Single-incision laparoscopic surgery for diverticulitis in overweight patients

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Bariatric Surgery Considerations

Background:

• Single-incision laparoscopic surgery (SILS) is a minimally invasive approach for colorectal conditions.
• Diverticulitis of the sigmoid colon frequently requires sigmoid colectomy.
• The influence of obesity on SILS outcomes for diverticulitis is not well-established.

Purpose of the Study:

• To evaluate the impact of obesity on the outcomes of SILS sigmoid colectomy for diverticulitis.
• To compare SILS sigmoid colectomy results across different body mass index (BMI) categories.

Main Methods:

• A prospective database of 377 patients undergoing SILS sigmoid colectomy for diverticulitis was analyzed.
• Patients were stratified into four groups based on BMI: normal weight (<25 kg/m²), overweight (25-29.9 kg/m²), obese (30-34.9 kg/m²), and morbidly obese (>35 kg/m²).

Main Results:

• Groups were comparable in age, sex, diverticulitis status, and inflammation.
• The prevalence of comorbidities was higher in overweight and obese groups (p<0.05).
• Conversion rates were significantly higher in overweight (9.3%) and morbidly obese (12.5%) groups compared to normal weight (2.3%) patients (p<0.05).
• Surgery duration, hospitalization length, and morbidity rates did not significantly differ across BMI groups.

Conclusions:

• Single-incision laparoscopic surgery for diverticulitis is feasible and yields comparable outcomes up to a BMI of 35 kg/m².
• While conversion rates increase with higher BMI, overall surgical success and patient recovery are not significantly compromised.
• Obesity should not be an absolute contraindication for SILS sigmoid colectomy.