Original Article

A Novel Approach to Minimally Invasive Management of Sigmoid Volvulus

Abstract

Resection is the most common treatment choice for sigmoid volvulus, a common complication in our region. A new minimally invasive technique for sigmoid resection with local anesthesia was done in this study. This method is invented to avoid general on regional anesthesia in high-risk patients. Nineteen patients were evaluated and then 14 were enrolled in this study. Sigmoidectomy with a left lower quadrant incision was performed and demographic data, the length of hospital stay, complications and procedure time were recorded. The mean age of participants was 65.68, and the male to female ratio was 1:2.7. The mean duration of the operation was 91.42 min. Complications include one case each of wound hematoma and wound infection. The intraoperative pain score was 1.2/10 and postoperative pain score was 2.35/10. The mean hospital staying was 8.3 days. By meticulous patient selection, sigmoidectomy under local anesthesia for sigmoid volvulus could be a surgeons’ armamentarium in special situations.

Vestweber B, Alfes A, Paul C, Haaf F, Vestweber KH. Single-incision laparoscopic surgery: a promising approach to sigmoidectomy for diverticular disease. Surg Endosc 2010; 24:3225–3228. doi: 10.1007/s00464-010-1090-2. PubMed PMID:20464419

Neudecker J, Bergholz R, Junghans T, Mall J, Schwenk W. Laparoscopic sigmoidectomy in Germany--a standardised procedure?Langenbecks Arch Surg 2007; 392:573–579. PubMed PMID:17375318

Adair J, Gromski MA, Nagle D.Single-incision laparoscopic sigmoidectomy and rectopexy case series. Am J Surg. 2011;202:243-5. doi: 10.1016/j.amjsurg.2010.08.034. PubMed PMID:21810504

Bucher P, Pugin F, Morel P.Transumbilical single incision laparoscopic sigmoidectomy for benign disease. Colorectal Dis. 2010;12:61-5. doi: 10.1111/j.1463-1318.2009.01825.x. PubMed PMID:19320667

Antoniou SA, Antoniou GA, Koch OO, Pointner R, Granderath FA Robot-assisted laparoscopic surgery of the colon and rectum. Surg Endosc. 2012;26:1-11. doi: 10.1007/s00464-011-1867-y. PubMed PMID:21858568

Litwin DE, Darzi A, Jakimowicz J, Kelly JJ, Arvidsson D, Hansen P,etal. Hand-assisted laparoscopic surgery (HALS) with hand port system: initial experience with 68 patients, Ann Surg. 2000; 231: 715-723. PubMed PMID:10767793.PMCID:PMC1421059

Zhang H, Li M, Zhan TC, Yao YF, Peng YF, Gu J. Comparison of short-term postoperative outcomes between hand-assisted laparoscopic and conventional sigmoidectomy. Zhonghua Wei Chang Wai Ke Za Zhi. 2011;14:462-4. PubMed PMID:21713711

Leroy J, Cahill RA, Asakuma M, Dallemagne B, Marescaux J. Single-access laparoscopic sigmoidectomy as definitive surgical management of prior diverticulitis in a human patient. Arch Surg. 2009;144:173-9. doi: 10.1001/archsurg.2008.562. PubMed PMID:19221330

Mutter D, Bouras G, Forgione A, Vix M, Leroy J, Marescaux J. Two-stage totally minimally invasive approach for acute complicated diverticulitis. Colorectal Dis. 2006;8:501-5. PubMed PMID:16784471

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IssueVol 54, No 10 (2016) QRcode
SectionOriginal Article(s)
Keywords
Local anaesthesia Sigmoidectomy Minimally invasive

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Tavassoli A, Maddah G, Noorshafiee S, Salehi M, Imannezhad S, Ghorbanian E. A Novel Approach to Minimally Invasive Management of Sigmoid Volvulus. Acta Med Iran. 2016;54(10):640-643.