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Robotic Surgery for Diverticulitis

man holding his abdomen in pain

September 29, 2026 | Colon

What Patients Should Know About Treatment, Recovery, and Why Surgical Experience Matters

For many people, diverticulitis starts with a single, unforgettable episode of sharp pain in their lower-left abdomen, fever, and a trip to urgent care or the emergency room. Some never have another attack. However, for others, the flare-ups keep coming back, each one bringing more pain, more antibiotics, more missed work, and more worry about when the next one will strike.

If you are in the second group, you may eventually hear the word “surgery,” and you may also hear the word “robotic” along with it. This blog helps explain when surgery makes sense, what a robotic approach actually involves, and why the experience of the surgeon at the controls matters just as much as the technology itself.

What Is Diverticulitis?

Diverticula are small pouches that can develop in weakened areas of the colon wall. Having these pouches is called diverticulosis, and many people never experience symptoms from them.

Diverticulitis occurs when one or more of the pouches become inflamed. Symptoms may include:

  • Pain, often in the lower-left abdomen
  • Fever or chills
  • Abdominal tenderness
  • Nausea or vomiting
  • Constipation, diarrhea, or another change in bowel habits

Mild, uncomplicated diverticulitis may be managed without surgery. Depending on the individual situation, treatment may include temporary dietary changes, pain management, antibiotics when appropriate, and close observation.

More serious cases may involve an abscess, an abnormal connection between the colon and another organ known as a fistula, narrowing or blockage of the colon, or a perforation that allows intestinal contents to leak into the abdomen. These complications may require hospitalization, drainage procedures, or surgery.

When Is Surgery Considered?

Surgery is not automatically necessary after a specific number of diverticulitis attacks. You may have heard the old rule of thumb that surgery should follow a second attack but current guidelines favor a more individualized decision.

Your surgeon may consider several factors, including:

  • The severity of your previous attacks
  • How frequently symptoms return
  • Whether you have developed an abscess, fistula, obstruction, perforation, or narrowing of the colon
  • Whether symptoms continue between acute episodes
  • The effect diverticulitis has on your work, travel, eating habits, and quality of life
  • Your overall health and immune status
  • The risks and potential benefits of continuing nonsurgical care versus surgery

Emergency surgery may be necessary when there is uncontrolled infection, a significant perforation, or another life-threatening complication.

However, when possible, surgery is planned electively after the active inflammation has improved. This gives the surgeon an opportunity to evaluate the condition carefully and discuss the available options with the patient.

What Happens During Surgery for Diverticulitis?

The most common operation for diverticulitis is a sigmoid colectomy. During this procedure, the surgeon removes the diseased portion of the colon (most often the sigmoid colon) and reconnects the healthy ends.

In many planned operations, the colon can be reconnected during the same procedure. In more complicated cases, particularly during an emergency or when inflammation and infection are extensive, a temporary or permanent ostomy may be necessary.

The operation may be performed through:

  • Traditional open surgery
  • Conventional laparoscopic surgery
  • Robotic-assisted minimally invasive surgery

The best approach depends on the extent of the disease, prior abdominal operations, the patient’s anatomy and health, the urgency of the situation, and importantly, the surgeon’s training and experienced with advanced minimally invasive surgical techniques.

How Does Robotic Surgery Work?

Despite its name, robotic surgery is not performed by a robot acting independently.

The surgeon remains in control throughout the entire operation. From a console in the operating room, the surgeon directs small instruments and views the surgical area through a highly magnified, three-dimensional camera.

The robotic system translates the surgeon’s hand movements into precise movements inside the body. The instruments can bend and rotate in ways that may be especially helpful when working in tight spaces or around tissue altered by repeated inflammation.

Diverticulitis can make an operation technically challenging. Recurrent inflammation may cause scar tissue, thickening, or abnormal connections between the colon and surrounding structures. In selected cases, the visualization and range of motion offered by the robotic platform can help the surgeon perform a complex operation through small incisions.

This is where the difference between a surgeon who simply uses the robot and one who has truly mastered it matters most. After repeated bouts of inflammation, the colon can become scarred and stuck to nearby organs, such as the bladder or small intestine. During surgery, your surgeon has to gently free the colon, protect important nearby structures like the ureter (the tube that carries urine from the kidney to the bladder), and find healthy tissue to reconnect.

This is careful, detailed work. An experienced robotic surgeon knows how to use the robot’s magnified view and precise instruments to move through these challenges step by step, so you can still benefit from small incisions and a smoother recovery.

What Are the Potential Benefits?

When compared with traditional open surgery, a minimally invasive approach may offer benefits such as:

  • Smaller incisions
  • Less postoperative discomfort
  • Reduced blood loss
  • A shorter hospital stay
  • Faster return of bowel function
  • Earlier return to normal daily activities
  • Lower risk of certain incision-related complications

Research comparing robotic and conventional laparoscopic surgery for diverticular disease suggests that robotic surgery is a safe and feasible option. Some studies have found a lower likelihood of needing to convert from minimally invasive surgery to an open procedure, although robotic operations may take longer. That matters, because converting to a larger open incision can reduce many of the recovery advantages patients hope to gain from a minimally invasive surgical approach.

