Our Summary

This article discusses the increasing use of laparoscopic surgery (a minimally invasive surgical technique) in treating complicated cases of diverticulitis, which is an inflammation of small pouches in the colon. The authors looked at English-language research to provide a brief overview. They found that in cases of diverticulitis with abscess or air outside the colon, monitoring the patient instead of immediately resorting to surgery is not considered substandard care. However, they note that this non-surgical approach might increase the likelihood of a narrowing in the sigmoid colon.

FAQs

  1. What is laparoscopic surgery and how is it used in treating diverticulitis?
  2. Is monitoring the patient without immediate surgery considered substandard care in cases of diverticulitis with abscess or air outside the colon?
  3. Can a non-surgical approach to diverticulitis increase the likelihood of a narrowing in the sigmoid colon?

Doctor’s Tip

A helpful tip a doctor might tell a patient about diverticulitis surgery is to make sure to follow all pre-operative instructions, such as fasting before the surgery and stopping certain medications as directed. It is also important to discuss any concerns or questions with your healthcare team before the surgery to ensure you are well-prepared and informed about the procedure. Additionally, following post-operative care instructions, such as taking prescribed medications and gradually reintroducing solid foods, will help promote a successful recovery.

Suitable For

In general, patients who are recommended diverticulitis surgery are those who have:

  1. Recurrent episodes of diverticulitis that do not respond to conservative treatment such as antibiotics and dietary changes.
  2. Complicated diverticulitis, such as the presence of abscesses, perforations, fistulas, or strictures.
  3. Severe symptoms such as persistent pain, fever, and bowel obstruction.
  4. Complications such as bleeding, perforation, or abscess formation.
  5. Failed non-surgical interventions or recurrent symptoms despite medical management.
  6. Younger patients with multiple episodes of acute diverticulitis who may benefit from surgery to prevent future complications.

Ultimately, the decision to recommend diverticulitis surgery is based on the individual patient’s specific condition, symptoms, and overall health status. It is important for patients to discuss their options with their healthcare provider to determine the best course of treatment for their particular situation.

Timeline

Before diverticulitis surgery:

  • Patient experiences symptoms such as abdominal pain, fever, nausea, and changes in bowel habits
  • Diagnosis is made through imaging tests such as CT scans or colonoscopy
  • Antibiotics are prescribed to treat the infection and inflammation
  • In severe cases, a drainage procedure may be performed to remove abscesses

After diverticulitis surgery:

  • Laparoscopic surgery is performed to remove the affected part of the colon
  • Recovery time is shorter compared to traditional open surgery
  • Patient may experience temporary discomfort, bloating, and changes in bowel habits
  • Follow-up appointments are scheduled to monitor recovery and ensure no complications arise
  • Patient is advised to follow a special diet to prevent future flare-ups of diverticulitis

What to Ask Your Doctor

  1. What are the potential risks and complications of diverticulitis surgery?
  2. How long is the recovery process after surgery and what can I expect during the recovery period?
  3. Will I need to make any lifestyle changes after surgery to prevent future episodes of diverticulitis?
  4. What are the success rates of laparoscopic surgery for diverticulitis compared to traditional open surgery?
  5. How long will I need to stay in the hospital after the surgery?
  6. Will I need to follow a special diet after surgery? If so, what dietary restrictions will I need to follow?
  7. What is the likelihood of experiencing a recurrence of diverticulitis after surgery?
  8. Will I need to undergo any additional tests or procedures before the surgery?
  9. Are there any alternative treatments to surgery that I should consider?
  10. How experienced are you in performing diverticulitis surgery and what is your success rate with this procedure?

Reference

Authors: Gachabayov M, Essani R, Bergamaschi R. Journal: Langenbecks Arch Surg. 2018 Feb;403(1):11-22. doi: 10.1007/s00423-017-1621-6. Epub 2017 Sep 5. PMID: 28875302