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Single-incision laparoscopic surgery for diverticulitis in overweight patients

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Abstract

Aim

Single-incision laparoscopic surgery (SILS) has been introduced as a new technique for the treatment of various colorectal diseases. Recurrent or complicated diverticulitis of the sigmoid colon is a frequent indication for minimally invasive sigmoid colectomy. The aim of this study was to investigate the impact of obesity on the outcome of SILS sigmoid colectomy.

Methods

From September 2009 to October 2014, data from 377 patients who had intended SILS sigmoid colectomy for diverticulitis at our institution were collected in a prospective database. The patients were categorized in the following subgroups: group 1 (normal weight, body mass index (BMI) < 25 kg/m2) , group 2 (overweight, BMI 25–29.9 kg/m2), group 3 (obesity, BMI 30–34.9 kg/m2), and group 4 (morbid obesity, BMI > 35 kg/m2).

Results

The groups were equivalent for sex, age, status of diverticulitis, the presence of acute inflammation in the specimen, and the percentage of teaching operations, but the percentage of patients with accompanying diseases was significantly more frequent in groups 2, 3, and 4 (p = 0.04, 0.008, and 0.018, respectively). As compared to group 1, the conversion rate was significantly increased in groups 2 and 4 (2.3 vs. 9.3 % (p = 0.013) and 2.3 vs. 12.5 % (p = 0.017), respectively). The duration of surgery, hospitalization, and morbidity did not differ between the four groups.

Conclusion

Up to a body mass index of 35 kg/m2, increased body weight does not significantly reduce the feasibility and outcome of single-incision laparoscopic surgery for diverticulitis.

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Acknowledgments

We thank Dr. Jörg Haensel for linguistically and grammatically reviewing our manuscript.

Compliance with ethical standards

ᅟ

Funding

None

Conflicts of interest

Boris Vestweber got fees for developing, teaching, and supervising single-port laparoscopic colorectal surgery from Covidien. There are no other conflicts of interest.

Informed consent

All patients included in this trial gave informed consent concerning the use of the surgical methods described in this manuscript.

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Authors and Affiliations

  1. Department of General, Visceral, and Thoracic Surgery, Leverkusen General Hospital, Am Gesundheitspark 11, 51375, Leverkusen, Germany

    Andreas D. Rink, Boris Vestweber, Jasmina Hahn, Angelika Alfes, Claudia Paul & Karl-Heinz Vestweber

  2. King Edward VII Memorial Hospital, PO-Box HM 1023, Hamilton HM DX, Bermuda

    Boris Vestweber

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  1. Andreas D. Rink
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  2. Boris Vestweber
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  6. Karl-Heinz Vestweber
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Correspondence to Andreas D. Rink.

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Rink, A.D., Vestweber, B., Hahn, J. et al. Single-incision laparoscopic surgery for diverticulitis in overweight patients. Langenbecks Arch Surg 400, 797–804 (2015). https://doi.org/10.1007/s00423-015-1333-8

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  • DOI: https://doi.org/10.1007/s00423-015-1333-8

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