It is important to recognize that no surgical approach guarantees a particular result. Individual outcomes depend on the severity of the disease, the complexity of the operation, the patient’s health, and the experience of the surgical team.

Does Robotic Surgery Eliminate the Possibility of an Ostomy?

Not necessarily.

Many patients undergoing planned surgery can have the healthy ends of the colon reconnected without an ostomy (an opening created on the abdomen that allows stool to pass into a small pouch worn outside the body). However, patient safety must always come first.

An ostomy may be needed when:

  • There is severe infection or contamination in the abdomen
  • The remaining bowel tissue is not healthy enough for a safe connection
  • The patient is medically unstable
  • The operation is performed during an emergency
  • The surgeon determines that a new connection needs time to heal

When an ostomy is required, it may be temporary. Your surgeon should discuss this possibility with you before the procedure whenever circumstances allow.

What Is Recovery Like?

Recovery varies based on the type and complexity of the operation.

Patients are generally encouraged to begin walking soon after surgery. Food is gradually reintroduced as bowel function returns, and pain is managed with a combination of medications. Some patients leave the hospital within a few days, while others require a longer stay.

After returning home, patients typically increase their activity gradually. Heavy lifting and strenuous exercise may be restricted for several weeks. Your surgeon will provide specific instructions regarding your diet, incision care, medications, driving, work, and physical activity.

Contact your surgical team promptly if you experience worsening abdominal pain, persistent vomiting, fever, increasing redness or drainage from an incision, difficulty eating or drinking, or significant changes in bowel function.

The Robot Is a Tool – The Surgeon Makes the Difference

Robotic technology is a remarkable surgical tool, but it does not make decisions and it does not operate on its own. Two surgeons using the same robotic system can bring very different levels of skill, efficiency, and judgement to the operating room. Like any advanced technique, robotic surgery has a learning curve, and experience at the console matters.

A surgeon must determine whether an operation is needed, what portion of the colon should be removed, whether the bowel can be safely reconnected, and whether a robotic, laparoscopic, or open approach is most appropriate.

The goal is not to use the newest technology in every case. The goal is to select the safest and most effective approach for the individual patient.

Advanced Robotic Expertise at Long Island Laparoscopic Doctors

Dr. Hesham Atwa, founder of Long Island Laparoscopic Doctors, has spent more than 20 years at the forefront of minimally invasive surgery. After completing fellowship training in laparoscopic and bariatric surgery at the University of Texas and the Cleveland Clinic, he became the first fellowship-trained laparoscopic surgeon in a community hospital setting in the Port Jefferson area when he began practicing in 2001. Today, he is one of Long Island’s most experienced robotic surgeons.

Dr. Atwa’s robotic surgery credentials include:

  • More than 2,500 robotic surgeries performed
  • Designation as a Master Surgeon in Robotic Surgery by the Surgical Review Corporation
  • Appointment as a proctor for Intuitive, the maker of the da Vinci® Surgical System, overseeing the training of surgeons who are learning robotic techniques
  • Director of Robotic Surgery and Director and Chief of Surgery at S. Charles Hospital in Port Jefferson, a Surgical Review Corporation Center of Excellence in Minimally Invasive Surgery
  • Author of Robotic Surgery Mastery, a book written to help surgeons shorten their learning curve, improve efficiency, and reduce complications

For patients, this experience is more than a list of titles. It means your operation is performed by a surgeon who teaches other surgeons how to use the robotic platform, who understands both its capabilities and its limits, and who approaches every case with the same guiding question: What is the safest and most effective operation for this patient?

Questions to Ask During Your Surgical Consultation

If you are considering surgery for diverticulitis, helpful questions include:

  • Why are you recommending surgery in my case?
  • What could happen if I continue with nonsurgical management?
  • Am I a candidate for robotic or laparoscopic surgery?
  • How many robotic operations have you performed, and how often do you perform this procedure?
  • What is the possibility that the procedure will need to be converted to open surgery?
  • What is my individual likelihood of needing an ostomy?
  • What should I expect during recovery?
  • How might surgery affect my future risk of diverticulitis symptoms?

Making an Individualized Decision

Not every patient with diverticulitis needs surgery, and not every patient who needs surgery should have the same operation.

If you have experienced recurrent attacks, ongoing symptoms, or a diverticulitis-related complication, a surgical consultation can help you understand your options. By reviewing your medical history, imaging, previous treatments, and personal concerns, your surgeon can recommend an approach tailored to your condition and goals.

If diverticulitis keeps interrupting your life, you do not have to keep waiting for the next attack. Schedule a consultation with Dr. Hesham Atwa at Long Island Laparoscopic Doctors to review your history, imaging tests, and goals, and learn whether robotic surgery may be right for you. Call (631) 476-9296 or request an appointment online at https://www.journeytothenewyou.com

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