US surgeons perform more than 300,000 colectomies every year. every year. Recent changes in management have meant fewer procedures are done openly.

For example, in 1996 approximately 2.7% of all colectomies were performed laparoscopically. But this number jumped over 30% by 2009.

The adoption of laparoscopic surgery during this period inspired researchers. They wanted to try to develop new methods of colon resection surgery for diverticulitis (done with robotic surgery).

One of these new procedures was the robotic NICE procedure. This is a robotic-assisted surgery specifically designed for diverticulitis of the colon.

If you have been referred for colon resection, this article is for you. In this article, we will walk you through everything you need to know about the NICE procedure and whether it’s right for your condition.

What Is Diverticulitis?

Diverticulosis is a process when part of the colonic wall develops an outpouching through its outer layer. This process can be benign in and of itself. However, it can also close off and cause bacteria to develop behind a blockage.

Diverticulosis is extremely common. It is present in many people who eat predominantly red meat and low fiber diets.

On occasion, inflammation and infection can occur in an outpouching developed by diverticulosis. This is called diverticulitis.

While many cases of diverticulitis will resolve on their own, in severe cases, surgery may be indicated. Historically, surgeons would do an open or laparoscopic procedure to create segments of the bowel on either side of the problem area. They would then reconnect them using sutures or staples.

Recently, scientific researchers have developed the NICE procedure specifically for the situation. As a patient, here’s exactly what you need to know.

NICE Procedure Goals

This unique procedure utilizes the da Vinci Xi platform that was developed by the West Coast company for release in 2018. When robotic surgery is performed, the system is still controlled by the surgeon. There is no autonomous surgery being performed.

However, surgeons will prepare the incision sites and position the arms of the robot. They will then control it from a separate sitdown controller system on the other side of the room. A three-dimensional image is transferred over to the controller using a camera held by other operating room staff.

Robotic surgery allows surgeons to have more precision and control. However, it sometimes increases the procedure time slightly.

In most cases, robotic or minimally invasive surgery is the cutting edge in surgical fields.

The NICE procedure is unique in that it uses a natural body orifice. It doesn’t require abdominal incisions, which can be a nidus for infection.


Instead, surgeons can use the rectum as a point of entry with robotic assistance. This provides many advantages to both the surgeon and the patient. By using a natural body orifice, patients will have decreased risk of adhesions that can cause problems like small bowel obstructions down the road.

Oftentimes, we need to take out the whole diseased segment of the bowel. This includes dragging a passive body tissue that is filled with infectious bacteria through a small orifice.

The NICE procedure avoids incisions over the abdomen. This can significantly improve postoperative outcomes.

It may make the entire experience easier for the patient because less manipulation of intra-abdominal tissues is necessary.

Is the NICE Procedure Right for You?

Ultimately, you’ll need to have a discussion with your surgeon as to whether surgery is the right option for you. If you have recurrent bouts of diverticulitis, it may be best to segment out that section of disease bowel.

Only a handful of surgeons are performing minimally invasive surgery for colorectal disease including diverticulitis. If you want to have this procedure performed, you want to go to a physician who has been fellowship trained to perform it. You’ll need to have a discussion with your doctor as to whether or not there are any available surgeons in your area who offer the service.

Dr. Valentine

Dr. John Valentine is a fellow of the American College of Surgeons who is specially trained to perform robotic minimally invasive surgery. He focuses his surgical practice on colon, hernia, and gallbladder surgery. However, he does perform a variety of other procedures using the most advanced available technology.

Other types of general surgery procedures include noninvasive options like endoscopy. Dr. Valentine prefers getting to know patients on a personal level so that he can provide compassionate care. 

He is known as a calm and capable surgeon. He desires to provide individualized care to every patient who walks into his office. He operates through SURGCO in the Hendersonville TN, area.

If you are interested in making an appointment with Dr. Valentine, please contact the SURGCO office today. He will be happy to provide consultation to help you assess whether or not a robotic NICE procedure could help with your diverticulitis.

Should You Get Colon Resection Surgery for Diverticulitis (Done With Robotic Surgery)?

At the end of the day, colon resection surgery for diverticulitis (done with robotic surgery) remains a great alternative for many patients. If you want to avoid going under the knife with abdominal incisions, the NICE procedure may be for you. You’ll be able to improve your quality of life with diverticulitis greatly.

Our surgeon, Dr. John Valentine, is highly trained in all types of robotic surgery. He enjoys providing compassionate and thoughtful care to patients who are suffering from painful or uncomfortable illnesses.

If you are interested in setting up an appointment with Dr. Valentine, please contact us today!