SILS sigmoidectomy versus multiport laparoscopic sigmoidectomy for diverticulitis

Abstract

Background and Objectives: In this single-institution study, we aimed to compare the safety, feasibility, and outcomes of single-incision laparoscopic sigmoidectomy (SILSS) with multiport laparoscopic sigmoidectomy (MLS) for recurrent diverticulitis. Methods: Between October 2011 and February 2013, 60 sigmoidectomies were performed by the same surgeon. Forty patients had a MLS and 20 patients had a SILSS. Outcomes were compared. Results: Patient characteristics were similar. There was no difference in morbidity, mortality or readmission rates. The mean operative time was longer in the SILSS group (P =.0012). In a larger proportion of patients from the SILSS group, 2 linear staplers were needed for transection at the rectum (P =.006). The total cost of disposable items was higher in the SILSS group (P ˂.0001). No additional ports were placed in the SILSS group. Return to bowel function or return to oral intake was faster in the SILSS group (P =.0446 and P =.0137, respectively). Maximum pain scores on postoperative days 1 and 2 were significantly less for the SILSS group (P =.0014 and P =.047, respectively). Hospital stay was borderline statistically shorter in the SILSS group (P =.0053). SILSS was also associated with better cosmesis (P ˂.0011). Conclusion: SILSS is feasible and safe and is associated with earlier recovery of bowel function, a significant reduction in postoperative pain, and better cosmesis.