Aurelio Francisco Aranzana Gomez, Jara Hernandez Gutierrez, Beatriz Muñoz Jimenez, Juan S Malo Corral. CH Toledo
Introduction: The diverticular disease of the colon is a chronic entity with a variety of abdominal symptoms that can present with recurrent episodes of acute diverticulitis (AD). The prevalence of diverticulosis is not influenced by gender and increases with age, which, according to the increase in life expectancy, explains the accumulation of cases in Western countries. The classic diagnostic and therapeutic algorithm of the disease is based on the modified Hinchey classification. The use of laparoscopy with washing and drainage in cases with peritonitis is nowadays more and more widespread.
The aim of the video is to demonstrate the safety and efficacy of the laparoscopic approach for the definitive treatment in cases with complicated diverticular disease.
Methods ans Procedures: Clinical case: A 46-year-old man with history of Diverticulitis 10 years ago with complete resolution and normal control colonoscopy. He presents in the last two months 3 episodes of acute Diverticulitis. Physical examination reveals an inflammatory plastron in the hypogastric region without defense, CT- thickening of a 10 cm. segment of the sigma, with a 3cm not drainable collection in the mesosigmoid. The complementary explorations and iconography of interest are exposed. Given the evolution, an elective surgical management is proposed.
Results: Preoperative bilateral ureteral catheterization, laparoscopic approach is performed. The video shows a rectosigmoid resection including the diverticular plastron, with negative intraoperative biopsy, a mechanical colorectal anastomosis was performed. Correct postoperative course and discharge on the 6th. PO day. Definitive result of the specimen: perforated Diverticulitis, absence of malignancy.
Conclusion(s): The laparoscopic approach is a valid and effective alternative in cases of complex and severe diverticular disease.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94343
Program Number: V153
Presentation Session: Video Loop Day 1
Presentation Type: VideoLoop