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Laparoscopic Low Anterior Resection

David Berger, MD
Massachusetts General Hospital

Abstract

Colonic diverticula represent saccular outpouchings of the colonic wall and are referred to as diverticulosis under normal circumstances, and as diverticulitis when inflamed. Diverticulosis is usually asymptomatic and rare in patients younger than 30 years of age, but the incidence increases with age. In addition, 10-25% of these patients will progress to diverticulitis and experience abdominal pain, bloating, and/or fever. Diverticulitis can be further differentiated as uncomplicated or complicated depending on the type of perforation and whether or not it is associated with purulent or fecal peritonitis, or a pelvic abscess. Treatment ranges from oral antibiotic and diet modification for a single episode of uncomplicated diverticulitis to intravenous antibiotic and surgical management for recurrent diverticulitis. Surgery entails removal of the diseased segment of the colon with anastomosis or colostomy depending on the degree of inflammation and amount of healthy tissue. Here, we present a case of a female patient with 12 previous episodes of uncomplicated diverticulitis in a span of a year and a half. Laparoscopic low anterior resection with a side-to-end Baker-type rectocolon anastomosis was elected to remove the diseased segment and prevent recurrence.

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