Laparoscopic sigmoidectomy for sigmoid diverticulitis in an obese (BMI=39) female patient
Epublication WebSurg.com, Jun 2007;07(06). URL: http://websurg.com/doi/vd01en2124
This video demonstrates the laparoscopic approach to sigmoid resection following previous attacks of diverticulitis. The medial vascular approach is employed, although in this case the inferior mesenteric artery is preserved. Obesity presents particular problems of reduced space and difficulty in identification of structures because of visceral adiposity. This video is suitable for advanced laparoscopic digestive surgeons. The authors use the medial vascular approach, preserving the inferior mesenteric artery. The obese patient presents the dual challenge of reduced space and difficulty in identifying structures. The authors gain exposure of the mesosigmoid, and initially incise the peritoneum to divide the vessels, respecting the superior rectal vessels. They divide only the sigmoid vessels to preserve the superior rectal artery and vein.