Laparoscopic colopexy for neo-left colonic volvulus 10 years after anterior resection

Abstract

Recurrent neo-left colonic volvulus is a rare complication following anterior resection. The conventional approach to treating recurrent volvulus is a large bowel resection with anastomosis or colostomy formation after successful endoscopic decompression. However, in elderly and comorbid patients, this can result in significant morbidity or mortality. Laparoscopic colopexy is a less invasive alternative that has not been previously reported for the treatment of neo-left colonic volvulus. We describe a case of an 86-year-old male who presented with recurrent neo-left colonic volvulus 10 years post-laparoscopic anterior resection for cancer. A laparoscopic colopexy was performed to resolve the volvulus and prevent future recurrence. Interrupted prolene sutures were used to fix the neo-left colon to the posterior stomach and the left lateral abdominal wall. The patient had an uncomplicated postoperative recovery and was discharged 6 days after surgery. He was well at 6 months follow-up.

Sigmoid volvulus and concomitant clinical entities

“…[47,48] On the other hand, surgery of the sigmoid colon for SV or other disorders may lead to the volvulus of the other colonic segments, whereas surgically modified anatomy of the colons may cause SV or SV-related problems. Cecum, [49] transverse colon, [50] descending colon, [51] and neo left colon volvulus [52] following the resection of the sigmoid colon are some examples of such pathologies.…”

Comments on ‘Metachronous transverse and sigmoid volvulus’

“… 3 , 4 Regarding the metachronous TV following the surgical treatment of SV, the main cause is the mobilization of the colon segments during the previous surgical procedure, which carries the neo-colon from retroperitoneal area into peritoneal space and makes the rotation easier resulting in volvulus. 5 …”