Patient Selection and General Patient Considerations

  • Jason BinghamEmail author
  • Scott R. Steele


Colon and rectal surgery has witnessed a vast increase in both the use of and subsequent publications about single-incision laparoscopic surgery (SILS). While single-incision surgery goes by several different names, it is important to keep in mind that when learning any new approach, the operative procedure (with regard to safety and outcomes) should remain the same. Although there is a learning curve that each surgeon must complete and overcome in order to become proficient, the patient should not suffer in the interim. With regard to colon and rectal surgery, special populations such as those with inflammatory bowel disease, diverticulitis, large tumors, and other inflammatory disorders may present technical challenges for open as well as other minimally invasive approaches. Therefore, it is especially important when selecting the operative approach to match it to the individual patient at hand, as well as being realistic about one’s technical expertise and experience with a particular procedure. In this chapter, we will highlight the unique challenges of single-incision surgery, discuss general patient selection and consideration issues, and examine how this approach relates to those particular cohorts such as those with inflammatory bowel disease and obesity.


Single-incision laparoscopic surgery (SILS) Laparo-endoscopic single-site surgery (LESS) Single port access surgery (SPA) Minimally invasive surgery Laparoscopic surgery Single-access surgery Single-site surgery “Scarless surgery,” Patient selection Obesity IBD 

Supplementary material

Video 2.1

Lighted ureteric stent in the left ureter (Courtesy of Scott R. Steele, MD) (MP4 35428 kb)


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of SurgeryMadigan Army Medical CenterTacomaUSA
  2. 2.Division of Colorectal Surgery, University Hospitals Case Medical Center, Case Western Reserve UniversityClevelandUSA

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