Volvulus Detorsion
What is Volvulus Detorsion?
Volvulus detorsion is a procedure to untwist a segment of the intestine that has rotated around itself (volvulus), causing a bowel obstruction. It is typically an emergency intervention to restore blood flow, relieve obstruction, and prevent bowel ischemia or perforation. While detorsion can be non-surgical (endoscopic) or surgical, it is often a temporary measure, with definitive surgery (e.g., resection or fixation) required to prevent recurrence. In India, volvulus detorsion is performed in specialized colorectal and general surgery centers, offering high-quality care at affordable costs. For patients and families in India, understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for informed decision-making and optimal outcomes.
Why do you need Volvulus Detorsion?
Volvulus detorsion is indicated for:
- Sigmoid volvulus: Most common type, often in older adults with chronic constipation or a redundant sigmoid colon.
- Cecal volvulus: Less common, involving the cecum (first part of the colon), typically in younger patients with congenital mobility of the cecum.
- Midgut volvulus: Rare, often in infants with malrotation, but can occur in adults with congenital anomalies.
- Acute bowel obstruction: Symptoms include abdominal pain, distension, vomiting, and constipation.
The procedure aims to relieve the obstruction, restore blood flow, and assess bowel viability, often as a bridge to definitive surgery. In India, hospitals like Apollo, Fortis, Medanta, and AIIMS specialize in volvulus detorsion, using endoscopic or surgical approaches based on the patient’s condition.
Why Do Volvulus Detorsion Costs Vary in India?
Costs range from ₹50,000 to ₹5 lakh :
- Procedure Type: Endoscopic detorsion (₹50,000–₹1.5 lakh), surgical detorsion (₹1.5–3 lakh), with resection (₹3–5 lakh).
- Hospital/Location: Higher in metro cities (Apollo, Fortis); lower in government hospitals (AIIMS, ₹20,000–₹1 lakh).
- Surgeon’s Expertise: Experienced colorectal surgeons charge more.
- Additional Costs: Diagnostics (CT, X-ray), hospital stay, resection, or stoma creation.
- Insurance: Covered for emergencies; Ayushman Bharat offers subsidies.
Volvulus Detorsion Procedure
The procedure varies depending on the volvulus location, severity, and patient stability:
- Before Procedure Evaluation:
- Diagnosis:
- Physical exam reveals abdominal distension, tenderness, and absent bowel sounds.
- X-ray or CT scan confirms volvulus with a “coffee bean” sign (sigmoid volvulus) or “whirlpool” sign (cecal/midgut volvulus).
- Blood tests assess for dehydration, electrolyte imbalances, and signs of ischemia (e.g., elevated lactate).
- IV fluids and nasogastric tube decompression stabilize the patient.
- Patients with signs of perforation or peritonitis (fever, severe tenderness) require immediate surgery, skipping endoscopic detorsion.
- Diagnosis:
- Detorsion Techniques:
- Endoscopic Detorsion (Sigmoid Volvulus):
- Performed under sedation or light anesthesia, lasting 30–60 minutes.
- A flexible sigmoidoscope is inserted through the anus to visualize the twisted sigmoid colon.
- The scope gently untwists the volvulus, often confirmed by a rush of gas and stool.
- A rectal tube is placed to maintain decompression and prevent immediate recurrence, left in for 24–48 hours.
- Suitable for stable patients without signs of bowel ischemia or perforation.
- Success rate: 70–90%, but recurrence risk is high (40–70%) without definitive surgery.
- Surgical Detorsion:
- Performed under general anesthesia, lasting 1–2 hours, often in unstable patients or failed endoscopic attempts.
- Open Surgery:
- A midline abdominal incision provides access to the twisted bowel.
- The surgeon manually untwists the volvulus and assesses bowel viability (color, peristalsis).
- If the bowel is viable, detorsion alone may suffice; if non-viable, resection (e.g., sigmoidectomy) is performed.
- Laparoscopic Surgery:
- Uses 3–4 small incisions, a laparoscope, and instruments to untwist the bowel.
- Preferred in stable patients, offering faster recovery.
- A temporary colostomy may be created if resection is needed in an emergency (e.g., Hartmann’s procedure).
- Definitive Surgery Post-Detorsion:
- Sigmoid volvulus: Elective sigmoidectomy within 48–72 hours to prevent recurrence.
- Cecal volvulus: Right hemicolectomy or cecopexy (fixation of the cecum to the abdominal wall).
- Midgut volvulus: Ladd’s procedure (correcting malrotation and fixing the bowel).
- Endoscopic Detorsion (Sigmoid Volvulus):
- After Procedure:
- Patients are monitored in the hospital for 2–5 days (endoscopic) or 5–10 days (surgical).
- IV fluids and antibiotics manage dehydration and infection risk.
- Bowel function resumes within 2–4 days, starting with clear liquids.
- Follow-up plans definitive surgery to prevent recurrence.
Recovery After Volvulus Detorsion
- Hospital Stay: 2–5 days (endoscopic), 5–10 days (surgical).
- Post-Procedure Care:
- Pain managed with medications (e.g., paracetamol, NSAIDs).
- IV fluids and gradual oral intake resume within 2–4 days.
- Antibiotics prevent infection, especially if resection was performed.
- Activity/Diet:
- Light walking in 1–2 days; strenuous activities avoided for 2–4 weeks (endoscopic) or 4–6 weeks (surgical).
