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We report on five male patients with sigmoid volvulus treated by laparoscopy-assisted sigmoid colectomy. Intraoperative colonic irrigation was used in two patients prior to resection and primary anastomosis. An intracorporeal technique of bowel anastomosis was used that allowed smaller skin incisions as compared with the extracorporeal technique. All five patients recovered uneventfully, and most were discharged within 1 week after the operation. There was no recurrence at the conclusion of the follow-up. Laparoscopy-assisted sigmoid colectomy may prove to be the procedure of choice in patients with sigmoid volvulus.

We investigated the optimal position of the laparoscope in relationship to the working ports. The optical angle (theta), defined as the angle formed by the line of action (determined by the working ports) and the line of vision (determined by the laparoscope), was varied by 30 degrees intervals from 0 degree to 180 degrees to the left and to the right. We also studied the time taken to accomplish a standardized task of tying a square knot with each optical angle in a laparoscopic simulator setting. The optimal position is at the optical angle of 0 degree. The optimal range of the optical angle is 60 degrees to the left and 60 degrees to the right of the optimal position of 0 degree.