1. Date of download: 5/28/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Single-Access Laparoscopic Sigmoidectomy as Definitive Surgical Management of Prior Diverticulitis in a Human Patient Arch Surg. 2009;144(2):173-179. doi:10.1001/archsurg.2008.562 View of single multichannel port in situ subumbilically with the patient in a steep Trendelenburg tilt. A 10-mm camera is initially used, allowing 2 other 5-mm instruments to be inserted synchronously via the port. This camera is later changed to a 5-mm one when larger laparoscopic instruments (eg, the EndoGIA stapler; Covidien, Autosuture, Hamilton, Bermuda) are required. The insert displays the low profile of the port after placement with both its internal and external aspects being flush with the abdominal wall. Figure Legend:

2. Date of download: 5/28/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Single-Access Laparoscopic Sigmoidectomy as Definitive Surgical Management of Prior Diverticulitis in a Human Patient Arch Surg. 2009;144(2):173-179. doi:10.1001/archsurg.2008.562 A, Initial medial mesenteric dissection using a Ligasure advance (Covidien, Valleylab, Norwalk, Conneticut). Retraction of the sigmoid is provided by a combination of a roticulated graspers manipulated synchronously via the Triport (Advanced Surgical Concepts, Wicklow, Ireland) and an intraluminal sigmoidoscope within the distal sigmoid. The line of dissection is near the bowel wall. B, After initial dissection, the metal stapler head that will be used to make the anastomosis is passed into the distal descending colon. C, This is then anchored in place in the descending colon above the line of intended proximal transection by a second magnet placed extracorporeally on the anterior abdominal wall. Figure Legend:

3. Date of download: 5/28/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Single-Access Laparoscopic Sigmoidectomy as Definitive Surgical Management of Prior Diverticulitis in a Human Patient Arch Surg. 2009;144(2):173-179. doi:10.1001/archsurg.2008.562 A, Proximal colonic transection is performed using an EndoGIA (Covidien, Autosuture, Hamilton, Bermuda). Moving the extracorporeal magnet now will also provide a means of changing the position of the proximal intestine as it is magnetically locked to the stapler anvil. B, After further distal mesenteric dissection, a linear EndoGIA with a roticulated head can be placed across the bowel to perform the distal transection. Figure Legend:

4. Date of download: 5/28/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Single-Access Laparoscopic Sigmoidectomy as Definitive Surgical Management of Prior Diverticulitis in a Human Patient Arch Surg. 2009;144(2):173-179. doi:10.1001/archsurg.2008.562 A, With the sigmoid now resected, a colotomy is made adjacent to the proximal staple line (in the descending colon) to deliver the anvil pike in preparation for the reanastomosis. B, Magnetic attraction then allows the pike of the anvil to be withdrawn snugly through the colotomy. During this maneuver, a roticulated grasper inserted via the transabdominal port provides downward traction on the proximal colonic segment. C, Once the pike has been snugged in the colotomy and secured in place with an endoloop, the anvil stapler is mated with the circular head of the stapler inserted per ano into the colorectal stump. Figure Legend:

5. Date of download: 5/28/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Single-Access Laparoscopic Sigmoidectomy as Definitive Surgical Management of Prior Diverticulitis in a Human Patient Arch Surg. 2009;144(2):173-179. doi:10.1001/archsurg.2008.562 Photograph of the patient taken on the eighth postoperative day during follow-up at our clinic demonstrating her single subumbilical scar. Figure Legend: