Robotic surgery for perforated diverticulitis

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Diverticulitis complicated by diffuse purulent or fecal peritonitis should be treated surgically. This treatment usually consists of a sigmoid colon resection with or without primary anastomosis, depending on the general condition of the patient and the quality of the tissue. Technical difficulties arise when this type of surgery is approached laparoscopically, leading to a high percentage of patients undergoing upfront open surgery or being converted to laparotomy after initial laparoscopic exploration. In our experience, the robotic platform allows a minimally invasive approach in the emergency setting, with a conversion rate lower than laparoscopy, similar as documented for oncological resections. The current chapter presents the authors' personal step-by-step approach for surgical treatment of acute complicated diverticulitis using the robotic platform to perform emergency sigmoid colon resection with primary anastomosis or a Hartmann's resection. The detailed description of each operative step allows to adjust the chronology according to each specific case. Several tips and tricks to deal with difficulties during surgery, such as identification of the ureter, difficult mobilization of the splenic flexure, and presence of an inflammatory mass, are addressed.

Original languageEnglish
Title of host publicationRobotic Colorectal Surgery
Subtitle of host publicationComplete Manual of Surgical Techniques
EditorsPeter Coyne, Jim Khan
PublisherSpringerLink
Chapter18
Pages207-219
Number of pages13
ISBN (Electronic)978-3-031-15198-9
ISBN (Print)978-3-031-15197-2
DOIs
Publication statusPublished - 1 Jan 2022

Bibliographical note

Publisher Copyright:
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

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