{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:04:11Z","timestamp":1789959851807,"version":"4.0.1"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T00:00:00Z","timestamp":1789862400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Laparoscopic surgery is increasingly used to treat colonic diverticulitis; however, its role in emergency, perforated, high\u2010risk, and procedure\u2010specific settings remains uncertain. This structured narrative review evaluated and synthesized comparative evidence by clinical setting, operative strategy, and patient risk profile to provide a clinical decision\u2010making framework for identifying settings in which laparoscopy may offer meaningful benefits and those in which its role remains uncertain. In elective settings, randomized trials and observational studies generally demonstrated short\u2010term advantages of laparoscopy, including reduced postoperative morbidity, less pain, faster recovery, and shorter hospitalization, although clear mid\u2010 or long\u2010term superiority has not been established. In emergency, perforated, and high\u2010risk settings, observational and nationwide database studies reported favorable short\u2010term outcomes of laparoscopy; however, these findings were strongly influenced by patient selection, disease severity, and institutional expertise. Benefits were most consistent for resection\u2010based procedures but were less clear for laparoscopic Hartmann procedures and inconsistent for lavage\u2010 or drainage\u2010based strategies. Stoma creation rates tended to be lower after laparoscopy in selected cohorts, although this finding depended on disease severity and operative strategy. Evidence regarding intraoperative complications remains limited. Overall, laparoscopic surgery is associated with favorable short\u2010term outcomes, with the most consistent evidence arising from elective diverticular surgery. In emergency surgery and perforated disease, however, the available evidence remains predominantly observational and susceptible to selection bias. These findings support a selective, context\u2010dependent approach based on disease severity, patient condition, operative strategy, and institutional expertise, with careful surgical planning and timely conversion when necessary.<\/jats:p>","DOI":"10.1002\/ags3.70285","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T02:49:01Z","timestamp":1789958941000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic Versus Open Surgery for Diverticular Disease: A Structured Review Across Clinical Settings and Operative Strategies"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3380-7233","authenticated-orcid":false,"given":"Marie","family":"Hanaoka","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery Institute of Science Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yudai","family":"Fukui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Toranomon Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koya","family":"Hida","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery Kyoto University Graduate School of Medicine  Kyoto Japan"},{"name":"Guideline Committee of the Japan Society for Endoscopic Surgery  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3947-0128","authenticated-orcid":false,"given":"Hiroya","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Guideline Committee of the Japan Society for Endoscopic Surgery  Tokyo Japan"},{"name":"Department of Surgery Hamamatsu University School of Medicine  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Kinugasa","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery Institute of Science Tokyo  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","first-page":"2143","DOI":"10.1007\/s00268-011-1117-4","article-title":"Outcomes of Laparoscopic Versus Open Colectomy in Elective Surgery for Diverticulitis","volume":"35","author":"Masoomi H.","year":"2011","journal-title":"World Journal of Surgery"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"1837","DOI":"10.1007\/s00464-011-2142-y","article-title":"Elective Laparoscopic Versus Open Colectomy for Diverticulosis: An Analysis of ACS\u2010NSQIP Database","volume":"26","author":"Kakarla V. R.","year":"2012","journal-title":"Surgical Endoscopy"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"2883","DOI":"10.1007\/s00268-010-0762-3","article-title":"Elective Open Versus Laparoscopic Sigmoid Colectomy for Diverticular Disease: A Meta\u2010Analysis With the Sigma Trial","volume":"34","author":"Siddiqui M. R.","year":"2010","journal-title":"World Journal of Surgery"},{"key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1159\/000450683","article-title":"Laparoscopic Versus Open Surgery for Diverticulitis: A Systematic Review and Meta\u2010Analysis","volume":"34","author":"Wu K. L.","year":"2017","journal-title":"Digestive Surgery"},{"issue":"1","key":"e_1_2_12_6_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/SLA.0b013e31818e416a","article-title":"Laparoscopic