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Sigmoidectomy via an elective approach for sigmoid volvulus (with video)
+Model
ARTICLE IN PRESS
JVS-665; No. of Pages 2
Journal of Visceral Surgery (2017) xxx, xxx—xxx
Available online at
ScienceDirect www.sciencedirect.com
VISCERAL SURGERY VIDEOS
Sigmoidectomy via an elective approach for sigmoid volvulus (with video) H. Najah a, G. Godiris Petit a, S. Noullet a, A. Ayed b, F. Menegaux a, C. Trésallet a,∗ a
Service de chirurgie générale, viscérale et endocrinienne, Hôpital de la Pitié Salpêtrière, AP—HP, Pierre-et-Marie-Curie, Sorbonne Universités, Paris 6, 47-83, boulevard de l’Hôpital, 75013 Paris, France b Service de radiologie, Hôpital de la Pitié Salpêtrière, AP—HP, Pierre-et-Marie-Curie, Sorbonne Universités, Paris 6, 47-83, boulevard de l’Hôpital, 75013 Paris, France
KEYWORDS Sigmoid volvulus; Surgery; Resection; Mini-incision laparotomy
∗
Sigmoid volvulus (SV) is one of the three most common causes of acute colonic obstruction. Initial sigmoidoscopic decompression followed by surgery is currently the accepted treatment for SV. Due to the high risk of recurrence, surgery is recommended at the initial admission [1]. The gold standard operation consists in a resection of the redundant sigmoid colon either via laparotomy or laparoscopy [2]. Herein, we describe the technique of sigmoidectomy via an elective approach. This technique is easily reproducible, and in addition to the cosmetic benefit, it results in good immediate and long-term outcomes [3]. A 23-year-old woman presented to the emergency department with 2 days history of severe abdominal pain, distension and constipation. She had no significant past medical or surgical history. Physical examination showed a distended abdomen with generalized mild tenderness. The rectum was empty at digital examination. Abdominal computed tomography scan showed a massive dilatation of the sigmoid colon loop arising from the pelvis and extending to the diaphragm, associated with a whirl sign, quite typical of SV. There were no signs of perforation or gangrene. Untwisting of the sigmoid volvulus was successfully achieved by means of flexible sigmoidoscopy, and a rectal tube was placed. During the same hospitalization, and after bowel preparation, the patient underwent surgery four days later. A sigmoid resection was successfully performed via an elective approach (Figs. 1—3). The video shows the different steps of the procedure. This patient recovered uneventfully and was discharged on postoperative day 3.
Corresponding author. E-mail address: [email protected] (C. Trésallet).
http://dx.doi.org/10.1016/j.jviscsurg.2016.11.003 1878-7886/© 2016 Elsevier Masson SAS. All rights reserved.
Please cite this article in press as: Najah H, et al. Sigmoidectomy via an elective approach for sigmoid volvulus (with video). Journal of Visceral Surgery (2017), http://dx.doi.org/10.1016/j.jviscsurg.2016.11.003
+Model JVS-665; No. of Pages 2
ARTICLE IN PRESS
2
H. Najah et al.
Disclosure of interest The authors declare that they have no competing interest.
Appendix A. Supplementary data Supplementary data associated with this article can be found, in the online version, at http://dx.doi.org/10.1016/ j.jviscsurg.2016.11.003.
References Figure 1.
Exteriorization of the sigmoid loop. [1] Chung YF, Eu KW, Nyam DC, Leong AF, Ho YH, SeowChoen F. Minimizing recurrence after sigmoid volvulus. Br J Surg 1999;86:231—3, http://dx.doi.org/10.1046/ j.1365-2168.1999.01034.x. [2] Raveenthiran V, Madiba TE, Atamanalp SS, De U. Volvulus of the sigmoid colon. Colorectal Dis 2010;12:e1—17, http://dx.doi.org/10.1111/j.1463-1318.2010.02262.x. [3] Basato S, Lin Sun Fui S, Pautrat K, Tresallet C, Pocard M. Comparison of two surgical techniques for resection of uncomplicated sigmoid volvulus: laparoscopy or open surgical approach? J Visc Surg 2014;151:431—4, http://dx.doi.org/10.1016/ j.jviscsurg.2014.09.002.
Figure 2.
Division of the sigmoid mesocolon.
Figure 3.
Mechanical side to side colo-colonic anastomosis.
