Some patients with complications from diverticulitis or those who develop recurrent attacks of diverticulitis may need a colectomy. Since attacks of diverticulitis most commonly involve the sigmoid colon, this is the portion of the colon that may need to be resected when patients need surgery (usual procedure is a "sigmoid colectomy"). Surgery to remove a portion of the colon, also known as "colon resection" or "colectomy," is a technically challenging operation compared to other common laparoscopically performed procedures such as removal of the gall bladder or surgery to correct GERD (gastro-esophageal reflux disorder).
During colectomy, it is commonly necessary for the surgeon to operate in more than one area of the abdomen in order to separate the bowel from its blood vessels, resect the colon and join the two ends of bowel together (anastomosis). The procedure can be performed either laparoscopically (small incisions) or via an open midline conventional (laparotomy) approach. During laparoscopic surgery, the surgeon utilizes a small incision through which a "port" is placed to inflate the abdominal cavity with gas. A camera is then introduced through the port to help visualize the inside of the abdominal cavity on a television monitor. Surgery is performed with instruments through additional ports placed via small incisions in the abdominal wall.
After the colon segment has been removed, it is necessary to make a small incision or enlarge one of the port wounds to an overall length of 5 to 7 cm. in order to safely withdraw the specimen from the abdomen and to facilitate the connecting of the open ends of the remaining bowel. Because of the need for this larger wound, a more proper name for minimally invasive colectomy is laparoscopic-assisted colectomy. However, for brevity's sake, the term "laparoscopic colectomy" is often used. For purposes of comparison, the length of an open laparotomy incision for colectomy ranges from 15 to 28 cm.