title: Single incision laparoscopic resection for diverticulitis.
abstract: BACKGROUND
  Laparoscopic sigmoidectomy is the standard procedure in elective surgery for recurrent diverticular disease. Recently, Single Incision Laparoscopic Surgery (SILS) have been developed as the next generation technique of minimally invasive surgery. SILS advantages include reduced surgical trauma due to reduction in the number of surgical incisions, faster recovery times, and reduced hospitalization. However, the use of SILS in colorectal surgery is technically demanding and requires expert surgeons, which has hampered the reproducibility and the diffusion of this technique.
  
  
  METHODS
  Between October 2009 and August 2013, 488 consecutive patients were referred to Evangelisches Hochstift Hospital (Worms, Germany) and/or Stadt Klinikum Frankental Hospital (Frankenthal, Germany) for sigmoidectomy for diverticular disease. SILS sigmoidectomy via the umbilicus was performed in 484/488 cases. Clinical outcomes such as the rate of conversion to standard laparoscopy and/or to open surgery, operation time, post-operative complications and hospitalization time were recorded.
  
  
  RESULTS
  SILS sigmoidectomy was successfully completed for 484 out of 488 patients. SILS was converted to standard laparoscopy in 3 patients (0.6%) and to an open procedure in 1 patient (0.2%). Median time for the procedures was 103.26 min (range, 52-156 min). No mortalities or major complications were noted. The average hospitalization period was of 5 days.
  
  
  CONCLUSIONS
  Our work demonstrates that SILS sigmoidectomy via the umbilicus is effective in the treatment of patients affected by diverticular disease on a routine basis and, moreover, is technically feasible also in patients who have been subjected to previous abdominal surgery, with high Body Mass Index and/or patients with perforation at presentation. Thus this procedure represents a valid alternative to standard laparoscopy.
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Italy. Electronic address: arizzuto@unicz.it.
authors.forename: Antonia
authors.initials: A
authors.lastname: Rizzuto
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Italy.
authors.forename: Ugo
authors.initials: U
authors.lastname: Lacamera
authors.affiliation: Department of Surgery, Stadt Klinikum Frankenthal, Germany.
authors.forename: Franz Ulrich
authors.initials: FU
authors.lastname: Zittel
authors.affiliation: Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Sacco
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004238:Diverticulitis / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D005858:Germany; D006801:Humans; D007416:Intestinal Perforation / Q000601:surgery; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012810:Sigmoid Diseases / Q000601:surgery*; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery
keywords: Diverticular disease; Laparoscopic colon resection; SILS sigmoidectomy