Management of Complicated Diverticulitis
Annotation for Point I
LAVAGE AND DRAIN
Pneumoperitoneum is established using an open technique to place a 12-mm umbilical port. Two 5-mm ports are placed in the suprapubic and right lower quadrant to assist with manipulation and lavage. The abdomen is thoroughly inspected without vigorous manipulation of the inflamed colon. If there is no evidence of free perforation of the colon (i.e., fecal peritonitis), the four quadrants of the abdomen are lavaged until the drainage is clear. A closed suction flat drain is placed in the pelvis and brought out of the right lower quadrant port.