February 2005
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Minimally invasive procedure treats severe diverticulitis
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John Sweeney, MD |
Surgeons at Baylor College of Medicine are treating a painful colon disease with a minimally invasive procedure known as laparoscopic colon resection.
More than half of Americans 60 years of age and older have diverticulosis, a condition where weak areas of the colon develop abnormal bulges. According to experts, the bulges, known as diverticuli, are caused by increased pressure within the colon. This pressure is thought to be directly linked to a low fiber diet.
"Diverticulosis is common in the Western civilized world where many diets consist of processed, high fat foods that are low in fiber," said John Sweeney, MD, associate professor and chief of general surgery in the Michael E. DeBakey Department of Surgery at BCM. "Although diverticulosis is asymptomatic in most cases, the bulges can become infected or inflamed evolving to a disease known as diverticulitis."
According to Sweeney, the inflammation and infection associated with diverticulits occurs when tiny tears develop in one or more of the diverticuli, admitting bacteria. Symptoms of diverticulitis include abdominal pain, fever, nausea and changed bowel habits. If untreated, the infection can lead to blockages, abscesses or free perforations, a condition in which a hole forms in the bowel, allowing intestinal contents to enter the abdomen. Obstruction and free perforations are serious conditions that require emergency surgery.
Mild diverticulitis can be treated on an outpatient basis with antibiotics and a liquid diet. However, when a case is severe, an operation known as a colon resection may be necessary to remove the infected portion of the colon.
Traditionally, colon resections have been performed through open surgery, with a large incision being made from the navel to the pubic bone. However, in the early 1990s, doctors began to perform the operation laparoscopically, a method that resulted in less pain and a faster recovery for the patient.
During the procedure, four to five small incisions, each less than two inches in length, are made in the abdomen. A camera is inserted into the abdomen to allow the surgeon to view the procedure on a monitor during surgery.
"After the infected area of the colon is identified and removed, the two ends are sewn back together," said Sweeney, who has performed laparoscopic colon resections at Baylor for more than five years.
In addition to a faster recovery time, Sweeney says that the laparoscopic procedure reduces the risk of infection and pain. Patients remain in the hospital for three to five days and are able to return to work shortly thereafter.
Unlike most surgeries, laparoscopic colon resection does not require major lifestyle changes following the procedure.
"We recommend that the patient assume a high fiber diet to avoid developing additional diverticular problems in the future," said Sweeney. "Shortly after surgery, the patient may experience a small change in bowel movements, but their body will quickly adapt and reach equilibrium."
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