This presentation demonstrates the technique of fixing the sigmoid volvulus by inserting three PEG tubes percutaneously into the fixed colon. The first aim is to make sure that the volvulus in the sigmoid colon is reduced. Next, the colon is transilluminated. Following the subcutaneous injection of Lignocaine with 1% adrenalin 1:100000, a percutaneous cannula is inserted into the colon and captured with a colonoscopy snare. The guide-wire is withdrawn from the rectum and after the PEG tube attached, it is drawn back into the colon to abut on the mucosa. The exercise is repeated twice more to prevent further rotation of the colon. At 6-8 weeks, 2 of the tubes are removed and the third is replaced with a button ostomy to allow the colon to be decompressed.

complex cases

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