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Related Concept Videos

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
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Is Laparoscopy Underutilized for Sigmoid Volvulus?

Scott H Nguyen1, Kelli Tavares1, Ashley Chinn1

  • 1Department of Surgery, Tripler Army Medical Center, Honolulu, HI.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|August 12, 2022
PubMed
Summary
This summary is machine-generated.

Laparoscopic surgery for sigmoid volvulus is underutilized but leads to fewer complications and shorter hospital stays compared to open surgery. Conversion to open surgery does not negatively impact outcomes.

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Area of Science:

  • Colorectal surgery
  • Minimally invasive surgery
  • Surgical outcomes research

Background:

  • Minimally invasive surgery (MIS) is increasingly common, yet open colectomy remains standard for sigmoid volvulus.
  • This study investigates the comparative effectiveness of laparoscopic versus open colectomy for sigmoid volvulus.

Purpose of the Study:

  • To compare outcomes between laparoscopic and open colectomy for sigmoid volvulus.
  • To evaluate the impact of surgical approach on morbidity, mortality, and length of stay.

Main Methods:

  • Analysis of the American College of Surgeons National Surgical Quality Improvement Program and colectomy-targeted procedure databases (2013-2018).
  • Propensity score matching of patients undergoing partial colectomy for volvulus based on planned laparoscopic versus planned open approach.
  • Subgroup analysis comparing unplanned laparoscopic to open conversion (CTO) with planned open procedures.

Main Results:

  • Laparoscopic colectomy was associated with longer operative times but decreased overall morbidity (OR: 0.71) and shorter length of stay (OR: 0.70 for >7 days).
  • Of 492 cases initiated laparoscopically, 79% were completed without conversion to open surgery.
  • Unplanned conversion to open surgery showed no significant difference in outcomes compared to planned open procedures.

Conclusions:

  • Laparoscopic colectomy for sigmoid volvulus is associated with improved outcomes, including reduced morbidity and shorter hospital stays.
  • The majority of laparoscopic procedures for sigmoid volvulus are completed successfully without conversion.
  • Surgeons should consider laparoscopy for sigmoid volvulus, as it offers benefits even when conversion to open surgery is necessary.