Laparoscopic lavage for perforated sigmoid diverticulitis seemed at one point to be an attractive, novel option, which could avoid the morbidity associated with sigmoid resection and the possible need for a stoma creation. This is one of the main randomized trials providing a more realistic picture and demonstrating the limitations of laparoscopic lavage. The trial was interrupted due to initially excessive morbidity rate in the laparoscopic lavage arm, although follow-up studies indicated comparable morbidity between laparoscopic lavage and initial sigmoid resection. Laparoscopic lavage remains a controversial approach.