Our Summary

This research paper is about a new method of surgically treating recurrent diverticulitis - an inflammation or infection in one or more small pouches in the digestive tract. The usual treatment is a surgery called a sigmoidectomy, which involves removing the affected part of the colon. The researchers have used a robot to perform this surgery in a new way.

This new technique, called NOSHA, involves removing the affected tissue through the patient’s anus, then manually sewing the remaining tissue back together. The researchers looked at data from all patients who underwent this procedure between 2018 and 2020.

They found that this technique was successful in all 16 patients in the study. However, in two cases, the diseased tissue had to be reduced in size before it could be removed. On average, the operation took about 171.7 minutes, and patients were able to resume normal bowel function within about 35.2 hours. The average hospital stay was 2.9 days.

There were only two complications out of the 16 patients - one had a blockage in their intestine after surgery, which was managed without further surgery, and another was readmitted for abdominal pain, which resolved on its own. There were no leaks from the sewn-up tissue or any cases where further surgery was needed.

The researchers concluded that the robotic NOSHA is a promising new technique for treating recurrent diverticulitis, but more studies are needed to see how it works for different diseases and in different hospitals.

FAQs

  1. What is a sigmoidectomy and how is it used to treat recurrent diverticulitis?
  2. What is the role of the robotic platform in performing a sigmoidectomy?
  3. What were the results and complications observed in the study of robotic NOSHA for the treatment of diverticulitis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sigmoidectomy is to follow postoperative instructions carefully, including taking prescribed medications, following a specific diet, and avoiding strenuous activities until fully recovered. It is important to attend follow-up appointments to monitor healing and address any concerns promptly.

Suitable For

Patients who are typically recommended sigmoidectomy are those with recurrent diverticulitis. This surgical treatment is considered the most definitive for this condition. In this study, patients with recurrent diverticulitis were treated with robotic sigmoidectomy using natural orifice specimen extraction and hand-sewn anastomosis (NOSHA). This technique was found to be effective in achieving successful outcomes with low complication rates. Further studies are needed to establish the utility of this technique for various diseases and its reproducibility across clinical practices.

Timeline

  • Preoperative: Patients with recurrent diverticulitis undergo evaluation and consultation with a surgeon to determine the need for sigmoidectomy. Preoperative tests and preparations are done to ensure the patient is fit for surgery.
  • Intraoperative: The sigmoidectomy is performed using a robotic platform with natural orifice specimen extraction and hand-sewn anastomosis technique. The surgery typically takes around 171.7 minutes to complete.
  • Postoperative: Patients experience a return of bowel function within an average of 35.2 hours after surgery. The mean hospital length of stay is 2.9 days. Complications, such as postoperative ileus, may occur in a small percentage of patients but can be managed conservatively. Patients are monitored for any signs of anastomotic leaks or reoperations, which were not observed in this study.

What to Ask Your Doctor

  1. What is the success rate of robotic sigmoidectomy with natural orifice specimen extraction and hand-sewn anastomosis for treating recurrent diverticulitis?
  2. What are the potential risks and complications associated with this procedure?
  3. How long is the typical recovery time after undergoing this surgery?
  4. Will I need any additional procedures or treatments after the sigmoidectomy?
  5. Are there any specific dietary or lifestyle changes I should make following the surgery?
  6. What is the long-term outlook for patients who undergo this type of surgery?
  7. How experienced is the surgical team in performing robotic sigmoidectomy with natural orifice specimen extraction and hand-sewn anastomosis?
  8. Are there any alternatives to this procedure that I should consider?
  9. Will I need to follow up with a specialist or undergo additional tests after the surgery?
  10. Are there any specific factors about my health or medical history that may affect the outcome of the surgery?

Reference

Authors: Kudsi OY, Gokcal F, Bou-Ayash N, Chudner A. Journal: Colorectal Dis. 2021 Jul;23(7):1919-1923. doi: 10.1111/codi.15624. Epub 2021 Mar 23. PMID: 33709504