The professionals of the digestive system service at Parc Taulí, Dr. Félix Junquera and Dr. Valentí Puig, have been pioneers in using the innovative endoscopic SIGMOIDOPEXIA technique to treat a patient, who could not be operated on, with recurrent volvuli in the sigmoid colon.
This is a pathology that occurs when there is a twisting of the sigmoid colon, one of the last parts of the large intestine, and which causes intestinal obstruction causing pain, abdominal distention and complications such as tissue necrosis. Mostly, it affects elderly men, over 70 years old, and who suffer from other associated neurological diseases. It is very common for this twisting of the colon to recur, in 70%-80% of cases, so it must be treated with surgery. But there is a percentage of patients who are not tributary to the surgical procedure due to their comorbidity or their associated diseases.
Faced with the case of a 61-year-old patient with advanced multiple sclerosis, who could not be intubated, and with recurrent volvuli every 15 days, he had to be admitted to the emergency room with unbearable pain that was causing a rapid deterioration in his quality of life , Dr. Puig and Dr. Junquera decided to look for an alternative. After presenting the case to the director of the pneumology service, Dr. Manel Luján, and the coordinator of the anesthesiology service, Dra. Isabel Esteve, and Dra. Gemma Pujol, to determine which sedation was the most suitable for the complexity of the patient, it was decided that the best treatment was to practice the endoscopic sigmoidopexy technique.
"The decision was very thoughtful, shared and multidisciplinary due to the complexity presented by the patient. The collaboration of the pneumology and anesthesia unit was very important to guarantee the success of the intervention, because we only had one opportunity to be able to do this technique", explained Dr. Reed
The intervention lasted 40 minutes, thanks to the coordination of the different professionals who participated. From the anesthesiology unit, it was decided to perform superficial sedation with local anesthesia, due to the patient's breathing problems, this meant that he was awake and talking to the team, who monitored his progress during the intervention.
The procedure was a success and he was discharged home within 48 hours. The subsequent revisions are being very satisfactory.
Endoscopic SIGMOIDOPEXIA technique
It is a quick and minimally invasive technique. It consists of two parts: in the first, three punctures are made that fix the intestine to the abdominal wall; in the second, a prosthesis is inserted over a guide, which will keep the bowel fixed to the abdominal wall and which will prevent a new torsion from occurring.
This technique, which is already implemented in two European hospitals, but it is the first time that it is put into practice in a hospital center in Spain.
"It is a technique designed for very complex patients, with recurrent volvuli, and who cannot undergo the surgical procedure. But it can also be performed as a temporary measure for patients who cannot be operated on immediately. It can be a temporary option until the day of the operation to ensure that the torsion of the sigmoid, one of the last parts of the large intestine, does not recur.", explained Dr. up
With the introduction of this new technique, Parc Taulí continues to bet on the innovation and excellence of its professionals to continue offering high quality assistance to its patients.