Advanced innovations in reducing anastomotic leak: a review of emerging biomaterial applications in colorectal surgery

The rising global incidence of colorectal cancer surgeries has been paralleled by advancements in minimally invasive techniques such as laparoscopic and robot-assisted surgeries. Despite these improvements, anastomotic leaks remain a significant postoperative complication, leading to increased mortality. Traditionally, diverting ileostomy has been the preferred method to reduce this risk, yet it carries its own set of complications and impacts on patient quality of life. Recent advancements in biomaterial science have introduced alternative methods to protect anastomosis without the need for external stomas. This review explores current technological approaches, including devices like Colovac, LeakGuard, CG-100, the C-seal, and the Self-degrading Intestinal Diversion stent, which aim to replicate the protective effects of ileostomy while minimizing associated complications. The Colovac device, an intraluminal bypass sheath, and the LeakGuard biodegradable stent are both designated as "breakthrough devices" by the FDA. The CG-100, C-seal devices, and Self-degrading Intestinal Diversion stent also demonstrate potential in reducing anastomotic leakage rates through innovative mechanisms. However, widespread clinical adoption of these devices requires further validation through large-scale randomized controlled trials to assess their long-term outcomes and cost-effectiveness. This review highlights the potential of these innovations to enhance the safety and efficacy of colorectal cancer surgeries, ultimately improving patient outcomes and quality of life.