General Surgery Expert Witness Opines on Laparoscopic Sigmoidectomy

This case involves a thirty-eight-year-old female who has a past medical history of diverticulosis. Her condition was managed conservatively for close to eight years. She underwent a colonoscopy for the above matter, and an incidental finding of a polyp was made. He was prescribed Flagyl and Ciprofloxacin. The patient continually had flare ups causing abdominal pain and diarrhea. He also felt increased anxiety which was attributed to the increased effect of caffeine due to Ciprofloxacin. He was admitted to the hospital on one of these occasions. On this admission, general surgery was consulted, and a laparoscopic sigmoidectomy was recommended. The surgeon encountered multiple complications including the laceration to the splenic capsule, resulting in splenectomy, and conversion to open laparotomy.

Question(s) For Expert Witness

1. What are the common complications of a laparoscopic sigmoidectomy?

Expert Witness Response E-006210

Serious complications that occur with laparoscopic procedures can result from patient selection, surgical inexperience, and the technical constraints that are inherent to the minimally invasive approach. The overall incidence of laparoscopic complications is also related to the experience of the surgeon. Furthermore, credentialing for laparoscopic surgery is now becoming a reality. Many institutions currently, or soon, will require proof of a fundamental skill-set in basic laparoscopy for credentialing purposes. To this end, the American College of Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) have developed a validated assessment tool named Fundamentals in Laparoscopic Surgery. (FLS) In summary, like any surgery, there is considerable risk involved, however, the risk increases dramatically when an inexperienced surgeon is operating.