Sigmoid Colectomy (Open, Laparoscopic, Robotic)

Procedure Snapshot

• Indication: Recurrent diverticulitis, sigmoid cancer.
• Expected duration: ___
• Special instruments: Stapler, lap ports, energy device.

Step Workflow

1. Mobilize sigmoid colon medial → lateral; identify ureter.
2. Ligate sigmoid branches of IMA.
3. Divide colon & rectosigmoid junction; perform anastomosis.

Key Pimp Questions

• Q: Preferred approach for diverticulitis? Laparoscopic if not perforated (PMID 33034328).
• Q: When Hartmann’s? In purulent/fecal peritonitis.

Critical Anatomy

• Landmarks: Ureter, IMA, marginal artery.
• Danger zones: Presacral veins, ureter.

Informed Consent Highlights

• Leak, bleeding, stoma, recurrence of diverticulitis.

Post-op Considerations

• ERAS diet; stoma teaching if diverted.

References

• Chassin’s, Colon chapter; Clinical Scenarios, Colorectal.
• Simillis 2020 (PMID 33034328).