General Surgery

Sigmoidectomy is a surgery done by the removal of the sigmoid colon and indicated to treat cancer of the sigmoid colon; sigmoid volvulus; large cysts of the sigmoid; prolapse of the rectum; inflammatory bowel diseases(ulcerative colitis and Crohn disease); benign tumors of the sigmoid colon; fistula between the bladder and sigmoid colon; and scleroderma of the colon. Before sigmoidectomy procedure can begin, the individual is given general anesthesia. The patients lower abdomen is shaved and washed with soap and antiseptic, and draped so that only the area between the pubis and navel is exposed. A vertical incision is performed between the pubis and the navel; some doctors prefer a horizontal incision along a line just above the pubis. The muscles, fascia, skin are cut in layers and bleeding vessels are cauterized or ligated. The sigmoid colon is found and freed from its supporting structures by blunt and scalpel dissection. After the diseased part of the sigmoid has been freed, it is clamped at both ends and cut between the 2 clamps. The removed part is sent for examination to the pathologist. The different layers over the colon, such as fascia, skin, and muscle are closed with sutures. In some cases staples may also be used. The person is transferred to the recovery room. Most individuals will have a nasogastric tube (a tube that is inserted through nose and runs down to the stomach) for the first few days after the sigmoidectomy to keep the body regular secretion of gastric juices out of the lower intestine. The tube is usually taken out, when it is clear that the bowel is working again and the internal connections have had time to heal. The person is started on a liquid diet and gradually returned to solid food.