Diverticulitis Surgery: Types, Procedure, Recovery and Risks
Updated: 3 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer: What is diverticulitis surgery?
Diverticulitis surgery removes the part of the colon damaged by diverticulitis, usually the sigmoid colon, and reconnects the healthy ends. Surgery may be needed when medicines do not work, when diverticulitis keeps coming back or when a fistula forms. It usually takes three to four hours, and up to 98% of people have no further episodes afterward. [1]
What the research says
Surgery improved quality of life for people with recurring or ongoing symptoms. In the DIRECT randomized trial of 109 adults with repeated diverticulitis or persistent complaints, people who had elective sigmoid resection scored higher on a gut quality-of-life scale at 6 months than those managed without surgery (114.4 vs. 100.4). However, 15% of those who had surgery developed an anastomotic leak, and 23% of the non-surgical group eventually needed an operation. (van de Wall et al., The Lancet Gastroenterology & Hepatology, 2017) [2]
Reconnecting the colon in an emergency led to fewer permanent stomas. A meta-analysis of 12 studies (918 patients) with perforated diverticulitis and widespread peritonitis found that resection with immediate reconnection, compared with Hartmann's procedure, lowered the rate of permanent stomas and major complications (risk ratio 0.67 across both operations), with no difference in 30-day deaths. These results apply to patients who were stable enough for this approach. (Ryan et al., Techniques in Coloproctology, 2020) [3]
Key takeaways
Diverticulitis surgery removes the damaged part of the colon, usually the sigmoid colon. [1]
It is considered when treatment fails, diverticulitis keeps returning or a fistula forms. [1]
Laparoscopic or robotic surgery typically causes less pain and faster healing than open surgery. [1]
Some people need a temporary colostomy or ileostomy, which is usually reversed later. [1]
Full recovery takes a few months, and diverticulitis rarely comes back. [1]
What is diverticulitis surgery?
Diverticulitis happens when small pouches (diverticula) in the wall of the colon become inflamed or infected. Diverticulitis surgery treats severe disease by removing the affected part of the colon. This type of operation is called a partial colectomy. Depending on your situation, the surgery may also include an ostomy, an opening on the belly that lets stool leave the body. [1]
Surgery is an option when other treatments fall short.
When is diverticulitis surgery needed?
Your provider may recommend surgery if: [1]
Medicines or other nonsurgical treatments are not working
Diverticulitis comes back many times after nonsurgical treatment
A fistula (an abnormal tunnel) forms between the colon wall and a nearby organ, such as the bladder or vagina
Diverticulitis that causes a hole (perforation) in the colon can lead to peritonitis, a serious infection of the belly lining that needs urgent care.
What are the types of diverticulitis surgery?
The most common operation is a sigmoid colectomy. The surgeon removes the sigmoid colon, the last part of the colon, and reconnects the healthy ends. Removing this section usually ends the symptoms. [1]
Approach | How it is done | What to expect |
Open surgery | One large vertical incision in the belly | A larger wound to heal |
Laparoscopic or robotic surgery | Several small incisions for a camera and small tools | Typically less pain and faster healing |
Sources: [1]
If the healthy ends of the colon cannot be safely reconnected, the surgeon creates an ostomy: [1]
Ostomy type | What it is | How long it lasts |
A section of colon is brought to the skin | Usually temporary, often reversed several months later | |
Ileostomy | A section of the small intestine (ileum) is brought to the skin to protect the new connection | Temporary |
Sources: [1]
In emergencies, some surgeons perform a Hartmann's procedure, which removes the diseased colon and creates an end colostomy to be reconnected later.
How do you prepare for diverticulitis surgery?
Your surgeon will give you specific instructions. Preparation is the same for open and laparoscopic or robotic surgery and may include: [1]
Extra imaging, such as a CT scan or special X-rays
Health checks such as blood tests, a colonoscopy, an EKG or X-rays
A meeting with the anesthesia team
Drinking only clear liquids for several hours before surgery
A bowel prep to clean out your bowels
What happens during diverticulitis surgery?
All diverticulitis surgeries are done under general anesthesia, so you are asleep. The operation usually takes three to four hours, depending on the approach and whether an ostomy is needed. [1]
A sigmoid colectomy removes the diseased colon and reconnects the healthy ends.
You receive general anesthesia.
The surgeon makes one large vertical incision, or one small incision for a camera and three to five half-inch incisions for tools.
The section of colon affected by diverticulitis is removed.
The healthy sections of colon are reconnected with staples or sutures.
A colostomy or ileostomy is created, if needed.
The incisions are closed.
Sources: [1]
What are the benefits and risks of diverticulitis surgery?
Diverticulitis surgery is typically very successful. Its main benefit is a lower risk of painful attacks and complications, and up to 98% of people have no further diverticulitis episodes. Quality of life usually improves. [1]
Benefits | Risks |
Up to 98% have no further episodes | Anastomotic leak (leaking where the colon was reconnected) |
Lower risk of painful attacks and complications | Bleeding |
Usually better quality of life | Surgical site infection |
Sources: [1]
What is recovery like after diverticulitis surgery?
Most people stay in the hospital for a few days. Before you go home, your care team teaches you how to care for your wound and, if you have one, your ostomy bag. A dietitian may help you plan meals. Full recovery takes a few months. [1]
Recovery happens in stages over a few months.
