Skip to main content
SpringerLink
Log in

Prospective Comparison and Quality of Life for Single-Incision and Conventional Laparoscopic Sleeve Gastrectomy in a Series of Morbidly Obese Patients

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

Abstract

Background

Laparoscopic sleeve gastrectomy has gained a wide acceptance in the surgical community with an increasing popularity in the field of bariatric surgery. Simultaneously more surgeons have become acquainted with the single port techniques and sleeve gastrectomy has been regarded as an ideal field of application. Literature is scarce about operative and clinical outcomes of single port sleeve gastrectomy compared to conventional laparoscopy. The primary purpose of the study was to compare operative outcomes in the two study groups. Assessment and comparison of functional outcomes in terms of quality of life between groups was also performed.

Methods

Prospective data on 130 consecutive patients who underwent randomized SI or CL sleeve gastrectomy were collected between January 2009 to December 2014. Preoperative parameters, outcomes, post-operative functional results and quality of life, according to the short-form SF-36 questionnaire, were evaluated and compared between groups.

Results

65 patients underwent conventional laparoscopic (CL) and 65 single incision (SI) sleeve gastrectomy. Operative time, post-operative pain, in-hospital stay, and complications were similar in the two groups. No difference emerged with respect to passage of flatus and resumption of oral intake (p = NS). Cosmetic results were excellent in SI patients with higher satisfaction rates. Post-operative quality of life was significant higher compared to baseline (p < 0.05), and comparable between the two procedures.

Conclusions

Single incision sleeve gastrectomy is safe, effective and comparable to the conventional laparoscopic technique in terms of outcomes. Post-operative quality of life is comparable between the two procedures.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  3. Sammour T, Hill AG, Singh P, Ranasinghe A, Babor R, Rahman H. Laparoscopic sleeve gastrectomy as a single-stage bariatric procedure. Obes Surg. 2010;20:271–5.

    Article  PubMed  Google Scholar 

  4. Boza C, Salinas J, Salgado N, Pérez G, Raddatz A, Funke R, Pimentel F, Ibáñez L. Laparoscopic sleeve gastrectomy as a stand-alone procedure for morbid obesity: report of 1,000 cases and 3-year follow-up. Obes Surg. 2012;22:866–71.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  PubMed  Google Scholar 

  6. Vidal P, Ramón JM, Goday A, Benaiges D, Trillo L, Parri A, González S, Pera M, Grande L. Laparoscopic gastric bypass versus laparoscopic sleeve gastrectomy as a definitive surgical procedure for morbid obesity. Mid-Term Results Obes Surg. 2013;23:292–9.

    Article  PubMed  Google Scholar 

  7. Deytel M, Crosby RD, Gagner M. The first international consensus summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.

    Article  Google Scholar 

  8. Hunag CK, Tsai JC, Lo CH, Houng JY, Chen YS, Chi SC, Lee PH. Preliminary surgical results of single-incision transumbilical laparoscopic bariatric surgery. Obes Surg. 2011;21:391–6.

    Article  Google Scholar 

  9. Greaves N, Nicholson J. Single incision laparoscopic surgery in general surgery: a review. Ann R Coll Surg Engl. 2011;93:437–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Reavis KM, Hinojosa MV, Smith BR, Nguyen NT. Single-laparoscopic incision transabdominal surgery sleeve gastrectomy. Obes Surg. 2008;18:1492–4.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  12. Gentileschi P, Camperchioli I, Benavoli D, Di Lorenzo N, Sica G, Gaspari AL. Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series. Surg Obes Relat Dis. 2010;6:665–9.

    Article  PubMed  Google Scholar 

  13. Farìas C, Fernandez JI, Ovalle C, Cabrera C, De la Maza J, Kosiel K, Molina AM. Transumbilical sleeve gastrectomy with an accessory lateral port: surgical results in 237 patients and 1-year follow-up. Obes Surg. 2013;23:325–31.

    Article  PubMed  Google Scholar 

  14. Lo C, Latin L, Fariñas Á, Cruz Pico CX, Postoev A, Ibikunle C, Sanni A. Does single-port laparoscopic sleeve gastrectomy result in improved short-term perioperative outcomes compared to conventional multi-port laparoscopic sleeve gastrectomy? Int J Surg. 2015;22:67–71.

