There is no doubt that we all fear invasive surgeries and try to opt for the one that has minimal invasions or none at all. Sigmoidectomy is one of the surgeries that require minimal invasion. This surgery is carried out to remove a part of the sigmoid colon. In sigmoidectomy, laparoscopic surgery is used, which undoubtedly offers multiple advantages over conventional open surgeries.
Today in this article, we are going to explore the anatomy, perspective care, the procedure itself, drawbacks, and the evidences to endorse this procedure.
Table of Contents
Anatomy:
There is a specific section of the large intestine located between the descending colon and the rectum, called the sigmoid colon. This area has an important function in storing and expelling fecal waste. The sigmoid colon is around 35–40 cm long and is arranged in an unusual S shape. It is the perfect candidate for laparoscopic surgery because of its location and mobility.
Descending and Sigmoid Colon:
The section of the large intestine that descends from the splenic flexure to the sigmoid colon is known as the descending colon. The abdominal cavity’s left side is where it runs. On the other hand, the sigmoid colon originates from the termination point of the descending colon and extends toward the rectum. Understanding the course and relationships of these structures is crucial during a sigmoidectomy.
Blood Supply:
During surgical procedures related to the sigmoid colon, it is vital to recognize and protect certain arteries that are responsible for delivering blood to this area. Two important arteries that contribute to the oxygenated blood supply of the sigmoid colon are the left colic artery and the sigmoid arteries. Safeguarding and preserving these arteries is crucial during surgery to ensure sufficient blood flow to the remaining colon. Surgeons can identify these arteries and implement appropriate measures to protect them, which is essential for maintaining optimal blood circulation and enhancing the overall outcome of the procedure.
Topography:
The sigmoid colon lies in the left lower quadrant of the abdomen. It is generally fixed to the posterior abdominal wall by the sigmoid mesocolon, a fold of peritoneum that attaches the colon to the retroperitoneal structures. This fixed position allows for better visualization and manipulation during laparoscopic surgery.
Perioperative Management:
Before performing a laparoscopic sigmoidectomy, the patient undergoes a thorough preoperative evaluation, including blood tests, imaging studies, and a detailed medical history. Adequate bowel preparation is essential to ensure a clean operative field. Antibiotic prophylaxis is usually administered to reduce the risk of surgical site infections.
Technique:
Laparoscopic sigmoidectomy involves several key steps. The surgeon creates a pneumoperitoneum by introducing carbon dioxide gas into the abdominal cavity, which creates a working space. Multiple small incisions are made in the abdominal wall to insert trocars, and specialized instruments are used for visualization and manipulation. A laparoscope, a thin tube with a camera and light source, is inserted through one of the trocars to provide a magnified view of the surgical field. The sigmoid colon is then mobilized, and the blood supply is carefully preserved. Once the diseased segment is identified, it is divided and removed. The remaining healthy ends of the colon are then reconnected using sutures or staples, creating a new, functional pathway for fecal matter.
Evidence:
The laparoscopic approach to sigmoidectomy has gained popularity due to its numerous benefits. Its effectiveness and safety have been proven in several investigations, and the oncological results are equivalent to open surgery. Minimized postoperative discomfort, shortened hospital stays, faster recovery, and enhanced cosmetic outcomes have all been associated with laparoscopic sigmoidectomy. Nonetheless, several factors, including the patient’s overall health, disease severity, and surgeon’s expertise, determine the appropriate approach between laparoscopic and open sigmoidectomy.
FAQ’s:
What are the functions of the descending and sigmoid colons?
The descending and sigmoid colons have important roles in the digestive process. These intestine-related organs aid in the assimilation of water and electrolytes from digested meals. They also assist in the production and storage of feces.
Are there any common ailments or diseases associated with the descending and sigmoid colons?
There are some diseases that affect the colon and thus require operations. These diseases may include colorectal, diverticulitis, and benign polyps.
What are the different methods used to perform a sigmoidectomy?
Multiple ways can be used to treat sigmoidectomy. These include open surgery, laparoscopic surgery, and robotic-assisted surgery. However, the only thing that matters when choosing the method is personal preference. Smaller incisions and specialized tools are used in minimally invasive surgical techniques like laparoscopic and robotic-assisted procedures. On the other hand, open surgery necessitates making a wider abdominal incisionMultiple ways can be used to treat sigmoidectomy these include open surgery, laparoscopic surgery, and robotic-assisted surgery. However, the only thing that matters when choosing the method is personal preference. Smaller incisions and specialized tools are used in minimally invasive surgical techniques like laparoscopic and robotic-assisted procedures. On the other hand, open surgery necessitates making a wider abdominal incision.
