Laparoscopic Sigmoidectomy using a Prolapsing Technique for Sigmoid Colon Volvulus in Children

Abstract

ratory data showed a white blood cell count of 9 800 / mm 3 (normal 3 500 -9 000) with a mild left shift, a C-reactive protein level of 0.15 mg / dl (normal, < 0.17) and a creatine kinase level of 123 IU / I (normal, 62 -287). The diagnosis was sigmoid colon volvulus and the patient underwent colonoscopic decompression. He was discharged and was followed up on an outpatient basis. A similar event occurred 6 months later, and he underwent colonic decompression followed by elective laparoscopic sigmoidectomy after complete bowel preparation. The patient was placed in the lithotomy position, and a 5-mm trocar for the laparoscope was inserted through a sub-umbilical incision, while the other three 5-mm trocars were inserted in the right upper, right lower, and left upper quadrants along the mid-clavicular line, respectively, and CO 2 gas was then insuffl ated at pressure of 8 mmHg. An elongated sigmoid colon with moderate dilatation was seen, with a long narrow-based mesentery and close approximation of the two limbs of the sigmoid loop. After simple fenestration of the sigmoid mesentery, a balloon catheter was introduced into the sigmoid colon through the anus, and the sigmoid colon was then tied tightly with umbilical tape just below the insuffl ated balloon. The catheter was carefully pulled out, creating a rectosigmoid prolapse ( • ▶ Fig . 2a,b ). The colon was transected at the rectosigmoid junction, the divided sigmoid colon was exteriorized via the anus, and the redundant part was resected with dissection of the arcade and straight vessels ( • ▶ Fig . 2c ). The detachable anvil

Recurrent Sigmoid Volvulus in Children—Our Experience and Systematic Review of the Current Literature

“…A total of 73 patients underwent elective surgery after SV ( Table 5 ); in 26 cases, this took place after a recurrence. The procedures were SRPA in 49 patients, and in 1 patient this was accomplished transanally [ 33 ]. Four patients received a resection with colostomy formation (one due to CIPO) and one a total colectomy [ 18 , 19 ].…”

“…Our surgical method, which involves laparoscopic identification of the sigmoid and its eventration through a short periumbilical, median laparotomy followed by resection and a hand-sewn anastomosis outside the abdominal cavity, can be conducted without a stapling device and advanced laparoscopic skills and while still ensuring a safe anastomosis and minimizing contamination. The prolapsing, transanal technique described by Hamada et al [ 33 ] is another useful method for SRPA especially for pediatric surgeons used to transanal pull-through for HD.…”

Laparoscopic detorsion and colopexy for splenic flexure volvulus in an infant

“…To the best of our knowledge, there are no previous reports regarding laparoscopic operations for splenic flexure volvulus. Instances of laparoscopic management in other types of colonic volvulus have been recently reported [11][12][13]. Laparoscopic fixation of the splenic flexure is minimally invasive and cosmetically and physically beneficial.…”