A brief analysis of the application of laparoscopy in perforation of colonic diverticulum

LAI Jianbo; HUANG Yisha; ZHONG Keli; XIA Ligang; YUE Shuqiang

doi:10.13276/j.issn.2097-1656.2025.09.011

Abstract：Colonic diverticulosis is a common and frequently occurring disease in clinical practice,and diverticular perforation represents a particularly challenging manifestation of acute abdomen.Based on a comprehensive review of the literature and the authors' clinical experience,this article systematically outlines the application strategies of laparoscopic techniques in the diagnosis and treatment of colonic diverticular perforation.Notably,the anatomical distribution of diverticular perforations varies geographically,with right-sided colonic involvement being significantly more prevalent in Asian populations compared to Western countries.In terms of diagnosis,laparoscopic exploration facilitates the differentiation of cecal diverticular perforation from similar conditions such as acute appendicitis through intraoperative assessment of bowel wall morphology and omental wrapping patterns,thereby markedly improving diagnostic accuracy.Therapeutically,laparoscopic surgery offers distinct advantages in reducing postoperative recovery time,minimizing surgical site infections,and lowering the risk of permanent stoma formation.For right-sided localized perforations,laparoscopic partial resection of bowel wall is a feasible option,whereas complex left-sided cases are better managed with primary anastomosis combined with selective stoma creation.Despite challenges such as a relatively high conversion rate to open surgery,laparoscopy retains irreplaceable technical benefits in abscess clearance and anatomical dissection.With the advent of high-definition imaging systems and novel surgical instruments,the indications for laparoscopic intervention continue to expand,offering new minimally invasive pathways for the treatment of acute abdominal conditions.