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Beverly Hills · 435 N. Bedford Dr., Suite 308Mon–Fri 9:00 am – 5:00 pmMost PPO insurance accepted
Allen KamravaMD · MBA · FACS · FASCRS

Procedure

Operative

Sigmoid Colectomy

Removal of the sigmoid colon (the lower-left segment) and reconnection of the healthy ends — most often for diverticulitis or cancer.

Request a consultationSurgery is arranged with a coordinator by phone.
Setting
Operative
Anesthesia
General anesthesia, in the operating room
Back to work
2 - 6 weeks
Pain relief
Prescription Pain Medications
Success rate
Greater than 95%
Recurrence
Less than 10% (for diverticulitis)

What it is

What is a Sigmoid Colectomy?

A sigmoid colectomy is the surgical resection of the sigmoid colon. It is most commonly performed for recurrent or complicated diverticulitis, but is also performed for colon cancer, large polyps that cannot be removed endoscopically, volvulus, or strictures. The procedure involves mobilizing the sigmoid colon, dividing its blood supply (the sigmoid branches of the inferior mesenteric artery), and then removing the diseased segment. Intestinal continuity is then restored by creating an anastomosis between the descending colon and the rectum.

Am I a candidate?

Who is a Good Candidate for a Sigmoid Colectomy?

Ideal candidates are patients with symptomatic sigmoid colon disease that has not responded to or is not amenable to medical management. This includes:

  • Diverticulitis: Patients with recurrent episodes of uncomplicated diverticulitis that affect their quality of life, or those who have had a complicated episode (abscess, fistula, stricture, or perforation).
  • Colon Cancer: Patients with adenocarcinoma of the sigmoid colon.
  • Large Polyps: Patients with benign polyps that are too large or complex for safe endoscopic removal.
  • Volvulus: Patients who have had an episode of sigmoid volvulus, to prevent recurrence.

How it's done

  1. 1Under general anesthesia, usually through small keyhole (laparoscopic or robotic) incisions.
  2. 2The diseased sigmoid segment is removed.
  3. 3The two healthy ends of bowel are reconnected (an anastomosis), and the connection is tested during surgery for air leaks.
  4. 4A short hospital stay follows to make sure the bowel wakes up and you can eat and move.
  5. 5Often patients are discharged within 1 - 2 days of surgery.

What to expect

  1. Days 0–2

    In hospital — walking early, gradually returning to eating.

  2. Home

    Usually within a couple of days, depending on how the bowel recovers.

  3. 2–4 weeks

    Most people return to light activity and work.

Risks & considerations

What are the Risks?

A sigmoid colectomy is a major abdominal operation with potential risks, including:

  • Anastomotic Leak: The connection between the colon and rectum can leak, which can lead to a serious intra-abdominal infection and may require a temporary or permanent colostomy.
  • Bleeding: Intra-abdominal bleeding can occur, sometimes requiring blood transfusions or reoperation.
  • Infection: Surgical site infections, including wound infections and intra-abdominal abscesses, are possible.
  • Injury to the Ureter: The left ureter runs in close proximity to the sigmoid colon's blood supply and can be injured during the dissection.
  • Nerve Injury: The autonomic nerves that control bladder and sexual function can be injured, leading to urinary or sexual dysfunction. This is more common in deep pelvic dissections for cancer.
  • Stoma-Related Complications: If a stoma is created, it carries risks of hernia, prolapse, or skin irritation.

The risks that matter

Every operation carries a long list of possible complications. These are the ones that are serious enough — and common enough — to understand in real numbers before you decide.

Anastomotic leak

guideline

Where the two ends of bowel that were reconnected don't fully seal, letting intestinal contents escape into the abdomen.

about 7–11%— roughly 1 in every 10 to 15 operations
Why it happens
The new connection has to heal in a demanding environment, and even in expert hands a small fraction won't seal fully. It is a recognized complication of the operation itself — not a sign that anything was done carelessly. Every colorectal surgeon manages leaks over a career; it is part of doing this surgery.
If it happens
It's watched for closely afterward with exams, blood tests, and a CT scan if there's any concern. If it happens, treatment ranges from antibiotics and a drain to a return to the operating room and, sometimes, a temporary stoma to let the bowel rest and heal.
How we lower the odds
The odds are reduced by building a tension-free, well-perfused connection, testing it during surgery, optimizing your health beforehand (nutrition, blood sugar, stopping smoking), and monitoring closely in recovery.

Lowering the odds is not the same as removing them. Even when everything is done right, this can still happen — that is the nature of the operation, not a failure of your care.

Source: ASCRS Textbook of Colon and Rectal Surgery, 4th ed.; ASCRS Clinical Practice Guidelines.

Sources

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