Our Summary

This research paper discusses a new surgical technique used for an 82-year-old man who was suffering from a health issue where his colon and bladder were connected (a condition known as colovesical fistulas) due to a disorder called sigmoid diverticulitis. This condition had caused him to feel tired and pass air and fecal matter through his urine. The doctors decided to perform a laparoscopic surgery, which is a minimally invasive surgical procedure done through small incisions.

The challenge during this type of surgery is to avoid damaging the ureter, a tube that carries urine from kidneys to the bladder. To overcome this, the surgeons used a new tool called a Near-infrared Ray Catheter. This device emits a green light, which helps the surgeons to clearly see and avoid the ureter during the surgery.

The surgery was successful and the patient was in good health after the procedure. The researchers believe that this new surgical technique can be useful in other similar cases where there is a high risk of damaging the ureter.

FAQs

  1. What is the new surgical technique discussed in this research paper for treating colovesical fistulas due to sigmoid diverticulitis?
  2. How does the Near-infrared Ray Catheter tool help surgeons during this minimally invasive surgical procedure?
  3. Can this new surgical technique be applied to other similar cases where there is a high risk of damaging the ureter?

Doctor’s Tip

A doctor might tell a patient undergoing diverticulitis surgery to follow post-operative care instructions carefully, including taking prescribed medications, avoiding heavy lifting or strenuous activity, and sticking to a soft diet to allow the intestines to heal properly. It is important to attend follow-up appointments to monitor recovery and address any concerns promptly. Additionally, maintaining a healthy diet with plenty of fiber and staying hydrated can help prevent future episodes of diverticulitis.

Suitable For

Patients who are typically recommended diverticulitis surgery include those who have recurrent episodes of diverticulitis that do not respond to conservative treatments such as antibiotics and dietary changes. Surgery may also be recommended for patients who have complications of diverticulitis such as abscesses, perforations, or fistulas. Additionally, surgery may be recommended for patients who have severe symptoms such as persistent abdominal pain, fever, and vomiting.

In some cases, surgery may be recommended as a preventative measure for patients who have a history of recurrent diverticulitis and are at a high risk of developing complications. Surgery may also be recommended for younger patients with diverticulitis who are at a higher risk of complications due to factors such as immunosuppression or underlying medical conditions.

Overall, the decision to recommend diverticulitis surgery is based on the individual patient’s symptoms, medical history, and risk factors for complications. Patients should consult with their healthcare provider to determine the most appropriate treatment plan for their specific situation.

Timeline

Before the surgery:

  • Patient experiences symptoms of sigmoid diverticulitis, such as abdominal pain, bloating, and changes in bowel habits
  • Patient undergoes diagnostic tests, such as a colonoscopy or CT scan, to confirm the diagnosis of colovesical fistulas
  • Surgeons discuss the risks and benefits of surgery with the patient and develop a treatment plan

During the surgery:

  • Laparoscopic surgery is performed using small incisions and a Near-infrared Ray Catheter to avoid damage to the ureter
  • Surgeons carefully separate the colon from the bladder and repair the fistulas
  • The surgery is successful and the patient is monitored in the recovery room before being transferred to a hospital room

After the surgery:

  • Patient is monitored for any complications, such as infection or bleeding
  • Patient is given pain medication and instructions on how to care for the incisions
  • Patient is gradually allowed to start eating and drinking again
  • Patient is discharged from the hospital once they are stable and able to care for themselves at home

Overall, the patient experiences relief from symptoms and improved quality of life after the diverticulitis surgery. The new surgical technique using the Near-infrared Ray Catheter shows promise in reducing the risk of complications during similar procedures.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing surgery for diverticulitis?
  2. What is the success rate of this laparoscopic surgical technique for treating colovesical fistulas caused by diverticulitis?
  3. How long is the recovery time after this type of surgery?
  4. Are there any potential complications or side effects associated with this surgical procedure?
  5. What lifestyle changes or dietary modifications should I make after the surgery to prevent recurrence of diverticulitis?
  6. Will I need any additional treatments or follow-up appointments after the surgery?
  7. How experienced is the surgical team in performing this specific procedure?
  8. Are there any alternative treatment options available for diverticulitis besides surgery?
  9. What can I expect in terms of pain management and post-operative care following the surgery?
  10. How likely is it that the diverticulitis will recur after undergoing this surgery?

Reference

Authors: Osumi W, Yamamoto M, Taniguchi K, Masubuchi S, Hamamoto H, Ishi M, Izuhara K, Tanaka K, Okuda J, Uchiyama K. Journal: Medicine (Baltimore). 2021 May 28;100(21):e26085. doi: 10.1097/MD.0000000000026085. PMID: 34032744