Sigmoid Resection for Diverticulitis Decreases Major Morbidity Rates: A Randomized Control Trial: Short\u2010Term Results of the Sigma Trial","volume":"249","author":"Klarenbeek B. R.","year":"2009","journal-title":"Annals of Surgery"},{"key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1007\/s00464-010-1327-0","article-title":"Laparoscopic Versus Open Sigmoid Resection for Diverticular Disease: Follow\u2010Up Assessment of the Randomized Control Sigma Trial","volume":"25","author":"Klarenbeek B. R.","year":"2011","journal-title":"Surgical Endoscopy"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1007\/s00423-011-0825-4","article-title":"Laparoscopic Sigmoid Resection for Diverticular Disease Has no Advantages Over Open Approach: Midterm Results of a Randomized Controlled Trial","volume":"396","author":"Raue W.","year":"2011","journal-title":"Langenbeck's Archives of Surgery"},{"key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1007\/s00464-010-1252-2","article-title":"The Cost Effectiveness of Elective Laparoscopic Sigmoid Resection for Symptomatic Diverticular Disease: Financial Outcome of the Randomized Control Sigma Trial","volume":"25","author":"Klarenbeek B. R.","year":"2011","journal-title":"Surgical Endoscopy"},{"key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"2560","DOI":"10.1177\/00031348241248701","article-title":"Open Versus Minimally Invasive Emergent Colectomy for Diverticulitis","volume":"90","author":"Le N. K.","year":"2024","journal-title":"American Surgeon"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1177\/00031348211054553","article-title":"Laparoscopic Colectomy for Acute Diverticulitis in the Urgent Setting Is Associated With Similar Outcomes to Open","volume":"88","author":"Hajirawala L. N.","year":"2022","journal-title":"American Surgeon"},{"key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1016\/j.amjsurg.2014.07.017","article-title":"Laparoscopic Versus Open Colonic Resection for Complicated Diverticular Disease in the Emergency Setting: A Safe Choice?","volume":"209","author":"Letarte F.","year":"2015","journal-title":"American Journal of Surgery"},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0284729","article-title":"Association of Hospital Volume With Conversion to Open From Minimally Invasive Colectomy in Patients With Diverticulitis: A National Analysis","volume":"18","author":"Ebrahimian S.","year":"2023","journal-title":"PLoS One"},{"key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"3889","DOI":"10.1007\/s00464-015-4694-8","article-title":"Acute Laparoscopic and Open Sigmoidectomy for Perforated Diverticulitis: A Propensity Score\u2010Matched Cohort","volume":"30","author":"Vennix S.","year":"2016","journal-title":"Surgical Endoscopy"},{"key":"e_1_2_12_15_1","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1007\/s11605-019-04490-9","article-title":"Laparoscopic Versus Open Emergent Sigmoid Resection for Perforated Diverticulitis","volume":"24","author":"Lee Y. F.","year":"2020","journal-title":"Journal of Gastrointestinal Surgery"},{"key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1177\/0003134820950295","article-title":"Outcomes of Minimally Invasive Colectomy for Perforated Diverticulitis","volume":"87","author":"Moghadamyeghaneh Z.","year":"2021","journal-title":"American Surgeon"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1080\/00015458.2022.2122006","article-title":"Feasibility of Laparoscopic Resection for Perforated Diverticulitis: A Retrospective Observational Study of 77 Consecutive Patients","volume":"123","author":"Paasch C.","year":"2023","journal-title":"Acta Chirurgica Belgica"},{"key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1016\/j.jamcollsurg.2020.03.016","article-title":"Acute Colonic Diverticulitis and Cirrhosis: Outcomes of Laparoscopic Colectomy Compared With an Open Approach","volume":"230","author":"Kazi A.","year":"2020","journal-title":"Journal of the American College of Surgeons"},{"key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1007\/s00464-019-06943-3","article-title":"Laparoscopic Colectomy for Diverticulitis in Patients With Pre\u2010Operative Respiratory Comorbidity: Analysis of Post\u2010Operative Outcomes in the United States From 2005 to 2017","volume":"34","author":"Patel R.","year":"2020","journal-title":"Surgical Endoscopy"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1007\/s00423-022-02695-2","article-title":"Is Laparoscopic Surgery Safe for Elderly Patients With Diverticulitis? A National Database Study","volume":"407","author":"Braschi C.","year":"2022","journal-title":"Langenbeck's Archives of Surgery"},{"key":"e_1_2_12_21_1","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1007\/s00068-024-02661-1","article-title":"Laparoscopic Hartmann's Procedure for Complicated Diverticulitis Is Associated With Lower Superficial Surgical Site Infections Compared to Open Surgery With Similar Other Outcomes: A NSQIP\u2010Based, Propensity Score Matched