LAPAROSCOPIC SURGERY FOR ACUTE AND CHRONI C DIVERTICULAR-DISEASE

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.