Laparoscopic resection with transanal specimen extraction for sigmoid diverticulitis

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Microbiology

Background:

• Evaluating laparoscopic sigmoid resection techniques for diverticulitis.
• Assessing transanal specimen extraction and stapler anvil insertion.
• Examining microbiological outcomes of novel laparoscopic approaches.

Purpose of the Study:

• To assess the technical feasibility and microbiological consequences of laparoscopic sigmoid resection with transanal specimen extraction and per ano transcolonic stapler anvil insertion.
• To determine the safety and efficacy of a three-port laparoscopic approach for elective sigmoid colectomy.
• To investigate the incidence of infectious complications following transanal specimen extraction.

Main Methods:

• Prospective evaluation of 16 patients undergoing elective laparoscopic sigmoid colectomy.
• Utilized a three-port technique with transanal specimen extraction and transcolonic stapler anvil insertion.
• Conducted systematic intraoperative bacteriological sampling and prospectively analyzed outcomes.

Main Results:

• All 16 procedures were technically successful with a mean operating time of 120.9 minutes.
• No conversions or additional ports were required; four patients had minor complications without intervention.
• Polybacterial growth was observed in peritoneal samples, but no infection-related complications occurred.

Conclusions:

• Transanal specimen extraction and stapler anvil insertion enable a three-port laparoscopic sigmoid resection.
• Intraperitoneal bacterial contamination during the procedure did not result in significant infectious morbidity.
• This technique offers a viable option for elective sigmoid colectomy, potentially reducing invasiveness.