Our Summary

This research paper studies the effects of two different surgical techniques used in laparoscopic sigmoidectomy, a minimally invasive surgery to remove part of the large intestine for diverticular disease. The first method involves tying off a blood vessel (inferior mesenteric artery) below a branch leading to the left side of the colon (low ligation). The second method involves preserving the entire inferior mesenteric artery (IMA preservation).

The study involved 66 patients at two hospitals from January 2015 to March 2016. One group of 35 patients underwent the low ligation technique and a second group of 31 patients had the IMA preservation method.

The results showed no significant differences in major post-surgery complications, time to first bowel movement, or length of hospital stay between the two groups. However, the low ligation surgery was notably shorter and had less blood loss during the operation.

Importantly, neither surgical technique affected sexual and urinary function post-surgery, meaning both methods are safe and feasible for patients. The authors conclude that both surgical techniques allow good post-operative quality of life, but the low ligation approach is related to shorter operative time and less blood loss during surgery.

FAQs

  1. What are the two surgical techniques used in laparoscopic sigmoidectomy, as studied in this research paper?
  2. What were the main findings of the study comparing low ligation and IMA preservation methods in laparoscopic sigmoidectomy?
  3. Did either surgical technique in the study affect sexual and urinary function post-surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is that both the low ligation and IMA preservation surgical techniques are safe and effective for treating diverticular disease. However, the low ligation method may result in a shorter surgery time and less blood loss. It’s important to discuss with your surgeon which technique is best for your specific situation.

Suitable For

Patients who are typically recommended sigmoidectomy are those with diverticular disease, which is a condition where small pouches, called diverticula, form in the walls of the colon and become inflamed or infected. Symptoms of diverticular disease can include abdominal pain, bloating, changes in bowel habits, and potentially serious complications such as abscesses or perforations.

Sigmoidectomy may be recommended for patients with severe or recurrent diverticulitis, complications such as abscesses or fistulas, or for those who do not respond to other treatments such as dietary changes, medications, or less invasive procedures. The decision to undergo sigmoidectomy is usually made after careful evaluation by a healthcare provider, including a colorectal surgeon, based on the individual patient’s specific condition and medical history.

In the context of the research paper mentioned above, patients who underwent laparoscopic sigmoidectomy with either the low ligation or IMA preservation technique had good outcomes and post-operative quality of life. Both methods were found to be safe and effective for patients with diverticular disease requiring surgical intervention.

Timeline

Before sigmoidectomy:

  1. Patient is diagnosed with diverticular disease.
  2. Patient undergoes pre-operative testing and consultations with their healthcare team.
  3. Patient receives instructions on how to prepare for the surgery, including dietary restrictions and medication adjustments.

During sigmoidectomy:

  1. The patient is put under general anesthesia.
  2. The surgeon makes small incisions in the abdomen and inserts a laparoscope to remove part of the large intestine.
  3. The surgeon either ties off the inferior mesenteric artery below a branch leading to the left side of the colon (low ligation) or preserves the entire artery (IMA preservation).
  4. The incisions are closed and the patient is moved to a recovery area.

After sigmoidectomy:

  1. Patient wakes up from anesthesia and is monitored for any immediate post-operative complications.
  2. Patient may experience pain, bloating, and discomfort in the abdomen.
  3. Patient is gradually allowed to start drinking clear fluids and advance to a soft diet.
  4. Patient may need to stay in the hospital for a few days to monitor for any complications and ensure proper healing.
  5. Patient is discharged home with instructions on wound care, pain management, and follow-up appointments.
  6. Patient may experience changes in bowel habits and may need to adjust their diet and lifestyle to accommodate for the changes in their digestive system.
  7. Patient undergoes follow-up appointments with their healthcare team to monitor their recovery and address any concerns or complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with sigmoidectomy surgery?
  2. How long is the recovery time after sigmoidectomy surgery?
  3. Will I need to make any lifestyle changes or follow a special diet after surgery?
  4. What type of follow-up care will be needed after the surgery?
  5. How will my bowel function be affected after sigmoidectomy surgery?
  6. Are there any alternative treatment options to sigmoidectomy for my condition?
  7. How many sigmoidectomy surgeries have you performed, and what is your success rate?
  8. Can you explain the differences between the low ligation and IMA preservation surgical techniques for sigmoidectomy?
  9. What are the potential benefits of each surgical technique, and how do they compare in terms of outcomes and recovery?
  10. How will my quality of life be impacted after sigmoidectomy surgery?

Reference

Authors: Mari G, Crippa J, Costanzi A, Mazzola M, Magistro C, Ferrari G, Maggioni D. Journal: Chirurgia (Bucur). 2017 Mar-Apr;112(2):136-142. doi: 10.21614/chirurgia.112.2.136. PMID: 28463672