Since the beginning of 1993 until May 1994 in our hospital 25 patients
were operated upon for diverticular disease. 16 patients required a l
aparoscopic assisted elective one-stage resection, One laparoscopic Ha
rtmann's procedure was performed on account of a free perforation, 4 p
atients underwent laparoscopic recontruction of the intestinal continu
ity after an Hartmann's resection, In 4 cases it was necessary to chan
ge to the conventional procedure, Technique: the patient is placed in
dorso-sacral position (modified lithotomy position) in order to allow
transanal colonic access, 4 trocars are necessary, The linear stapler
is used to transsect the sigmoid colon and to dissect the entire mesen
tery, The left lateral trocar incision is enlarged to remove the speci
men, The intracorporeal double staple anastomosis is created by a circ
ular stapler, Results: there were two wound infections, one postoperat
ive bleeding and one small anastomotic leak, After the operation we ob
served all advantages of the laparoscopic procedure in form of less pa
in, earlier beginning of bowel movements, faster return to full diet a
nd earlier hospital discharge, These positive results combined with th
e possibility of a standardized procedure encourage us to continue lap
aroscopic sigmoidectomy.