Technical considerations for minimally invasive resection and reconstruction of redundant sigmoid colon

Abstract

Abstract Dolichosigmoid is a recognized risk factor for sigmoid volvulus, particularly in elderly or bedridden patients. Although endoscopic decompression is the first-line treatment, recurrent cases require surgical resection. We report a laparoscopic-assisted sigmoidectomy using single-incision laparoscopic surgery and two-fire functional end-to-end anastomosis. A 3.5–4.0 cm transumbilical incision allowed laparoscopic inspection and exteriorization of the redundant sigmoid colon. Reconstruction was performed extracorporeally, enabling accurate determination of the anastomotic site and straight, tension-free bowel alignment. Post-reconstruction laparoscopic inspection confirmed a stable anastomosis without torsion or mesenteric tension. Although follow-up periods were short, all patients remained recurrence-free. This technique may reduce wound-related morbidity, facilitate early postoperative mobilization, improve intraoperative assessment, and reduce stapler-related costs. It represents a simple and reproducible surgical option for elective treatment of sigmoid volvulus in elderly or high-risk patients. Further accumulation of cases and long-term outcome evaluation are needed to establish its efficacy and durability.