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Background Single-incision laparoscopic surgery (SILS) offers excellent cosmetic results compared with conventional multi-port laparoscopic surgery. Recently, this technique has been applied to Crohn’s disease (CD); however, the application of a laparoscopic approach for complex CD, which involves abscess formation, fistula formation, and recurrent CD, is controversial. The aim of this study was to investigate the feasibility and safety of SILS for patients with the complex disease and to compare its clinical results in patients with complex disease. Methods We investigated the feasibility and safety of SILS in sixty patients who underwent SILS for CD were divided into two groups: those with the complex disease (complex group, n = 30), and those with a simple disease (simple group, n = 30). The perioperative data were analysed and compared between the groups. Results The mean operative time and blood loss were 130.5 ± 28.3 min (range 105–166 min) and 230 ± 58 ml (range 116–410 ml) in the complex group, and 113.4 ± 21.5 min (range 95–151 min) and 72 ± 19ml (range 58–115 ml) in the simple group. There were no significant differences in the operative time between the two groups (p = 0.083, &amp;gt;0.05), but the blood loss was significantly greater in the cases of complex group (p = 0.025, &amp;lt;0.05). Two patients in the complex group required conversion to open surgery for a retroperitoneal fistula and recurrent CD disease. There were no conversions in the simple group. The frequency of postoperative complications was similar in the two groups. The length of the hospital stay was also similar in the two groups. Although the rate of conversion tended to be higher in the complex group, the rate of postoperative complications and length of hospital stay did not differ significantly between the groups (p = 0.061, &amp;gt;0.05). Conclusion SILS may be feasible and safe for carefully selected patients with complex CD.

P496 Feasibility and safety of single incision laparoscopic surgery for patients with complex Crohn’s disease