Analysis","volume":"50","author":"Amodu L. I.","year":"2024","journal-title":"European Journal of Trauma and Emergency Surgery"},{"key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1097\/DCR.0b013e3182749cf5","article-title":"Laparoscopic Versus Open Hartmann Procedure for the Emergency Treatment of Diverticulitis: A Propensity\u2010Matched Analysis","volume":"56","author":"Turley R. S.","year":"2013","journal-title":"Diseases of the Colon and Rectum"},{"key":"e_1_2_12_23_1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000022421","article-title":"The Role of Emergency Laparoscopic Surgery for Complicated Diverticular Disease: A Systematic Review and Meta\u2010Analysis","volume":"99","author":"Lin H.","year":"2020","journal-title":"Medicine (Baltimore)"},{"issue":"4","key":"e_1_2_12_24_1","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.jamcollsurg.2013.02.003","article-title":"Surgical Management of Complicated Diverticulitis: A Comparison of the Laparoscopic and Open Approaches","volume":"216","author":"Mbadiwe T.","year":"2013","journal-title":"Journal of the American College of Surgeons"},{"key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s00423-025-03924-0","article-title":"Fistula Formation in Recurrent Sigmoid Diverticulitis: A Domain of Laparoscopic Surgery?","volume":"411","author":"Zimniak L.","year":"2026","journal-title":"Langenbeck's Archives of Surgery"},{"key":"e_1_2_12_26_1","doi-asserted-by":"crossref","first-page":"E570","DOI":"10.1111\/ans.16985","article-title":"Open Versus Laparoscopic Surgery for the Treatment of Diverticular Colovesical Fistulas: A Systematic Review and Meta\u2010Analysis","volume":"91","author":"Trejo\u2010Avila M.","year":"2021","journal-title":"ANZ Journal of Surgery"},{"key":"e_1_2_12_27_1","first-page":"63","article-title":"Surgical Outcomes for Sigmoid Colovesical Fistula Caused by Colonic Diverticulitis","volume":"77","author":"Kosuge M.","year":"2024","journal-title":"Journal of Japan Society of Coloproctology"},{"key":"e_1_2_12_28_1","doi-asserted-by":"crossref","first-page":"4283","DOI":"10.1007\/s00464-021-08771-w","article-title":"Short\u2010Term Outcomes Following Resection of Right Colon Diverticulitis: A Comparison of Open and Minimally Invasive Approaches Using the NSQIP Database","volume":"36","author":"Horsey M. L.","year":"2022","journal-title":"Surgical Endoscopy"},{"key":"e_1_2_12_29_1","doi-asserted-by":"crossref","first-page":"2926","DOI":"10.1007\/s00464-012-2286-4","article-title":"Surgical Treatment of Complicated Right Colonic Diverticulitis: Laparoscopic Versus Open Surgery","volume":"26","author":"Kwon J. W.","year":"2012","journal-title":"Surgical Endoscopy"},{"key":"e_1_2_12_30_1","article-title":"Laparoscopic Versus Open Resection for Sigmoid Diverticulitis","volume":"11","author":"Abraha I.","year":"2017","journal-title":"Cochrane Database of Systematic Reviews"},{"issue":"3","key":"e_1_2_12_31_1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1001\/archsurg.2011.2029","article-title":"Incidence of Iatrogenic Ureteral Injury After Laparoscopic Colectomy","volume":"147","author":"Palaniappa N. C.","year":"2012","journal-title":"Archives of Surgery"},{"issue":"3","key":"e_1_2_12_32_1","doi-asserted-by":"crossref","DOI":"10.4293\/JSLS.2014.00158","article-title":"Ureteral Injury After Laparoscopic Versus Open Colectomy","volume":"18","author":"Zafar S. N.","year":"2014","journal-title":"JSLS: Journal of the Society of Laparoendoscopic Surgeons"},{"key":"e_1_2_12_33_1","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s10151-024-03008-z","article-title":"Iatrogenic Urinary Injuries in Colorectal Surgery: Outcomes and Risk Factors From a Nationwide Cohort","volume":"28","author":"McClelland P. H.","year":"2024","journal-title":"Techniques in Coloproctology"},{"key":"e_1_2_12_34_1","doi-asserted-by":"crossref","DOI":"10.3389\/fsurg.2026.1734869","article-title":"Fluorescence\u2010Guided Ureter Mapping in Colorectal Surgery: A Systematic Review of Intraureteral ICG and Emerging Renal Fluorophores","volume":"13","author":"Litchinko A.","year":"2026","journal-title":"Frontiers in Surgery"}],"container-title":["Annals of Gastroenterological Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ags3.70285","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ags3.70285","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ags3.70285","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T02:49:07Z","timestamp":1789958947000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ags3.70285"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,20]]},"references-count":33,"alternative-id":["10.1002\/ags3.70285"],"URL":"https:\/\/doi.org\/10.1002\/ags3.70285","archive":["Portico"],"relation":{},"ISSN":["2475-0328","2475-0328"],"issn-type":[{"value":"2475-0328","type":"print"},{"value":"2475-0328","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,20]]},"assertion":[{"value":"2026-06-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ags3.70285"}}