A Case of Laparoscopic Surgery for Perforation of a Diverticulum of the Sigmoid Colon in which a Fluorescent Ureteral Catheter was Useful

Abstract

A 49-year-old man presented with abdominal pain. A contrast-enhanced computed tomography (CT) scan showed multiple diverticula in the sigmoid colon and irregular wall thickening with increased peribronchial fatty tissue density, with abscess formation in the vicinity of them. The left ureter was severed at the lesion, and left hydronephrosis was observed. We diagnosed the case as an intra-abdominal abscess due to perforation of a sigmoid colon diverticulum. We had a plan to create a stoma emergently, followed by elective laparoscopic surgery. A fluorescent ureteral catheter was placed in the left ureter, and a laparoscopic sigmoid colon resection was performed. The retroperitoneal side was highly fibrotic, making it difficult to visualize the ureter. However, near-infrared light observation was used to clearly visualize the ureter and ensure its preservation. In cases where ureteral injury is feared, ureteral catheters have been placed prophylactically, but their visibility has been poor. Recently, fluorescent ureteral catheters have attracted attention as a device to improve visibility. We report the findings of our own case with a review of the literature.