- High-fiber diet (fruits, vegetables, whole grains) and 2–3 liters water daily prevent constipation.
- Follow-Up:
- Visits at 1–2 weeks, 4–6 weeks; elective surgery (e.g., sigmoidectomy) is planned within days to weeks.
- Bowel function normalizes in 1–2 weeks if no resection.
Most resume normal activities in 2–4 weeks (endoscopic) or 4–6 weeks (surgical). Recurrence risk is 40–70% without definitive surgery.
Risks and Complications
- Procedure Risks: Bleeding, perforation during endoscopic detorsion (1–3%), requiring emergency surgery.
- Bowel Viability: Ischemia or necrosis (10–20%), necessitating resection.
- General Risks: Anesthesia reactions, infection, blood clots.
- Long-Term: Recurrence (40–70% without definitive surgery), adhesions causing obstruction, stoma complications (if created).
Report fever, severe pain, or recurrent symptoms promptly.
Frequently Asked Questions (FAQs)
What causes volvulus?
Sigmoid volvulus: Chronic constipation, redundant colon (common in elderly). Cecal/midgut: Congenital anomalies, mobile cecum.
Is detorsion a permanent fix?
No, recurrence risk is high (40–70%); definitive surgery (e.g., sigmoidectomy, cecopexy) is often needed.
Can it be done endoscopically?
Yes, for sigmoid volvulus in stable patients without ischemia or perforation.
How soon can I resume activities?
2–4 weeks (endoscopic), 4–6 weeks (surgical).
Is it covered by insurance in India?
Yes, for emergencies; confirm with your provider.
Signs of complications?
Fever, severe pain, recurrent vomiting, or abdominal distension.
Will I have normal bowel function?
Yes, if no resection; resection may lead to more frequent stools.
Lifestyle changes post-procedure?
High-fiber diet, hydration, avoid straining, plan for definitive surgery.
Conclusion
Volvulus detorsion is an emergency procedure to relieve bowel obstruction, often requiring follow-up surgery to prevent recurrence. India’s top hospitals (Apollo, Fortis, AIIMS) offer affordable, high-quality care. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach volvulus detorsion confidently. Consult a colorectal or general surgeon for personalized guidance and successful treatment.
Looking for Best Hospitals for Volvulus Detorsion
Note: we are not promoting any hospitals
we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
50,000 |
2,00,000 |
Ahmedabad |
80,000 |
3,00,000 |
Ajmer |
50,000 |
2,00,000 |
Aligarh |
50,000 |
2,00,000 |
Allahabad |
50,000 |
2,00,000 |
Amritsar |
70,000 |
2,50,000 |
Aurangabad |
70,000 |
2,50,000 |
Bangalore |
80,000 |
3,00,000 |
Bareilly |
50,000 |
2,00,000 |
Belgaum |
70,000 |
2,50,000 |
Bhopal |
70,000 |
2,50,000 |
Bhubaneswar |
70,000 |
2,50,000 |
Bikaner |
50,000 |
2,00,000 |
Chandigarh |
80,000 |
3,00,000 |
Chennai |
80,000 |
3,00,000 |
Coimbatore |
80,000 |
3,00,000 |
Dehradun |
70,000 |
2,50,000 |
Delhi |
80,000 |
3,00,000 |
Dhanbad |
50,000 |
2,00,000 |
Durgapur |
50,000 |
2,00,000 |
Faridabad |
80,000 |
3,00,000 |
Ghaziabad |
80,000 |
3,00,000 |
Gorakhpur |
50,000 |
2,00,000 |
Guntur |
70,000 |
2,50,000 |
Gurgaon |
80,000 |
3,00,000 |
Guwahati |
70,000 |
2,50,000 |
Gwalior |
50,000 |
2,00,000 |
Hyderabad |
80,000 |
3,00,000 |
Indore |
80,000 |
3,00,000 |
Jabalpur |
50,000 |
2,00,000 |
Jaipur |
80,000 |
3,00,000 |
Jalandhar |
70,000 |
2,50,000 |
Jamshedpur |
70,000 |
2,50,000 |
Jodhpur |
50,000 |
2,00,000 |
Kanpur |
50,000 |
2,00,000 |
Kochi |
80,000 |
3,00,000 |
Kolkata |
80,000 |
3,00,000 |
Kollam |
70,000 |
2,50,000 |
Lucknow |
70,000 |
2,50,000 |
Ludhiana |
80,000 |
3,00,000 |
Madurai |
70,000 |
2,50,000 |
Mangalore |
70,000 |
2,50,000 |
Meerut |
50,000 |
2,00,000 |
Moradabad |
50,000 |
2,00,000 |
Mumbai |
80,000 |
3,00,000 |
Mysore |
80,000 |
3,00,000 |
Nagpur |
70,000 |
2,50,000 |
Nashik |
70,000 |
2,50,000 |
Navi Mumbai |
80,000 |
3,00,000 |
Noida |
80,000 |
3,00,000 |
Patna |
50,000 |
2,00,000 |
Pune |
80,000 |
3,00,000 |
Raipur |
70,000 |
2,50,000 |
Rajkot |
70,000 |
2,50,000 |
Ranchi |
50,000 |
2,00,000 |
Surat |
80,000 |
3,00,000 |
Thane |
80,000 |
3,00,000 |
Vadodara |
70,000 |
2,50,000 |
Varanasi |
50,000 |
2,00,000 |
Visakhapatnam |
70,000 |
2,50,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.