Sigmoid resection for diverticulitis is more difficult than for malignancies.

Area of Science:

• Colorectal Surgery
• Surgical Education
• Minimally Invasive Surgery

Background:

• Laparoscopic sigmoid resection is a foundational procedure for surgical residents.
• Diverticulitis and sigmoid malignancy are common indications for this surgery.

Purpose of the Study:

• To compare the difficulty of laparoscopic sigmoid resection for diverticulitis versus malignancy.
• To evaluate the suitability of diverticulitis resection for resident training programs.

Main Methods:

• A cohort study compared patients undergoing laparoscopic sigmoid resection for diverticulitis or malignancy.
• Difficulty was assessed via intraoperative complications, technical challenges, and conversion rates.
• Assistant-to-surgeon and surgeon-to-surgeon handovers were also recorded.

Main Results:

• The diverticulitis group had fewer comorbidities but significantly more technical challenges.
• Higher rates of resident take-overs (p=0.02) and surgeon-to-surgeon handovers (p=0.04) were observed in the diverticulitis group.
• Conversions to open surgery were significantly more frequent in the diverticulitis cohort (p=0.03).

Conclusions:

• Laparoscopic sigmoid resection for diverticulitis is technically more demanding than for malignancy.
• Diverticulitis may not be the ideal condition for initiating laparoscopic colorectal surgery training.
• Resident training programs may need to reconsider the initial case selection for laparoscopic sigmoid resection.