Diverticulectomy
What is Diverticulectomy ?
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Why do you need Diverticulectomy ?
Colonic diverticula are outpouchings in the colon wall, often in the sigmoid colon, associated with diverticulosis (presence of diverticula) or diverticulitis (inflammation/infection of diverticula). Diverticulectomy, typically a partial colectomy (e.g., sigmoidectomy), removes the affected colon segment to treat complications. Indications include:
- Recurrent or complicated diverticulitis: Persistent pain, abscesses, fistulas, or perforation after failed medical therapy.
- Colorectal obstruction: Caused by diverticular strictures or masses.
- Bleeding: Severe or recurrent diverticular hemorrhage.
- Prevention of recurrence: Elective surgery after multiple diverticulitis episodes (e.g., 2–3 episodes) to prevent complications.
Why Do Costs Vary in Philippines?
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Diverticulectomy Procedure
- Before Surgery Evaluation:
- Diagnosis is confirmed via:
- Colonoscopy: Identifies diverticula and rules out cancer or other conditions.
- CT scan: Assesses abscesses, fistulas, or perforation.
- Blood tests: Check for infection (elevated white cell count) or anemia (from bleeding).
- Bowel preparation involves laxatives (e.g., polyethylene glycol) and 2–3 liters of water the day before to empty the colon, sometimes with enemas.
- Patients undergo health screenings (e.g., ECG, chest X-ray) and meet the anesthesia team.
- Counseling addresses potential stoma creation (colostomy) and post-operative care.
- Diagnosis is confirmed via:
- Surgical Techniques:
- Open Diverticulectomy (Sigmoidectomy or Partial Colectomy):
- Performed under general anesthesia, lasting 2–4 hours.
- A 6–8-inch midline abdominal incision provides access to the colon.
- The surgeon removes the diseased colon segment (e.g., sigmoid colon) and performs:
- Primary anastomosis: Sewing healthy bowel ends together for continuity.
- Colostomy: Creating a stoma if reconnection is unsafe due to inflammation or infection (e.g., Hartmann’s procedure).
- Peritoneal lavage cleans the abdominal cavity if abscesses or perforation are present.
- Laparoscopic Diverticulectomy:
- A minimally invasive approach using 3–5 small incisions, a laparoscope (camera), and instruments.
- The abdomen is inflated with gas for better visualization.
- Suitable for elective cases or stable patients, offering less pain, smaller scars, and faster recovery.
- Takes 2–3 hours, with conversion to open surgery possible if complications arise.
- Robotic-Assisted Diverticulectomy:
- Uses robotic systems (e.g., da Vinci) for enhanced precision via tiny incisions and 3D imaging.
- More expensive but available in centers like Apollo or Medanta, ideal for complex cases.
- Hartmann’s Procedure (Emergency):
- Removes the diseased colon segment, creates a colostomy, and closes the distal bowel end.
- Common in emergencies (e.g., perforation, severe abscess) when anastomosis is risky.
- Open Diverticulectomy (Sigmoidectomy or Partial Colectomy):
- After Surgery:
- Patients are monitored in the ICU or high-dependency unit for 1–2 days for pain, infection, or bowel function.
- Hospital stay lasts 3–7 days for laparoscopic/robotic surgery or 5–10 days for open surgery.
- Antibiotics treat residual infection; a nasogastric tube (if used) is removed once bowel function resumes (2–5 days).
- Ostomy nurses train patients with colostomies on bag management and skin care.
- Pathology reports guide further treatment (e.g., ruling out cancer).
Recovery After Diverticulectomy
Recovery focuses on healing, restoring bowel function, and adapting to a colostomy (if present):
- Hospital Stay:
- Laparoscopic/robotic surgery: 3–7 days, with 1 day in the ICU.
- Open surgery: 5–10 days, with 1–2 days in the ICU.
- Post-Surgery Care:
- Pain is managed with medications (e.g., opioids initially, then NSAIDs).
- IV fluids and a gradual return to oral intake (clear liquids to soft foods) support bowel recovery (3–5 days).
- Antibiotics treat infection; drains (if placed) are removed once output decreases.
- Colostomy patients receive training on bag changes, skin care, and complication recognition.
- Activity and Diet:
- Light walking resumes within 1–2 days to prevent blood clots.
- Strenuous activities, heavy lifting, or driving are avoided for 6–8 weeks (open surgery) or 4–6 weeks (laparoscopic/robotic).
- A low-fiber diet (e.g., white rice, bananas) is followed for 4–6 weeks, transitioning to high-fiber foods (vegetables, fruits) to prevent recurrence.
- Avoid hot tubs or pools until incisions heal (4–6 weeks).
- Follow-Up:
- Visits at 1–2 weeks and 4–6 weeks assess wound healing, bowel function, and stoma status.
- Imaging (CT, colonoscopy) monitors for complications or recurrence.
- Colostomy reversal (if temporary) is planned after 3–6 months.
- Up to 98% of patients have no further diverticulitis episodes post-surgery.
Full recovery takes 1–3 months, with laparoscopic patients recovering faster (4–6 weeks).
Risks and Complications
Colonic diverticulectomy carries risks, particularly in emergency settings
- Surgical Risks:
- Bleeding, infection, or wound dehiscence.
- Anastomotic leak (5–15%), causing peritonitis or abscesses.
- Injury to nearby organs (e.g., ureter, bladder).
- Colostomy-Related Complications:
- Stoma prolapse, retraction, or blockage, requiring revision.
- Skin irritation around the stoma.
- General Risks:
- Adverse reactions to anesthesia.
- Blood clots (deep vein thrombosis or pulmonary embolism).
- Long-Term Issues:
- Recurrence of diverticulitis (5–22%).
- Bowel obstruction from adhesions.
- Permanent colostomy if reconnection fails.
- Prompt reporting of fever, severe pain, or no bowel output ensures timely management
Frequently Asked Questions (FAQs)
What causes the need for colonic diverticulectomy?
Recurrent or complicated diverticulitis (abscesses, fistulas, perforation), bleeding, or obstruction from diverticular disease.
Can diverticulitis be treated without surgery?
Most cases are managed with antibiotics, diet, and rest. Surgery is needed for complications or recurrent episodes.
Is a colostomy always required?
No, primary anastomosis is preferred in elective cases. Colostomy is used in emergencies or severe inflammation and may be temporary.
How soon can I resume normal activities?
Laparoscopic patients resume activities in 4–6 weeks; open surgery patients take 6–8 weeks.
Is diverticulectomy covered by insurance in India?
Most insurance plans cover it for complicated diverticulitis or emergencies. Confirm with your provider.
What are the signs of complications post-diverticulectomy?
Fever, severe pain, no bowel movements, or stoma issues require immediate attention.
Can elderly patients undergo diverticulectomy?
Yes, if health permits, with laparoscopic approaches reducing risks.
What lifestyle changes are needed post-diverticulectomy?
Follow a high-fiber diet after recovery, stay hydrated, avoid straining, and attend follow-ups.
Conclusion
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Looking for Best Hospitals for Diverticulectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.