding through the staple line13

HARMONIC™ HD 1000i with its increased sealing speed, multi-functionality, and simplified steps for use allows for optimal efficiency9 #

The ECHELON FLEX™ GST System provides 4x less tissue movement11 § which may eliminate one reload;12 ¥ full cartridge portfolio for individual hemostasis preference

The Ethicon Circular Stapler (ILS) with its fixed anvil design reduces tension on the anastomosis during opening compared to the Covidien DST Series EEA with its tilting anvil14 £

Mobilisation

Transection

Anastomosis

Colorectal cancer is the 2nd deadliest cancer in the EU, accounting for > 214,000 deaths.1

Partnering with surgeons on multiple fronts to reduce anastomotic leaks

† Benchtop testing on 1-7mm porcine splenic, thyrocervical and carotid arteries (mean burst pressure of 1400 mmHg). ‡ Preclinical testing on porcine carotids that measured mean max lateral thermal damage via histology (mean=1.57mm), # Based on a benchtop study § Benchtop testing in porcine stomach tissue. Mean tissue movement from after clamping on tissue to after firing ECHELON FLEX™ Powered Plus Stapler (PSEE60A) and ECHELON Reload with GST vs ENDO GIA™ ULTRA Handle (EGIAUSTND) and Endo GIA™ Reload with Tri-Staple™ Technology at 3.3 and 4.0mm tissue thicknesses (3.3mm: GST60T 0.642mm vs EGIA60AMT 4.806mm p<0.001; 4.0mm: GST60T 0.654mm vs EGIA60AXT 5.116mm p<0.001). ¥ Benchtop testing in porcine stomach tissue. Mean tissue movement from after clamping on tissue to after firing ECHELON FLEX™ Powered Plus Stapler (PSEE60A) and ECHELON Reload with GST vs ENDO GIA™ ULTRA Handle (EGIAUSTND) and Endo GIA™ Reload with Tri-Staple™ Technology at 1.5, 2.5, 3.3 and 4.0mm tissue thicknesses (1.5mm; GST60B 1.067mm vs EGIA60AMT 2.452mm p<0.001; 2.5mm: GST60G 1.148mm vs EGIA60AMT 3.261mm p<0.001; 3.3mm: GST60T 0.642mm vs EGIA60AMT 4.806mm p<0.001; 4.0mm: GST60T 0.654mm vs EGIA60AXT 5.116mm p<0.001). £ Benchtop testing on porcine jejunum. Comparing mean tissue stretch during anvil opening after firing of the Ethicon Circular Stapler (CDH25A) and the DST Series EEA circular stapler (EEA2535). 1.558cm vs 2.228cm, p<0.05.

C

OLORECTAL

S U R G E RY

Innovations combined into KIT solutions to optimize the anastomosis.

Ethicon continually partners with healthcare professionals to improve survival rates and quality of life for colorectal cancer patients.

For open or laparoscopic access, for Low Anterior Resection or Right Hemicolectomy. Regardless of which KIT fits your needs, every product contained in the kit aims for the same: a healthy anastomosis

Please refer always to the Instructions for Use / Package Insert that come with the device for the most current and complete instructions

The third-party trademarks used herein are trademarks of their respective owners

www.ethicon.com

© Ethicon Endo-Surgery (Europe) GmbH 2018, 092802-180601 EMEA

References: 1. Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray, F. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed on 19 June, 2018; 2. Source: Millenium Research Group, Inc.; 3. Luengo-Fernandez R et al. Economic burden of cancer across the European Union: a population-based cost analysis. Lancet Oncol. 2013 Nov;14(12):1165-74; 4. 2015 European Society of Coloproctology collaborating group. The relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit. Colorectal Dis. 2017 Mar 6. doi: 10.1111/codi.13646. [Epub ahead of print]; 5. Marra F et al. Anastomotic leakage as a risk factor for the long-term outcome after curative resection of colon cancer. Eur J Surg Oncol. 2009 Oct;35(10):1060-4; 6. Zoucas E, Lydrup ML. Hospital costs associated with surgical morbidity after elective colorectal procedures: a retrospective observational cohort study in 530 patients. Patient Saf Surg. 2014 Jan 3;8(1):2; 7. Ethicon PRC075988A Burst Pressure new algorithm vs old algorithm final, Dec 2016, Data on file. PRC075987A Burst Pressure Protocol new algorithm vs old algorithm, Nov 2016, Data on File (062784-161104) 8. Ethicon PSB004569 Final Report Brick Thermal Damage, Nov 2016, Data on File (062963-161108) 9. Ethicon, PRC074127B Buccaneer DV Transection Speed (Marching & Tip Bite), Sept 2016, Data on File.PRC074125B Buccaneer DV Vessel Transection Speed, Sept 2016, Data on File. PRC074607A Buccaneer Metrology Claims, Sept 2016, Data on File. PRC074111B Buccaneer DV Grasping Force (Tip & Full Bite), Sept 2016, Data on File. PRC074432A Buccaneer Energy Button Vessel Claims, Sept 2016, Data on File. (057619-160803) 10. Ethicon E945 Summary of Design Intent for CONTOUR Curved Cutter Stapler (CONTOUR), July 2017, Data on file (077152-170726) 11. Ethicon PRC067394Tissue flow and functional performance of ENDOPATH ECHELON Reloads (GST) and Covidien’s reloads with Tri-Staple™ technology, July 2014, Data on file (018980-171115) 12. Ethicon PRC067394Tissue flow and functional performance of ENDOPATH ECHELON Reloads (GST) and Covidien’s reloads with Tri-Staple™ technology, July 2014, Data on file (C1727, 018989-140728) 13. Ethicon E759 Summary of Design Intent for EES Linear Cutter to support claims, September 2015, Data on file (C1951, 040507-150916); 14. Benchtop testing on porcine jejunum. Comparing mean tissue stretch during anvil opening after firing of the Ethicon Circular Stapler (CDH25A) and the DST Series EEA circular stapler (EEA2535). 1.558cm vs 2.228cm, p<0.05. Ethicon PRC076781A Ethicon vs. Covidien Circular Stapler Comparison for Tissue Strain during Anvil Closing and Opening, October 2016, Data on file (061522-161011)

Professional Education on surgical techniques

Earlier diagnosis campaigns

Standardization of procedures

Patient Pathway optimization