Rectal Endo-Sponge therapy represents an advanced form of endoluminal negative-pressure wound therapy used in the management of anastomotic leaks and presacral abscesses following low anterior resection. By enabling continuous drainage, reducing bacterial burden and stimulating granulation tissue formation, this technique has increasingly become an integral part of postoperative management in colorectal surgery. Despite the central role of the endoscopist, optimal therapeutic outcomes depend heavily on the structured and highly skilled involvement of nursing staff within the endoscopy unit

This case report presents the successful use of Rectal Endo-Sponge on 71 year old male patient who was admitted for surgical removal of a rectal adenoma, followed by creation of a TT colorectal anastomosis. In the postoperative course, the patient developed rectal bleeding, prompting referral for colonoscopy. Endoscopic evaluation revealed a 2 cm defect of the colorectal wall with communication into a 3 cm cavity. Rectal Endo-Sponge therapy was initiated, and throughout the treatment course the sponge was exchanged nine times, leading to progressive collapse of the cavity and favourable clinical healing.

The abstract synthesizes current nurse competencies procedural standards across all procedural stages for Endo-Sponge placement and exchange: pre-procedural assessment of patient and tools, intraprocedural equipment assistance, patient monitoring, and post-procedural care. Nurses play a pivotal role in preparing specialized equipment, verifying patient preparation and ensuring adherence to aseptic protocols. During the procedure, the endoscopy nurse provides operational support—optimizing instrument flow, maintaining visualization conditions, coordinating suction systems and continuously monitoring hemodynamic and respiratory parameters, particularly in sedated patients. Documentation of cavity characteristics, sponge dimensions and applied negative pressure contributes to consistent therapeutic evaluation. Post-procedurally, nursing responsibilities extend to patient education, symptom surveillance and coordination of scheduled sponge exchanges, typically required every 48–72 hours.

Rectal Endo-Sponge therapy is a highly effective, minimally invasive strategy for managing complex anastomotic complications. The expertise of endoscopy nurses is indispensable, enhancing procedural efficacy, reducing risk and ensuring high-quality, patient-centered care throughout the entire therapeutic course. Nurses' responsibilities in this procedure, together with effective coordination and collaboration with the endoscopic team, significantly influences the overall safety profile and clinical success of therapy.