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Laparoscopic-assisted sigmoid colectomy for sigmoid volvulus
J A Sundin1, D Wasson, M M McMillen
1Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06510.
Surgical Laparoscopy & Endoscopy
|December 1, 1992
Summary
Laparoscopic-assisted sigmoid colectomy offers a minimally invasive approach for sigmoid volvulus, reducing pain and ileus. This technique, involving extracorporeal resection, is ideal for elderly patients with this condition.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Sigmoid volvulus is a common cause of large bowel obstruction, particularly in the elderly.
- Traditional surgical management can be associated with significant morbidity.
Observation:
- A 75-year-old man presented with symptoms of sigmoid volvulus.
- Initial nonoperative reduction was followed by elective exploration.
- Dense fibrous scarring of the sigmoid mesentery (mesosigmoiditis) was noted.
Findings:
- The study reports the first case of laparoscopic-assisted sigmoid colectomy with primary anastomosis for sigmoid volvulus.
- Exteriorization and extracorporeal resection were employed due to mesosigmoiditis.
- A stapled, functional end-to-end anastomosis was successfully created.
Implications:
- Laparoscopic-assisted sigmoid resection may provide advantages for elderly, debilitated patients with sigmoid volvulus.
- Exteriorization and extracorporeal resection represent a potentially rapid laparoscopic approach for this condition.
- This technique may lead to reduced postoperative pain and ileus.