Laparoscopic colopexy for neo-left colonic volvulus 10 years after anterior resection

Abstract

Recurrent neo-left colonic volvulus is a rare complication following anterior resection. The conventional approach to treating recurrent volvulus is a large bowel resection with anastomosis or colostomy formation after successful endoscopic decompression. However, in elderly and comorbid patients, this can result in significant morbidity or mortality. Laparoscopic colopexy is a less invasive alternative that has not been previously reported for the treatment of neo-left colonic volvulus. We describe a case of an 86-year-old male who presented with recurrent neo-left colonic volvulus 10 years post-laparoscopic anterior resection for cancer. A laparoscopic colopexy was performed to resolve the volvulus and prevent future recurrence. Interrupted prolene sutures were used to fix the neo-left colon to the posterior stomach and the left lateral abdominal wall. The patient had an uncomplicated postoperative recovery and was discharged 6 days after surgery. He was well at 6 months follow-up.

Comments on ‘Metachronous transverse and sigmoid volvulus’

“… 3 , 4 Regarding the metachronous TV following the surgical treatment of SV, the main cause is the mobilization of the colon segments during the previous surgical procedure, which carries the neo-colon from retroperitoneal area into peritoneal space and makes the rotation easier resulting in volvulus. 5 …”