Diverticulectomy

Diverticulectomy is a surgical procedure that removes a diverticulum, a pouch that protrudes from the wall of an organ. The term is used for diverticula in various sites, most commonly the colon and the bladder. In the colon, diverticulectomy is not typically performed as a standalone procedure for widespread diverticulosis; instead, diseased segments of bowel are usually resected (segmental colectomy) with primary anastomosis or ostomy. A localized or solitary diverticulum causing localized infection, inflammation, obstruction, or fistula may be treated with diverticulectomy to spare more bowel when feasible. In the bladder, diverticulectomy removes a bladder diverticulum, often to address recurrent infections, stones, or outlet obstruction; repair of the bladder wall and correction of underlying causes may accompany the operation.

Techniques and approaches vary by organ and surgeon preference. Procedures may be open, laparoscopic, or robot-assisted. Preoperative evaluation typically includes imaging such as computed tomography and, for bladder diverticula, cystoscopy. During surgery, the diverticulum is isolated, a margin of surrounding tissue is removed, and the diverticulum is excised. The defect is closed in layers with absorbable sutures, taking care to restore organ integrity and function. In the bladder, mucosal closure and detrusor restoration are important, and additional procedures may address underlying obstruction. In the colon, the aim is durable resection with a secure anastomosis.

Outcomes are generally favorable for appropriately selected cases, but risks include infection, leakage or fistula formation, bleeding, and recurrence of symptoms or diverticula in remaining tissue.