A modified caudal-to-cranial approach to perform laparoscopic left colectomy for benign diseases has been recently designed to facilitate the low-tie mesenteric dissection. A chart review has been performed including all consecutive patients with uncomplicated diverticulitis who have been treated by segmental left colectomy with a caudal-to-cranial approach. A total of 34 patients were included in the study. 21 patients were male, mean age was
54.1
±
11.3
, and mean BMI was
26
±
5.5
. Patients with ASA Score I were 7, with ASA II were 9, and with ASA Score III were 5. Incontinence Score (IS) resulted in an average of
5
±
2
,
2
grade of incontinence and the CS score showed an average of
10
±
3
,
2
grade of constipation. Health status, evaluated by Short Form-36 questionnaire, was demonstrated in these patients’ great physical function, role, general health, and social function. The anorectal manometry performed 6 months after surgery showed a normal value in terms of the anal resting pressure (
47
±
13
mmHg) and an increased volume to stimulate desire to defecate (
197
±
25
ml). The length of the anal sphincter was normal compared to the reference value (
37
±
5.4
mm). Although further studies are required to obtain definitive conclusions, our results are encouraging to propose low-tie segmental colectomy as the standard procedure for the treatment of uncomplicated diverticulitis, and our modified surgical approach could be considered useful to facilitate the surgical approach.
The pterional craniotomy: tips and tricks
