Diverticulitis: An Update From the Age Old Paradigm

Colostomy takedown is an under-appreciated and challenging operation. Restoration of bowel continuity is not performed in up to 50% of patients after their initial surgery for diverticulitis. It is essential to wait six months after the initial operation to minimize the risk of enterotomies and other complications. Preoperative planning is critical; review the initial operative note and defining the anatomy prior to reversal. When a complex abdominal wall closure is necessary, consider consultation with a hernia specialist. Open surgery is the preferred surgical approach for the majority of colostomy takedown operations. Finally, consider ureteral catheters, diverting loop ileostomy, and be prepared for all anastomotic options in advance.