Skip to main content
Log in

Single-Incision Sleeve Gastrectomy Versus Laparoscopic Sleeve Gastrectomy. A 2-Year Comparative Analysis of 600 Patients

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

This is a 2-year study to evaluate the feasibility; outcomes in terms of postoperative pain, weight loss, and complication rates; and cosmesis of the single-incision sleeve gastrectomy versus the conventional multiport sleeve gastrectomy.

Methods

A prospective comparative analysis was done in 300 patients in each arm who underwent laparoscopic sleeve gastrectomy and single-incision sleeve gastrectomy from September 2009 till January 2012. Both groups were matched for age and BMI. Postoperative pain scoring was done using visual analogue scale. Outcomes in terms of pain score, scar satisfaction score, excess weight loss, resolution of co-morbidities, and complications were compared in both groups at the end of 6 months, 1 year, and 2 years.

Results

Female patients preferred to undergo single-incision sleeve gastrectomy. Operating time and intraoperative blood loss were comparable in both groups. Visual analogue scale (VAS) scoring revealed lesser postoperative pain in the single-incision group. Excess weight loss and resolution of co-morbidities were also comparable in both groups at 6 months, 1 year, and 2 years. Incisional hernia was seen in 3 patients (1 %) in the single-incision group. Leak rate was comparable. Cosmetic satisfaction was superior in patients who underwent single-incision surgery.

Conclusions

Surgical outcomes are comparable in both groups at the end of 2 years. The myth of high long-term incisional hernia rate after single-incision surgery has been dispelled. Single-incision surgery is less painful with better cosmesis. It has come of age and should no longer be considered as an experimental procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Wheeless CR. A rapid, inexpensive, and effective method of surgical sterilization by laparoscopy. J Reprod Med. 1969;3:65–9.

    Google Scholar 

  2. Pelosi MA, Pelosi 3rd MA. Laparoscopic supracervical hysterectomy using a single-umbilical puncture (mini-laparoscopy). J Reprod Med. 1992;37(9):777–84.

    CAS  PubMed  Google Scholar 

  3. Esposito C. One-trocar appendectomy in pediatric surgery. Surg Endosc. 1998;12(2):177–8.

    Article  CAS  PubMed  Google Scholar 

  4. Navarra G, Pozza E, Occhionorelli S, et al. One-wound laparoscopic cholecystectomy. Br J Surg. 1997;84(5):695.

    Article  CAS  PubMed  Google Scholar 

  5. Bucher P, Pugin F, Morel P. Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis. 2008;23(10):1013–6.

    Article  PubMed  Google Scholar 

  6. Rane A, Rao P, Rao P. Single-port-access nephrectomy and other laparoscopic urologic procedures using a novel laparoscopic port (R-port). Urology. 2008;72(2):260–3.

    Article  PubMed  Google Scholar 

  7. Reavis KM, Hinojosa MW, Smith BR, et al. Single-laparoscopic incision transabdominal surgery sleeve gastrectomy. Obes Surg. 2008;18(11):1492–4.

    Article  PubMed  Google Scholar 

  8. Saber AA, Elgamal MH, Itawi EA, et al. Single incision laparoscopic sleeve gastrectomy (SILS): a novel technique. Obes Surg. 2008;18(10):1338–42.

    Article  PubMed  Google Scholar 

  9. Nguyen NT, Hinojosa MW, Smith BR, et al. Single laparoscopic incision transabdominal (SLIT) surgery-adjustable gastric banding: a novel minimally invasive surgical approach. Obes Surg. 2008;18(12):1628–31.

    Article  PubMed  Google Scholar 

  10. Saber A, El-Ghazaly TH, Minnick DB. Single port access transumbilical laparoscopic Roux-en-Y gastric bypass using the SILS port: first reported case. Surg Innov. 2009;16(4):343–7.

    Article  PubMed  Google Scholar 

  11. 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(6):658–64.

    Article  PubMed  Google Scholar 

  12. Lakdawala MA, Muda NH, Goel S, et al. Single-incision sleeve gastrectomy versus conventional laparoscopic sleeve gastrectomy—a randomised pilot study. Obes Surg. 2011;21(11):1664–70.

    Article  PubMed  Google Scholar 

  13. Huang C-K, Houng J-Y, Chiang C-J, et al. Single incision transumbilical laparoscopic Roux-en-Y gastric bypass: a first case report. Obes Surg. 2009;19:1711–5.

    Article  PubMed  Google Scholar 

  14. Soricelli E, Casella G, Rizzello M, et al. Initial experience with laparoscopic crural closure in the management of hiatal hernia in obese patients undergoing sleeve gastrectomy. Obes Surg. 2010;20(8):1149–53.

    Article  PubMed  Google Scholar 

  15. Musella M, Milone M, Bellini M, et al. Laparoscopic sleeve gastrectomy. Do we need to oversew the staple line? Ann Ital Chir. 2011;82(4):273–7.

    PubMed  Google Scholar 

  16. Al Hajj GN, Haddad J. Preventing staple-line leak in sleeve gastrectomy: reinforcement with bovine pericardium vs oversewing. Obes Surg. 2013;23(11):1915–21.

    Article  PubMed  Google Scholar 

  17. Noel P, Nedelcu M, Gagner M. SPIDER® sleeve gastrectomy—a new concept in single-trocar bariatric surgery: initial experience and technical details. J Visc Surg. 2014;18.

  18. Sieber P, Gass M, Kern B. Five-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2014;10(2):243–9.

    Article  PubMed  Google Scholar 

  19. 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):1–6.

    Article  PubMed  Google Scholar 

  20. Alptekin H, Yilmaz H, Acar F, et al. Incisional hernia rate may increase after single-port cholecystectomy. J Laparoendosc Adv Surg Tech A. 2012;22(8):731–7.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

Authors Bhasker A G, Dhar S, Dhulla N, Agrawal A, and Lakdawala M have no conflict of interest or financial ties to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Aparna Govil Bhasker.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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 25, 607–614 (2015). https://doi.org/10.1007/s11695-014-1461-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-014-1461-1

Keywords

Navigation