Recovery timeline
Time after surgery | What to expect |
A few days | Usual hospital stay |
First few weeks | Soft diet |
About the first month | Low-fiber meals |
Six to eight weeks | No heavy lifting |
Several months | A temporary colostomy is often reversed |
A few months | Full recovery; appetite may take this long to return |
Sources: [1]
Other recovery tips: [1]
Avoid hot tubs and pools until your incisions heal.
Do not drive until you have stopped taking pain medicine.
After about a month, most foods are usually fine again, including vegetables, fruits, popcorn, seeds, nuts and berries.
A temporary ostomy needs a second surgery to reverse it.
When should you call your surgeon?
Contact your surgeon after diverticulitis surgery if you have: [1]
Belly pain that medicine does not relieve or that gets worse over time
Not passing stool
Signs of infection, such as swelling or redness at the wound, fever or vomiting
Conclusion
Diverticulitis surgery removes the part of the colon that keeps causing trouble. For people whose diverticulitis does not respond to treatment, keeps coming back or causes a fistula, a sigmoid colectomy can end the attacks for good in most cases, with up to 98% having no further episodes.
Recovery takes a few months and sometimes includes a temporary ostomy. Ask your surgeon whether a minimally invasive approach is right for you, follow your diet and activity plan, and call promptly about worsening pain, fever or wound problems.
Keep learning: Read our Diverticulitis: Symptoms, Causes, Treatment & Diet — Complete Guide to understand the condition behind the surgery, or visit the American Society of Colon and Rectal Surgeons for more patient information.
FAQ
What is diverticulitis surgery?
Diverticulitis surgery removes the part of the colon damaged by diverticulitis, usually the sigmoid colon. It is a type of partial colectomy. [1]
When do you need surgery for diverticulitis?
Surgery may be needed when medicines or other treatments do not work, when diverticulitis keeps coming back, or when a fistula forms between the colon and the bladder or vagina. [1]
What is the most common diverticulitis surgery?
A sigmoid colectomy, which removes the last part of the colon and reconnects the healthy ends. [1]
How long does diverticulitis surgery take?
It usually takes three to four hours, depending on the approach and whether an ostomy is created. [1]
How long is the hospital stay?
Most people stay a few days, depending on how quickly they recover. [1]
Will I need a colostomy bag?
Only if the healthy ends of the colon cannot be reconnected. A colostomy is usually temporary and often reversed several months later. [1]
How long is recovery from diverticulitis surgery?
Full recovery takes a few months. Avoid heavy lifting for six to eight weeks. [1]
What can I eat after diverticulitis surgery?
Eat a soft diet for the first few weeks and low-fiber meals for about the first month. After that, most foods are usually fine again. [1]
Can diverticulitis come back after surgery?
It rarely does. Up to 98% of people have no further diverticulitis episodes after surgery. [1]
What are the risks of diverticulitis surgery?
Risks include anastomotic leak, bleeding and surgical site infection. [1]
How do I prepare for diverticulitis surgery?
Your surgeon gives you specific instructions, which may include extra imaging such as a CT scan, health checks such as blood tests, a colonoscopy or an EKG, a meeting with the anesthesia team, drinking only clear liquids for several hours before surgery, and a bowel prep [1].
Does diverticulitis surgery hurt, and what anesthesia is used?
All diverticulitis surgeries are done under general anesthesia, so you are asleep during the operation. You take pain medicine during recovery and should not drive until you have stopped taking it [1].
When should I call my doctor after diverticulitis surgery?
Contact your surgeon if you have belly pain that medicine does not relieve or that gets worse, are not passing stool, or have signs of infection such as swelling or redness at the wound, fever or vomiting [1].
Related Reading
The condition behind the surgery: Diverticulitis: Symptoms, Causes, Treatment & Diet — Complete Guide
When infection spreads in the belly: Peritonitis: Symptoms, Causes & Treatment — Belly Inflammation Explained
More about colon removal: Colectomy: Types, Procedure, Risks and Recovery Explained
The emergency option: Hartmann's Procedure: Why It's Done, Recovery and Reversal
Living with a stoma: Colostomy: Procedure, Types, and Recovery
Reconnecting later: Ostomy Reversal Surgery: Reconnecting Your Digestive System
References
Cleveland Clinic. Diverticulitis Surgery: Options, Recovery & What To Expect. Cleveland Clinic. Last updated November 12, 2024. https://my.clevelandclinic.org/health/procedures/diverticulitis-surgery
van de Wall BJM, Stam MAW, Draaisma WA, et al. Surgery versus conservative management for recurrent and ongoing left-sided diverticulitis (DIRECT trial): an open-label, multicentre, randomised controlled trial. Lancet Gastroenterol Hepatol. 2017;2(1):13-22. PMID 28404008. https://doi.org/10.1016/S2468-1253(16)30109-1
Ryan OK, Ryan ÉJ, Creavin B, et al. Systematic review and meta-analysis comparing primary resection and anastomosis versus Hartmann's procedure for the management of acute perforated diverticulitis with generalised peritonitis. Tech Coloproctol. 2020;24(6):527-543. PMID 32124112. https://doi.org/10.1007/s10151-020-02172-2
Medical disclaimer
This article is for general education only and does not replace advice from a qualified doctor or surgeon. Talk to your healthcare provider about your own treatment, and seek care promptly for worsening belly pain, fever or wound problems after surgery.
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