Diverticulectomy Surgery

Overview

Diverticulectomy is a surgical procedure aimed at removing diverticula, which are small, bulging pouches that can form in the digestive tract. This procedure is often necessary when diverticula become inflamed or infected, causing pain and other complications.

What are the Causes?

Diverticula can form due to several factors, including:

• Dietary Habits: Low-fiber diets can lead to the formation of diverticula.
• Aging: The likelihood of developing diverticula increases with age.
• Genetics: Family history can play a role in the development of diverticular disease.

What are the Symptoms?

Symptoms indicating the need for diverticulectomy include:

• Abdominal Pain: Severe and persistent pain, often on the lower left side of the abdomen.
• Fever and Chills: Indicating possible infection.
• Changes in Bowel Habits: Including constipation or diarrhea.
• Nausea and Vomiting: Common symptoms associated with diverticulitis.

Why Do People Get Diverticulectomy Surgery?

As discussed above, there can be two conditions associated with diverticula - diverticulosis, where the small pouches form in the lining of the gastrointestinal tract, and diverticulitis, where the pouches become inflamed or infected, causing pain, fever, and digestive disturbances. People undergo a diverticulectomy to manage and prevent these complications. Here’s an overview of the factors that lead to opting for a diverticulectomy:

• Recurrent diverticulitis: Surgery may be needed when there are multiple episodes of diverticulitis, especially when they’re severe, in order to prevent future occurrences and mitigate the risk of complications. 
• Complications: Surgery is needed when there is perforation of the colon (which can lead to a serious abdominal infection called peritonitis), abscesses (pockets of infection), fistulas (formation of abnormal connections between the colon and organs like the bladder), or intestinal obstruction.
• Severe or uncontrolled bleeding: When there is bleeding in the colon, that has become severe, recurrent, and uncontrollable with less invasive means, surgery might be considered.
• Failure of medical management: When treatment options like antibiotics, dietary changes, and other non-surgical treatments have failed, surgery might be needed to remove the affected portion of the colon.
• Immunocompromised patients: If individuals with a weakened immune system due to conditions like cancer or the use of immunosuppressive drugs experience diverticulitis, they may be advised surgery after the first episode only to prevent life-threatening complications.

The surgery aims at alleviating symptoms to prevent recurrence and reduce the risk of serious complications. The patient’s condition, the severity and frequency of diverticulitis, and the present complications are carefully evaluated before considering the surgery.

Understanding the Anatomy of the Colon and Diverticula

Large Intestine (Colon)

The colon or large intestine is a key part of the digestive system. Here are its structural details:

The colon is 5 feet long and divided into several parts:

• Cecum: It is the beginning of the colon, where the small intestine empties the digested food. 
• Ascending colon: This part travels upward on your abdomen’s right side.
• Transverse colon: It runs across the abdomen from left to right.
• Descending colon: This portion of the colon runs down on the left side.
• Sigmoid colon: This is the S-shaped section of the colon that connects to the rectum, leading to the anus through which feces are expelled.

Diverticula:

Diverticula, the small pouches, are most commonly found in the sigmoid colon, but can also develop anywhere else in the colon. They form when the inside lining of the intestine pushes into weak spots in the outer wall.

Understanding this anatomy is crucial to diagnosing and treating diverticula.

Diverticulectomy - What You Can Expect

Here’s what you can expect before, during, and after a diverticulectomy:

Before Surgery

Here’s what you can expect before the procedure:

• A preoperative assessment: Your overall health is evaluated to assess your eligibility for the surgery. This includes reviewing your medical history and performing a physical examination.  
• Diagnostic tests: Your doctor may recommend certain tests such as blood tests, stool tests, electrocardiogram (EKG), chest X-ray, CT scan, ultrasound, MRI (magnetic resonance imaging), and/or a colonoscopy to assess the diverticulum and determine the best course of action.
• Medication management: Inform your surgeon about the current medications and supplements if any. You may need to adjust the dosage or stop certain medications such as blood thinners for a brief duration.
• Bowel preparation: You may need to empty the colon before surgery, for which you will need to follow a clear liquid diet for 1-2 days before the procedure. You will also need to fast for a certain period after midnight on the day before surgery. 
• Arrange help: Make sure that you arrange for someone to drop you home from the healthcare facility or hospital. Also, arrange for help at home during your recovery. 

It is important to follow all preoperative instructions well to avoid/lower any chances of complications. The steps are tailored to one’s specific health needs, the type of diverticulectomy performed, and your specific needs.

During Surgery (Procedure)

The diverticulectomy procedure varies on how it is performed - traditionally (open) or through a minimally invasive technique (laparoscopic or robotic-assisted). Here’s a general overview of the procedure.

• Anesthesia: The patient is administered general anesthesia to ensure s/he is pain-free during the procedure.
• Incision: A long incision is made in the abdomen for an open technique. This is replaced with a few small incisions if it’s a minimally invasive technique, after which a laparoscope and other surgical instruments are inserted.
• Identification and removal: The diverticuli are removed from the onstestine wall. In some cases, a small part of your intestine is removed.
• Reconnection: When a part of the intestine is removed, the end will be sttached back together, and this procedure is called as Anastomosis. 
• Closure: Finally, the incision/s is closed using sutures, staples, or surgical glue.

After the completion of the surgery, the patient is moved to a recovery area where his/her vitals are monitored once s/he wakes up from anesthesia. 

After Surgery (Recovery and Outlook)

Recovery after a diverticulectomy surgery depends on and varies with the type of surgery, complications, and the patient’s adherence to postoperative instructions. 

• Immediate postoperative recovery: Hospital stay is longer for a traditional surgery when compared to a minimally invasive approach. Any and discomfort can be managed with medications. 
• Home recovery: Rest is crucial but light activity is encouraged to aid recovery and prevent the risk of blood clots. You will be advised to have a light diet to reduce stress on the digestive system. High-fiber foods may be recommended. 
• Long-term care: You can get back to your normal activities slowly by following your doctor’s instructions. Make sure that you attend the scheduled follow-up appointments in order to track your progress in healing.

The overall outlook after diverticulectomy is usually good as you can return to normal activities with a marked improvement in their quality of life. It is important that you communicate with their surgeon and discuss any possible concerns and adhere to the recommended lifestyle changes to support a healthy digestive system. 

What are the Complications if Left Untreated?

If left untreated, diverticulitis can lead to:

• Abscess Formation: Pockets of pus that form in the abdominal cavity.
• Perforation: A tear in the colon that can lead to peritonitis, a life-threatening infection.
• Fistulas: Abnormal connections between the colon and other organs.
• Intestinal Obstruction: Blockages that prevent the passage of stool or gas.

Why Choose Medfin in Bangalore?

1. Experienced Surgeons: Our board-certified surgeons in Bangalore specialize in digestive tract procedures, ensuring expert care.
2. Personalized Treatment Plans: We tailor our treatment plans to meet your specific needs and health conditions.
3. State-of-the-Art Facilities: Medfin clinics in Bangalore are equipped with the latest technology to provide a safe and comfortable environment.
4. Comprehensive Care: From diagnosis to post-surgery follow-ups, Medfin Bangalore is with you every step of the way.