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.
Similar content being viewed by others
References
Wheeless CR. A rapid, inexpensive, and effective method of surgical sterilization by laparoscopy. J Reprod Med. 1969;3:65–9.
Pelosi MA, Pelosi 3rd MA. Laparoscopic supracervical hysterectomy using a single-umbilical puncture (mini-laparoscopy). J Reprod Med. 1992;37(9):777–84.
Esposito C. One-trocar appendectomy in pediatric surgery. Surg Endosc. 1998;12(2):177–8.
Navarra G, Pozza E, Occhionorelli S, et al. One-wound laparoscopic cholecystectomy. Br J Surg. 1997;84(5):695.
Bucher P, Pugin F, Morel P. Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis. 2008;23(10):1013–6.
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.
Reavis KM, Hinojosa MW, Smith BR, et al. Single-laparoscopic incision transabdominal surgery sleeve gastrectomy. Obes Surg. 2008;18(11):1492–4.
Saber AA, Elgamal MH, Itawi EA, et al. Single incision laparoscopic sleeve gastrectomy (SILS): a novel technique. Obes Surg. 2008;18(10):1338–42.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Sieber P, Gass M, Kern B. Five-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2014;10(2):243–9.
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.
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.
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
Corresponding author
Rights and permissions
About this article
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
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-014-1461-1