title: Single-port laparoscopic resection for diverticular disease: experiences with more than 300 consecutive patients.
abstract: BACKGROUND
  Single-port laparoscopic surgery (SILS) is a new minimally invasive technique, which has been developed to minimize the surgical access trauma. For colorectal resection, the access trauma can be limited to the one incision, which is needed for specimen extraction anyways, but dissection might be more demanding than in multiport laparoscopic surgery. The aim of this study was to evaluate the usefulness of SILS for the treatment of diverticular disease of the sigmoid colon.
  
  
  METHODS
  Between July 2009 and December 2013, a total of 329 consecutive patients with intended SILS sigmoid colectomy for complicated or frequently recurring diverticulitis were studied. Clinical data were collected in a prospective database. Telephone follow-ups were performed to evaluate long-term morbidity and quality of life.
  
  
  RESULTS
  Of the 329 patients (139 male) with intended SILS sigmoid colectomy, 309 were successfully operated on in SILS technique, while 20 (6.1%) were converted to open surgery. The mean duration of surgery was 153.5 (65-434) min. Total morbidity rate was 18.3%. Anastomotic leakage was the most serious complication occurring in 13 patients (leak rate 4%) with one consecutive death (mortality rate 0.3%). Quality of life had significantly improved 6 months after surgery in comparison with the preoperative value. At a mean follow-up of 18.6 months, 16 patients (4.9%) had incisional hernia and one patient had recurrent diverticulitis.
  
  
  CONCLUSIONS
  In spite of almost 5% incisional hernia 6 months after surgery, single-incision sigmoid colectomy for diverticulitis is feasible and save and is therefore an alternative to multiport laparoscopic surgery. Further trials are necessary to evaluate its benefits over multiport laparoscopic surgery.
authors.affiliation: Department of General, Visceral and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany.|King Edward VII Memorial Hospital, PO Box HM 1023, Hamilton, HM DX, Bermuda.
authors.forename: Boris
authors.initials: B
authors.lastname: Vestweber
authors.affiliation: Department of General, Visceral and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Vestweber
authors.affiliation: Department of General, Visceral and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Paul
authors.affiliation: Department of General, Visceral and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany. andreas.rink@klinikum-lev.de.
authors.forename: Andreas D
authors.initials: AD
authors.lastname: Rink
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D012809:Colon, Sigmoid / Q000601:surgery*; D004239:Diverticulitis, Colonic / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012810:Sigmoid Diseases / Q000601:surgery*; D016896:Treatment Outcome
keywords: Diverticulitis; Single access surgery; Single-site surgery; Surgical treatment; Umbilical incision
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