    Article  PubMed  Google Scholar 

  15. Yee J, Koshiver J, Allbon C, Brown C. Comparison of intramuscular ketorolac tromethamine and morphine sulfate for analgesia of pain after major surgery. Pharmacotherapy. 1986;6:253–61.

    Article  CAS  PubMed  Google Scholar 

  16. O’Hara D, Fragen R, Kinzer M, Pemberton D. Ketorolac tromethamine as compared with morphine sulfate for treatment of postoperative pain. Clin Pharmacol Ther. 1987;41:556–61.

    Article  PubMed  Google Scholar 

  17. Gordon DB, Stevenson KK, Griffie J, Muchka S, Rapp C, Ford-Roberts K. Opioid equianalgesic calculations. J Palliat Med. 1999;2:209–18.

    Article  CAS  PubMed  Google Scholar 

  18. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Apolone G, Mosconi P. The Italian SF-36 health survey: translation, validation and norming. J Clin Epidemiol. 1998;51:1025–36.

    Article  CAS  PubMed  Google Scholar 

  20. Ware JE, Snow KK, Kosinski M. SF36 health survey. Manual and interpretation guide. Boston: New England Medical Centre, The Health Institute; 1993.

    Google Scholar 

  21. Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg. 2001;234:279–89.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Weller W, Rosati C. Comparing outcomes of laparoscopic versus open bariatric surgery. Ann Surg. 2008;248:10–5.

    Article  PubMed  Google Scholar 

  23. Saber AA, El-Ghazaly TH, Dewoolkar AV, Slayton SA. Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: technical considerations and strategic modifications. Surg Obes Relat Dis. 2010;658–664.

  24. Gomberawalla A, Salamat A, Lutfi R. Outcome analysis of single incision vs traditional multiport sleeve gastrectomy: a matched cohort study. Obes Surg. 2014;24:1870–4.

    Article  PubMed  Google Scholar 

  25. Delgado S, Ibarzabal A, Adelsdorfer C, Adelsdorfer W, Corcelles R, Momblan D, Lacy AM. Transumbilical single-port sleeve gastrectomy: initial experience and comparative study. Surg Endosc. 2012;26:1247–53.

    Article  PubMed  Google Scholar 

  26. Lakdawala M, Agarwal A, Dhar S, Dhulla N, Remedios C, Bhasker AG. Single-incision sleeve gastrectomy versus laparoscopic sleeve gastrectomy. A 2-year comparative analysis of 600 patients. Obes Surg. 2015;25:607–14.

    Article  PubMed  Google Scholar 

  27. Sucher R, Resch T, Mohr E, Perathoner A, Biebl M, Pratschke J, Mittermair R. 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;24:83–8.

    Article  PubMed  Google Scholar 

  28. Sajid MS, Ladwa N, Kalra L, Hutson KK, Singh KK, Sayegh M. Single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: meta-analysis and systematic review of randomized controlled trials. World J Surg. 2012;36:2644–53.

    Article  PubMed  Google Scholar 

  29. St Peter SD, Adibe OO, Juang D, Sharp SW, Garey CL, Laituri CA, et al. Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg. 2011;254:586–90.

    Article  PubMed  Google Scholar 

  30. Choi ST, Lee JN, Kim KK, Park YH, Lee WK, Baek JH, Lee TH. Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg. 2013;257:214–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General and Emergency Surgery, University of Milan, Ospedale S. Famiglia Fatebenefratelli, Erba, Italy

    Andrea Porta, Alberto Aiolfi, Cinzia Musolino, Ilaria Antonini & Marco Antonio Zappa

Authors
  1. Andrea Porta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alberto Aiolfi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cinzia Musolino
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ilaria Antonini
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marco Antonio Zappa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marco Antonio Zappa.

Ethics declarations

Conflict of Interest Statement

Porta A (MD), Musolino C (MD), Antonini I (MD), Aiolfi A (MD), Zappa MA (MD) declare no conflict of interest.

Informed Consent

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

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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 27, 681–687 (2017). https://doi.org/10.1007/s11695-016-2338-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-016-2338-2

Keywords

Search

Navigation