Percutaneous endoscopic sigmoidopexy in sigmoid volvulus with T-fasteners - Report of two cases

PURPOSE: We report two cases of percutaneous endoscopic sigmoidopexy in patients with sigmoid volvulus. METHODS: Two patients with recurrent sigmoid volvulus were considered unfit for resective surgery or general anesthesia (American Society of Anesthesiologists physical status III-M. Fixation of the sigmoid colon to the abdominal wall was performed percutaneously under sedation in the endoscopy suite. Fixation was obtained using three T-fasteners in a triangular disposition in the bowel. The T-fasteners were cut at the skin after 28 days. RESULTS: Both procedures were successfully performed in approximately 20 minutes and were well tolerated. Feeding commenced the same day. One patient died after seven months of follow-up, without recurrence, of causes not related to volvulus. The other patient had no recurrence after 18 months of follow-up. CONCLUSION: The authors purpose was to show a new technique for colonic fixation performed in patients with recurrent sigmoid volvulus who otherwise had contraindication for elective surgery. Future studies will be required to verify the effectiveness and safety of this novel technique.