Patient Selection and General Patient Considerations

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.