Sigmoid Colectomy for Sigmoid Volvulus Through a Limited Left Lower Quadrant Transverse Laparotomy Incision Without Laparoscopy.

Abstract

Sigmoid volvulus (SV) is a relatively rare cause of large bowel obstruction encountered by general surgeons in the United States. It predominantly affects the elderly, infirm, and institutionalized. Surgery after endoscopic reduction is the mainstay of treatment. Given the frail nature of the population requiring partial colectomy for SV, formal laparotomy and laparoscopic sigmoid colectomies come with significant risks. Much of the risk related to a minimally invasive, laparoscopic approach is due to the physiologic impacts of pneumoperitoneum. This series demonstrates a technique whereby a complete sigmoid resection with or without anastomosis can be achieved via a single, small incision equivalent to a laparoscopic extraction port. This technique took advantage of the redundancy in the sigmoid colon characteristic of SV. All patients tolerated their procedures well and had rapid return to their baseline function.