Long-term experience with the laparoscopic approach to perforated diverticulitis plus generalized peritonitis

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Surgical Innovation

Background:

• Perforated diverticulitis treatment is shifting from open surgery to less invasive methods.
• Laparoscopic peritoneal lavage is emerging as a viable option for complicated diverticulitis with peritonitis.

Purpose of the Study:

• To report the experience with laparoscopic peritoneal lavage and delayed resection for perforated diverticulitis.
• To evaluate the safety and efficacy of this minimally invasive approach.

Main Methods:

• Retrospective review of patients undergoing intraoperative peritoneal lavage for purulent diverticulitis.
• Data collected from April 1991 to September 2006 at the Texas Endosurgery Institute.

Main Results:

• Forty patients (26 male, 14 female, average age 60) were included.
• Average operating time was 62 minutes with no conversions to open surgery.
• Low complication rates, with over 50% undergoing elective laparoscopic sigmoid colectomy; no further surgical intervention needed during follow-up.

Conclusions:

• Laparoscopic lavage and drainage is a safe alternative for perforated diverticulitis, reducing morbidity and mortality.
• This approach avoids colostomy, decreases wound complications, and lowers overall treatment costs.
• Consider laparoscopic lavage and drainage as a standard of care when other treatments are not feasible.