Please cite this article in press as: Najah H, et al. Sigmoidectomy via an elective approach for sigmoid volvulus (with video). Journal of Visceral Surgery (2017), http://dx.doi.org/10.1016/j.jviscsurg.2016.11.003
ARTICLE IN PRESS
JVS-665; No. of Pages 2
Journal of Visceral Surgery (2017) xxx, xxx—xxx
Available online at
ScienceDirect www.sciencedirect.com
VISCERAL SURGERY VIDEOS
Sigmoidectomy via an elective approach for sigmoid volvulus (with video) H. Najah a, G. Godiris Petit a, S. Noullet a, A. Ayed b, F. Menegaux a, C. Trésallet a,∗ a
Service de chirurgie générale, viscérale et endocrinienne, Hôpital de la Pitié Salpêtrière, AP—HP, Pierre-et-Marie-Curie, Sorbonne Universités, Paris 6, 47-83, boulevard de l’Hôpital, 75013 Paris, France b Service de radiologie, Hôpital de la Pitié Salpêtrière, AP—HP, Pierre-et-Marie-Curie, Sorbonne Universités, Paris 6, 47-83, boulevard de l’Hôpital, 75013 Paris, France
KEYWORDS Sigmoid volvulus; Surgery; Resection; Mini-incision laparotomy
∗
Sigmoid volvulus (SV) is one of the three most common causes of acute colonic obstruction. Initial sigmoidoscopic decompression followed by surgery is currently the accepted treatment for SV. Due to the high risk of recurrence, surgery is recommended at the initial admission [1]. The gold standard operation consists in a resection of the redundant sigmoid colon either via laparotomy or laparoscopy [2]. Herein, we describe the technique of sigmoidectomy via an elective approach. This technique is easily reproducible, and in addition to the cosmetic benefit, it results in good immediate and long-term outcomes [3]. A 23-year-old woman presented to the emergency department with 2 days history of severe abdominal pain, distension and constipation. She had no significant past medical or surgical history. Physical examination showed a distended abdomen with generalized mild tenderness. The rectum was empty at digital examination. Abdominal computed tomography scan showed a massive dilatation of the sigmoid colon loop arising from the pelvis and extending to the diaphragm, associated with a whirl sign, quite typical of SV. There were no signs of perforation or gangrene. Untwisting of the sigmoid volvulus was successfully achieved by means of flexible sigmoidoscopy, and a rectal tube was placed. During the same hospitalization, and after bowel preparation, the patient underwent surgery four days later. A sigmoid resection was successfully performed via an elective approach (Figs. 1—3). The video shows the different steps of the procedure. This patient recovered uneventfully and was discharged on postoperative day 3.
Corresponding author. E-mail address: [email protected] (C. Trésallet).
http://dx.doi.org/10.1016/j.jviscsurg.2016.11.003 1878-7886/© 2016 Elsevier Masson SAS. All rights reserved.
Please cite this article in press as: Najah H, et al. Sigmoidectomy via an elective approach for sigmoid volvulus (with video). Journal of Visceral Surgery (2017), http://dx.doi.org/10.1016/j.jviscsurg.2016.11.003
+Model JVS-665; No. of Pages 2
ARTICLE IN PRESS
2
H. Najah et al.
Disclosure of interest The authors declare that they have no competing interest.
Appendix A. Supplementary data Supplementary data associated with this article can be found, in the online version, at http://dx.doi.org/10.1016/ j.jviscsurg.2016.11.003.
References Figure 1.
Exteriorization of the sigmoid loop. [1] Chung YF, Eu KW, Nyam DC, Leong AF, Ho YH, SeowChoen F. Minimizing recurrence after sigmoid volvulus. Br J Surg 1999;86:231—3, http://dx.doi.org/10.1046/ j.1365-2168.1999.01034.x. [2] Raveenthiran V, Madiba TE, Atamanalp SS, De U. Volvulus of the sigmoid colon. Colorectal Dis 2010;12:e1—17, http://dx.doi.org/10.1111/j.1463-1318.2010.02262.x. [3] Basato S, Lin Sun Fui S, Pautrat K, Tresallet C, Pocard M. Comparison of two surgical techniques for resection of uncomplicated sigmoid volvulus: laparoscopy or open surgical approach? J Visc Surg 2014;151:431—4, http://dx.doi.org/10.1016/ j.jviscsurg.2014.09.002.
Figure 2.
Division of the sigmoid mesocolon.
Figure 3.
Mechanical side to side colo-colonic anastomosis.
Please cite this article in press as: Najah H, et al. Sigmoidectomy via an elective approach for sigmoid volvulus (with video). Journal of Visceral Surgery (2017), http://dx.doi.org/10.1016/j.jviscsurg.2016.11.003