Laparoscopic sigmoid colectomy (Laparoscopic sigmoid resection)

The sigmoid colon is the last section of our large intestine – approximately 20-25 cm long – which is directly connected to the rectum.

The formation stool takes place here, and from there the stool is transferred to the rectum for further storage and then emptying.

Due to inflammatory, benign and malignant tumour lesions of the colon, it may be necessary to partially or, in rare cases, completely remove it.

Laparoscopic sigmoid resection is the complete removal of the sigmoid colon. During laparoscopic surgery, the abdominal cavity is filled with CO2 gas, then 3-4 pcs of 5-12 mm incisions are made, where the camera and other instruments necessary for the surgery are introduced. Using special instruments, the sigmoid colon and its associated lymph nodes are removed, the arteries and veins supplying the intestine are blocked, and then the intestine is raised to the level of the abdominal wall and removed through a small incision. The continuity of the colon is restored with a special intestinal suture machine or hand sutures.

Surgery may be necessary in the following cases:

Malignant tumours/colon cancer

Radical surgery plays a central role in most stages of malignant colon tumours.

In the case of a tumour discovered in time, correct oncological surgery results in a full recovery. In more advanced cases – for example, with lymph node metastasis – additional chemotherapy may be required in addition to surgery but even then, the cure rate can be 80-90%.

Approximately 30% of colon tumours affect the sigmoid colon.

During surgery, the cancerous section of the intestine, as well as the chain of supplying lymphatic vessels and lymph nodes, is removed. The continuity of the intestine is restored with a special intestinal sewing machine or hand stitches.

Diverticulosis/diverticulitis

During diverticulosis, glove-like protrusions form on the intestinal wall, which can also be considered a deterioration of the intestinal wall. It occurs most often in the sigmoid colon and its incidence increases with age.

Inflammation, so-called diverticulitis, may develop because of diverticulosis of the sigmoid colon, which may be accompanied by cramping pain in mild cases, and perforation, abscess formation, peritonitis or massive bleeding in severe cases. The risk of complications during surgery performed in the acute stage is several times higher than in intestinal resection performed in the non-inflammatory stage. Removal of a perforated, inflamed sigmoid colon can only be solved by temporary stoma formation in a significant proportion of cases.

Benign tumours or large polyps

Benign polyps are common in the colon, and their incidence increases after the age of 45.

It is recommended to remove all polyps, as they can continue to grow, and some of them may transform into malignant tumours.

Most polyps can be removed during colonoscopy, but if this is not possible due to size or location, surgery is required.

The advantages of laparoscopic surgery over open surgery:

• less surgical strain, pain
• shorter hospital stay and recovery period
• better cosmetic result
• faster onset of bowel function, earlier return to solid nutrition
• oncological radicality is the same as open surgery’s
• less postoperative adhesions

All procedures, including sigmoid colectomy, may carry risks, including:

• bleeding, intra-abdominal hematoma, vascular injury
• separation of intestinal sutures, infection of the abdominal wall wound
• formation of a fistula
• injury to other abdominal organs
• deep vein thrombosis

Colon surgeries may require complete emptying of the colon and rectum, therefore your surgeon may ask you to follow a liquid diet for a few days prior to surgery, and you may also need to take a stool softener/laxative before surgery. Your operating physician will provide you with detailed advice on this.

You can drink fluids a few hours after surgery, eat a few bites of biscuits or crackers, and get out of bed. You can usually follow a normal diet the day after surgery. At this time, we also try to have you spend as much time out of bed as possible, walking.

We most often use absorbable sutures, and there is no need to remove the sutures.

After surgery, it usually takes 2-3 days for bowel function to start. To avoid pain caused by constipation, it is recommended to drink plenty of fluids, eat vegetables, fruits, and foods rich in fibre. During your stay in the hospital, you can discuss the recommended diet in detail with our institution’s dietician.

In the first 6 weeks, avoid heavy physical work, lifting weights, and intense sports activities. Returning to work depends on the type of work and the extent of the surgery. In the case of laparoscopic surgery, you can expect to return to work within 1-2 weeks.