HAND-ASSISTED LAPAROSCOPIC SIGMOIDECTOMY FOR DIVERTICULITIS

BACKGROUND: Sigmoid colectomy for diverticular disease, a routine proc edure when performed using standard open methods, can prove much more challenging using minimum access techniques. Hand-assisted laparoscopi c colectomy is a new technique that reportedly has a minimum learning curve, yet retains the benefits of a laparoscopic procedure. The purpo se of this study was to perform and then prospectively to evaluate the outcome of this procedure on patients needing elective sigmoidectomy for diverticular disease. METHODS: Hand-assisted laparoscopic sigmoide ctomy was performed on all patients undergoing elective sigmoidectomy for diverticular disease between January 18, 1996, and November 21, 19 96. RESULTS: The study group consisted of six men and three women. Age averaged 50.8 (range, 39-66) years, weight averaged 183 (range, 150-2 24) pounds, and operation time averaged 3 hours and 42 minutes (range, 3-5 hours). No cases were converted to open methods. There were two m inor postoperative complications (bleeding from the staple line, 1 pat ient; urinary retention, 1 patient; 22 percent). Resumption of flatus (which was the indication to start the patient on an oral diet) occurr ed between one and three (average, 1.44) days postoperatively. Patient s were discharged from the hospital between one and three (average, 2. 1) days postoperatively. Primary surgeon responsibility was distribute d among four different surgeons, of which only the lead author previou sly had performed laparoscopic colectomy at this institution. CONCLUSI ONS: Hand-assisted laparoscopic sigmoidectomy is a procedure that has a minimum learning curve, yet retains the benefits of a laparoscopic p rocedure.