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Complications secondary to diverticular disease can still pose a surgical challenge regarding surgery timinig, the selected approach, or the indicated technique. Antonio M. Lacy and Ana Otero, from the Optimus ISE OR in Hospital Clinic Barcelona, were broadcast live in an ileosigmoidal fistula secondary to diverticular disease treatment. In addition, our team worked with 4K technology on a 85" monitor (courtesy of SONY), which optimized the endoscopic view of minimally invasive procedures.