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The sigmoid colon is the S-shaped portion of the lower part of the large intestine that terminates at the rectum. This section of the colon has the difficult job of contracting vigorously to expel solid waste out of the body through the rectum. Sometimes a medical condition will interfere with the function of the sigmoid colon. If this condition does not respond to medical treatment it is occasionally necessary to perform a sigmoid resection or surgical removal of the sigmoid colon.
Extreme pressure along the walls of the sigmoid colon can cause small pouches of the colon to bulge out. These bulging areas are called diverticula. When the diverticula become inflamed, a condition called diverticulitis has developed. Sometimes, diverticulitis will become so severe that these pouches will rupture and spread infection into the abdominal cavity. Chronic diverticulitis is a common reason why many people have a sigmoid resection.
Another possible reason for a sigmoid resection is colon cancer, possibly with an obstructing tumor in the sigmoid colon. In such cases, it is important that the surgeon removes all of the affected tissue. In most cases, he will remove the surrounding lymph nodes to prevent the cancer from spreading. Colon cancer can be curable if it is caught early enough.
In some cases, a sigmoid resection can be performed laparoscopically. This minimally invasive surgical procedure involves the surgeon making three or four small incisions into the abdominal wall. He will then insert several surgical instruments, including a laparoscope, into the incisions. The laparoscope allows the surgeon to see inside the abdomen and the other instruments can be manipulated to cut away and remove the sigmoid colon.
When the portion of the sigmoid is too diseased to be removed laparoscopically, the surgeon must open up the abdomen to get to the sigmoid colon. He will remove the diseased portion of the sigmoid colon and then re-connect the two healthy ends to produce a continuous loop of bowel. There are occasions when the colon needs to rest or a large portion of the colon is diseased. When this is the case, the surgeon will take a small loop of the bowel and pull it through an opening in the abdomen. This is called a colostomy.
Colostomies can be temporary or permanent, depending upon the circumstances of the individual. If the patient had a large amount of colon removed, the colostomy will usually be permanent. A colostomy bag is applied over the colostomy to catch the bowel movements. This bag can be easily emptied into the toilet.
A sigmoid resection will come with risks. As with any surgical procedure, there is a risk for infection or bleeding. There is also a slight risk for developing blood clots in the legs or in the lungs. Occasionally, the patient may experience obstructions in the intestines due to scar tissue. The risks of complications have decreased as technology advances.