title: A case of single-incision laparoscopic surgery for a bleeding Meckel's diverticulum diagnosed pre-operatively by double-balloon endoscopy.
abstract: BACKGROUND
  Meckel's diverticulum (MD) is a congenital true diverticulum that is residual yolk duct tissue, and some cases with complications require surgery. It has been reported that laparoscopic surgery is effective for patients with an MD.
  
  
  METHODS
  A 79-year-old man with melena visited our hospital. Upper gastrointestinal series and colonoscopy showed no bleeding lesion. Double-balloon endoscopy was then performed to examine the small intestine. The examination showed a large diverticulum 80cm proximal to the ileocecal valve and a circular ulcer. MD resection was performed using single-incision laparoscopic surgery (SILS) technique through a 3-cm zig-zag incision in the umbilicus. Three ports were inserted for the scope and forceps devices. The MD was located 80cm proximal to the ileocecal valve. There were no other intestinal lesions. From the wound, the lesion could be easily moved outside the body. The MD including the ulcer lesion was then resected. The patient's postoperative course was good, and he rarely felt wound pain. He started dietary intake three days after surgery and was discharged from hospital eight days after surgery.
  
  
  CONCLUSIONS
  SILS technique has attracted attention in the field of laparoscopic surgery. Using a single port with multiple working channels, SILS can reduce the number of incisions and the rates of incisional hernia port site-related complications, as well as improve cosmesis.
  
  
  CONCLUSIONS
  A definite diagnosis of an MD was made by double-balloon endoscopy preoperatively. The SILS approach was effective for cosmesis, postoperative pain, and a shortened hospital stay.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: tshiraishi@nagasaki-u.ac.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Shiraishi
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: tomitetsu2000@yahoo.co.jp.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Tominaga
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: tnonaka@nagasaki-mc.com.
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: kou-waka@hotmail.co.jp.
authors.forename: Kouki
authors.initials: K
authors.lastname: Wakata
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: kunisakimasaki2002@yahoo.co.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kunizaki
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: sh.toby577@gmail.com.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Tobinaga
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: y-sumida@nagasaki-u.ac.jp.
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Sumida
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: hidaka-s@nagasaki-u.ac.jp.
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.affiliation: Department of Pathology, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: daimonji@nagasaki-u.ac.jp.
authors.forename: Naoe
authors.initials: N
authors.lastname: Kinoshita
authors.affiliation: Cardiopulmonary Rehabilitation Science, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: sawai@nagasaki-u.ac.jp.
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan. Electronic address: nagayasu@nagasaki-u.ac.jp.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
keywords: Bleeding; Case report; Meckel’s diverticulum; Single-port laparoscopic surgery