Our Summary
A 76-year-old man had a small tumor in the lower part of his large intestine (sigmoid colon) removed using a method called endoscopic mucosal resection. Following that, a surgical procedure known as a laparoscopic sigmoidectomy was performed. This involved making 5 small incisions and using slim instruments to remove the affected part of the colon.
The removed tissue was then taken out of the body through the anus, rather than having to make an additional incision. Then, a device called an anvil was attached to the remaining part of the colon, which was then reconnected to the rectum using a special stapling device. This was done using a method known as the double stapling technique.
Using this method of removing the tissue through the anus, instead of through an additional incision, can lead to a better-looking result and less pain after the surgery. It also reduces the risk of a hernia developing at the site of an abdominal incision. This technique is easy to implement and doesn’t require any special equipment or retraining. Therefore, it’s a good option for minimally invasive surgery.
FAQs
- What is a sigmoidectomy and why was it performed on the 76-year-old patient?
- How is transanal specimen extraction beneficial in a laparoscopic sigmoidectomy?
- What are the advantages of the double stapling technique in colorectal anastomosis?
Doctor’s Tip
A helpful tip a doctor might tell a patient about sigmoidectomy is to follow post-operative care instructions carefully to ensure proper healing and reduce the risk of complications. This may include taking prescribed medications, avoiding heavy lifting or strenuous activity, and maintaining a healthy diet to promote healing. It is important to attend follow-up appointments with your healthcare provider to monitor recovery progress and address any concerns.
Suitable For
Patients who are typically recommended sigmoidectomy include those with:
- Stage T1 tumors of the sigmoid colon
- Colorectal cancer
- Diverticulitis
- Severe ulcerative colitis
- Chronic constipation or bowel obstruction
- Recurrent sigmoid volvulus
It is important for patients to discuss their individual medical history and condition with their healthcare provider to determine if sigmoidectomy is the appropriate treatment option for them.
Timeline
Before sigmoidectomy:
- Patient undergoes endoscopic mucosal resection for a stage T1 tumour of the sigmoid colon.
- Laparoscopic sigmoidectomy is performed through 5 ports using needlescopic instruments.
- Resected specimen is extracted from the abdominal cavity transanally.
After sigmoidectomy:
- An anvil is attached to the sigmoidal stump and the rectal stump is reclosed using an endoscopic linear stapler.
- Colorectal anastomosis is conducted using the double stapling technique.
- Transanal specimen extraction using needlescopic forceps improves aesthetic outcomes and reduces post-operative pain and the risk of abdominal incisional hernias.
- This method is considered an option for minimally invasive surgery due to its feasibility and conventional port arrangement.
What to Ask Your Doctor
- What is the reason for recommending a sigmoidectomy procedure?
- What are the potential risks and complications associated with sigmoidectomy?
- What is the expected recovery time and post-operative care plan?
- Are there any alternative treatment options available for my condition?
- How experienced is the surgeon in performing laparoscopic sigmoidectomy?
- Will I need any additional tests or evaluations before the procedure?
- What type of anesthesia will be used during the surgery?
- How long will the surgery take and how long will I need to stay in the hospital?
- What dietary or lifestyle changes will I need to make after the procedure?
- What is the long-term outlook for my condition after sigmoidectomy?
Reference
Authors: Takahashi R, Sakamoto K, Ro H, Kure K, Kawai M, Ishiyama S, Sugimoto K, Kojima Y, Okuzawa A, Tomiki Y. Journal: J Minim Access Surg. 2018 Jan-Mar;14(1):71-73. doi: 10.4103/jmas.JMAS_110_17. PMID: 29067939