Obesity Surgery

, Volume 28, Issue 7, pp 2105–2112 | Cite as

Retrospective Comparison of Single-Port Sleeve Gastrectomy Versus Three-Port Laparoscopic Sleeve Gastrectomy: a Propensity Score Adjustment Analysis

  • Claudio Mauriello
  • Elie Chouillard
  • Antonio d’alessandro
  • Gianpaolo Marte
  • Argyri Papadimitriou
  • Elias chahine
  • Radwan Kassir
Brief Communication



Evaluate the efficacy of single-port sleeve gastrectomy (SPSG) and then compare it to a less-invasive sleeve approach (three-port) (3PSG) according to a propensity score (PS) matching analysis.

Materials and Methods

We analyzed all patients who underwent SG through a three-port or a single-port laparoscopic approach.


After 2 years, the follow-up was completed in 84% patients treated with 3PSG and 95% patients of the SPSG group. Excess weight loss (EWL) was comparable for the first year of follow-up within the two groups except for the controls at 3 months in which the SPSG group showed a higher EWL (p = 0.0243).


We demonstrated the efficacy of SPSG in bariatric surgery even compared to another, less invasive, laparoscopic SG approach (three-port).


Sleeve gastrectomy Single port Port conventional laparoscopic Excess weight loss  Propensity score adjustment analysis 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interests.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Cottam D, Qureshi FD, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRefPubMedGoogle Scholar
  2. 2.
    Regan JP, Inabnet WB, Gagner M, et al. Early experience with two- stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.Google Scholar
  3. 3.
    Sammour T, Hill AG, Singh P, et al. Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure. Obes Surg. 2010;20:271–5.Google Scholar
  4. 4.
    Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.Google Scholar
  5. 5.
    Vidal P, Ramón JM, Goday A, et al. Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-term results. Obes Surg. 2013;23:292–9.Google Scholar
  6. 6.
    Lakdawala M, Agarwal A, Dhar S, et al. Single-incision sleeve gastrectomy versus laparoscopic sleeve gastrectomy. A 2-year comparative analysis of 600 patients. Obes Surg. 2015;25(4):607–14.Google Scholar
  7. 7.
    Rogula T, Daigle C, Dua M, et al. Laparoscopic bariatric surgery can be performed through a single incision: a comparative study. Obes Surg. 2014;24(7):1102–8.Google Scholar
  8. 8.
    Reavis KM, Hinojosa MV, Smith BR, et al. Single-laparoscopic incision transabdominal surgery sleeve gastrectomy. Obes Surg. 2008;18:1492–4.Google Scholar
  9. 9.
    Sato T, Matsuyama Y. Marginal structural models as a tool for standardization. Epidemiology. 2003;14:680–6.CrossRefPubMedGoogle Scholar
  10. 10.
    HAS. Obesite: prise en charge chirurgicale chez l'adulte. Saint Denis (France): HAS edition, 2009:1–263.Google Scholar
  11. 11.
    Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika. 1983;70(1):41–55.CrossRefGoogle Scholar
  13. 13.
    Austin PC. Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharmaceutical Statistics. 2011;10(2). Wiley Online Library):150–61.CrossRefPubMedGoogle Scholar
  14. 14.
    Saber AA, Elgamal MH, Itawi EA, et al. Single incision laparoscopic sleeve gastrectomy (SILS): a novel technique. Obes Surg. 2008;18(10):1338–42.Google Scholar
  15. 15.
    Lakdawala MA, Muda NH, Goel S, et al. Single-incision sleeve gastrectomy versus conventional laparoscopic sleeve gastrectomy—a randomised pilot study. Obes Surg. 2011 Nov;21(11):1664–70.
  16. 16.
    Sucher R, Resch T, Mohr E, et al. Single-incision laparoscopic sleeve gastrectomy versus multiport laparoscopic sleeve gastrectomy: analysis of 80 cases in a single center. J Laparoendosc Adv Surg Tech A. 2014;24(2):83–8. Epub 2014 Jan 16
  17. 17.
    Saber AA, El-Ghazaly TH, Elian A. Single-incision transumbilical laparoscopic sleeve gastrectomy. J Laparoendosc Adv Surg Tech A. 2009;19(6):755–8. discussion 9CrossRefPubMedGoogle Scholar
  18. 18.
    Alevizos L, Lirici MM. Laparo-endoscopic single-site sleeve gastrectomy: results from a preliminary series of selected patients. Minim Invasive Ther Allied Technol. 2012;21(1):40–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Fernandez JI, Farias CO, Ovalle CL, et al. Transumbilical single-incision laparoscopic sleeve gastrectomy. Obes Surg. 2015;25(3):430–5.Google Scholar
  20. 20.
    Gentileschi P, Camperchioli I, Benavoli D, et al. Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series. Surg Obes Relat Dis. 2010;6(6):665–9.Google Scholar
  21. 21.
    Huang CK, Tsai JC, Lo CH, et al. Preliminary surgical results of single-incision transumbilical laparoscopic bariatric surgery. Obes Surg. 2011;21(3):391–6.Google Scholar
  22. 22.
    Maluenda F, Leon J, Csendes A, et al. Single-incision laparoscopic sleeve gastrectomy: initial experience in 20 patients and 2-year follow-up. Eur Surg. 2014;46:32–7.Google Scholar
  23. 23.
    Mittermair R, Pratschke J, Sucher R. Single-incision laparoscopic sleeve gastrectomy. Am Surg. 2013;79(4):393–7.PubMedGoogle Scholar
  24. 24.
    Pourcher G, Di Giuro G, Lafosse T, et al. Routine single-port sleeve gastrectomy: a study of 60 consecutive patients. Surg Obes Relat Dis. 2013;9(3):385–9.Google Scholar
  25. 25.
    Porta A, Aiolfi A, Musolino C, et al. Prospective comparison and quality of life for single-incision and conventional laparoscopic sleeve gastrectomy in a series of morbidly obese patients. Obes Surg. 2017 Mar;27(3):681–7.
  26. 26.
    Gaillard M, Tranchart H, Lainas P, et al. Single-port laparoscopic sleeve gastrectomy as a routine procedure in 1000 patients. Surg Obes Relat Dis. 2016 Aug;12(7):1270–7. Epub 2016 Jan 18
  27. 27.
    Greaves N, Nicholson J. Single incision laparoscopic surgery in general surgery: a review. Ann R Coll Surg Engl. 2011;93:437–40.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Saber AA, El-Ghazaly TH, Dewoolkar AV, et al. Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: technical considerations and strategic modifications. Surg Obes Relat Dis. 2010;6:658–64.Google Scholar
  29. 29.
    Tranchart H, Ketoff S, Lainas P, et al. Single incision laparoscopic cholecystectomy: for what benefit? HPB (Oxford). 2013;15(6):433–8.Google Scholar
  30. 30.
    Pirracchio R, Resche-Rigon M, Chevret S. Evaluation of the propensity score methods for estimating marginal odds ratios in case of small sample size. BMC Med Res Methodol. 2012;12:70.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Digestive SurgeryCentre Hospitalier IntercommunalPoissyFrance
  2. 2.Department of Surgery, Regional Center for HPB SurgeryRegional Hospital of TrevisoTrevisoItaly
  3. 3.Department of Digestive SurgeryCHU Félix GuyonSaint DenisFrance
  4. 4.Department of Bariatric SurgerySaint DenisFrance

Personalised recommendations