Laparoscopic Sigmoid Colectomy with Inferior Mesenteric Artery (IMA) Preservation for Diverticular Disease - a video vignette.

Minimally invasive approach to diverticular disease (DD) has demonstrated better short term outcomes and lower postoperative morbidity than open surgery [1]. In addition, some technical aspects have been defined to improve the quality and results of surgery after laparoscopic colonic resections for DD [2]. Such aspects involve an accurate evaluation of the proximal sectional margin of the colon, the division of distal bowel in the upper rectum and, as for the vascular approach, the division of the inferior mesenteric artery (IMA) (high or low tie) or its preservation (with or without left colic artery ligation). However, after elective surgery for diverticulitis, a significant group of patients have reported impairment of bowel function or continue to suffer from persistent intestinal symptoms [3,4]. In this setting, only one RCT evaluated the effects of IMA preservation on the postoperative bowel function during sigmoidectomy for DD showing the benefits in terms of defecatory disorders, frequency and intensity of incontinence and constipation symptoms [5].