VM43 - Laparoscopic Sigmoidectomy for Complicated Diverticulitis: Tips & Tricks

ONGOING VIDEOS

Location: ASCRS Connect Lounge, Hall B1/B2, Ground Level

Video Presentation(s)

Ammar Saleem, MD

Assistant Registrar - General Surgery
Mubarak Alkabeer Hospital, Kuwait
Shaab, Hawalli, Kuwait

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Author(s)

Sarah A. Almutairi, MD

General Surgery Resident
McGill University
Bayan, Hawalli, Kuwait

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HA

Hadeel Alhamly, MD

General Surgery Resident
Ministry of Health
Kuwait City, Al Farwaniyah, Kuwait

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AA

Ahmed Alkhamis, MD, MSc, FRCSC, FACS, FASCRS

Assistant professor
Kuwait University
Kuwait, Al Asimah, Kuwait

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FA

Fawaz Alnaqi, MD, MPH, FACS, FRCSC

Assistant Professor
College of Medicine, Kuwait University
Kuwait city, Al Asimah, Kuwait

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Senior Author(s)

JA

Jasim Alabbad, MD, FACS, FRCSC

Associate Professor
Kuwait University
Kuwait City, Hawalli, Kuwait

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Ammar Saleem, MD: This individual has no financial relationships with ineligible companies.

Sarah A. Almutairi, MD: This individual has no financial relationships with ineligible companies.

Hadeel Alhamly, MD: This individual has no financial relationships with ineligible companies.

Ahmed Alkhamis, MD, MSc, FRCSC, FACS, FASCRS: This individual has no financial relationships with ineligible companies.

Fawaz Alnaqi, MD, MPH, FACS, FRCSC: This individual has no financial relationships with ineligible companies.

Jasim Alabbad, MD, FACS, FRCSC: This individual has no financial relationships with ineligible companies.

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Purpose/Background: Diverticular abscesses occur in up to 25% of patients with acute diverticulitis. Among these, 20-30% of complicated cases with abscesses fail to respond to antibiotics and percutaneous drainage. This video presentation offers valuable tips and techniques for laparoscopic sigmoidectomy, showcasing successful outcomes in managing persistent abscesses.

Methods/Interventions: A 54-year-old male patient presented with abdominal pain and fever following an episode of acute diverticulitis with an abscess managed by percutaneous drainage four weeks prior. Re-imaging with computed tomography of the abdomen revealed a 7.2 x 4.5 x 4.5 cm abscess adjacent to the sigmoid colon (Hinchey II). The patient was admitted, and percutaneous drainage was performed; however, his symptoms did not improve, and follow-up imaging revealed the persistence of the abscess. Due to the persistence of the abscess despite adequate drain placement, a laparoscopic sigmoidectomy was performed.

Results/Outcomes: This video demonstrates the management of complicated diverticulitis with a persistent abscess through laparoscopic sigmoidectomy, successfully performed without intraoperative complications. Key steps include draining the abscess cavity, lateral to medial mobilization to avoid ureteral injury, and precise division of the rectum and mesentery. The patient tolerated the procedure well, and the postoperative course was uneventful.

Conclusion/Discussion: This video presentation highlights the successful surgical management of complicated diverticulitis with a persistent abscess through laparoscopic sigmoidectomy. It emphasizes the importance of surgical intervention when percutaneous drainage is insufficient, showcasing effective techniques and positive outcomes.