The purpose of this study was to review the existing evidence on obese patients treated with single-incision laparoscopic sleeve gastrectomy (SILSG) or conventional laparoscopic sleeve gastrectomy (LSG), to compare the perioperative parameters and outcomes of the two bariatric procedures.
Materials and Methods:
A systematic literature search was performed in PubMed, Scopus, and Cochrane library, in accordance with the PRISMA guidelines. Seventeen articles met the inclusion criteria and incorporated 3843 patients.
Results:
This study reveals comparable mean operative time, length of hospital stay, and complications between the two approaches. The SILSG approach was associated with enhanced cosmetic results, but increased incisional hernia rate.
Conclusions:
These outcomes should be treated with caution given the small number of included comparative studies. Well-designed, randomized controlled studies, comparing LSG to SILSG, are necessary to assess further their clinical outcomes.
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References
1.
ColquitJL, PicotJ, LovemanE, et al.Surgery for obesity. Cochrane Database Syst Rev, 2009;CD003641.
2.
KueperMA, KramerKM, KirschniakA, et al.Laparoscopic sleeve gastrectomy: Standardized technique of a potential standalone bariatric procedure in morbidly obese patients. World J Surg, 2008; 32:1462–1465.
3.
AngrisaniL. 2014: The year of the sleeve supremacy. Obes Surg, 2017; 27:1626.
4.
SaberAA, ElgamalMH, ItawiEA, RaoAJ. Single incision laparoscopic sleeve gastrectomy (SILS): A novel technique. Obes Surg, 2008; 18:1338–1342.
5.
LiberatiA, AltmanDG, TetzlaffJ, et al.The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Med, 2009; 6:e1000100.
6.
HigginsJPT, GreenS. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration. [updated March2011]. www.cochrane-handbook.org (last accessed December20, 2016).
7.
StangA. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010; 25:603–605
8.
EggerM, Davey SmithG, SchneiderM, et al.Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997; 315:629–634.
9.
AlevizosL, LiriciMM. Laparo-endoscopic single-site sleeve gastrectomy: Results from a preliminary series of selected patients. Minim Invasive Ther Allied Technol, 2012; 21:40–45.
10.
AlexandrouA, AthanasiouA, MichalinosA, et al.Laparoscopic sleeve gastrectomy for morbid obesity: 5-year results. Am J Surg, 2015; 209:230–234.
11.
AlexandrouA, MichalinosA, AthanasiouA, et al.Laparoscopic sleeve gastrectomy for morbid obesity with intra-operative endoscopy: Lessons we learned after 100 consecutive patients. Obes Surg, 2015; 25:1223–1228.
12.
DelgadoS, IbarzabalA, AdelsdorferC, et al.Transumbilical singleport sleeve gastrectomy: Initial experience and comparative study. Surg Endosc, 2012; 26:1247–1253.
13.
FariasC, FernándezJI, OvalleC, et al.Transumbilical sleeve gastrectomy with an accessory lateral port: Surgical results in 237 patients and 1-year follow-up. Obes Surg, 2013; 23:325–331.
GaillardM, TranchartH, LainasP, et al.Single-port laparoscopic sleeve gastrectomy as a routine procedure in 1000 patients. Surg Obes Relat Dis, 2016; 12:1270–1277.
16.
GhinagowA, MalapanK, SeAO, et al.Mid-term results after single incision transumbilical laparoscopic sleeve gastrectomy. Transl Gastrointest Cancer, 2013; 2:6.
17.
GomberawallaA, SalamatA, LutfiR. Outcome analysis of single incision vs traditional multiport sleeve gastrectomy: A matched cohort study. Obes Surg, 2014; 24:1870–1874.
18.
LakdawalaM, AgarwalA, DharS, et al.Single-incision sleeve gastrectomy versus laparoscopic sleeve gastrectomy. A 2-year comparative analysis of 600 patients. Obes Surg, 2014; 25:607–614.
19.
MaluendaF, LeonJ, CsendesA, et al.Single-incision laparoscopic sleeve gastrectomy: Initial experience in 20 patients and 2-year follow-up. Eur Surg, 2014; 46:32–37.
20.
MuirKB, RiceWV. Weight-loss outcomes of SPIDER® sleeve gastrectomy at 6 months compared to traditional laparoscopic technique. Surg Endosc, 2015. DOI: 10.1007/s00464-015-4451-z.
21.
NguyenNT, SmithBR, ReavisKM, et al.Strategic laparoscopic surgery for improved cosmesis in general and bariatric surgery: Analysis of initial 127 cases. J Laparoendosc Adv Surg Tech A, 2012; 22:355–361.
22.
NoccaD, LoureiroM, SkalliEM, et al.Five-year results of laparoscopic sleeve gastrectomy for the treatment of severe obesity. Surg Endosc, 2016; 31:3251–3257.
23.
ParkK, AfthinosJN, LeeD, et al.Single port sleeve gastrectomy: Strategic use of technology to re-establish fundamental tenets of multiport laparoscopy. Surg Obes Relat Dis, 2012; 8:450–457.
24.
PortaA, AiolfiA, MusolinoC, 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, 2016. DOI 10.1007/s11695-016-2338-2.
25.
PourcherG, Di GiuroG, LafosseT, et al.Routine single-port sleeve gastrectomy: A study of 60 consecutive patients. Surg Obes Relat Dis, 2013; 9:385–389.
26.
PourcherG, De FilippoG, FerrettiS, et al.Short-term results of single-port sleeve gastrectomy in adolescents with severe obesity. Surg Obes Relat Dis, 2015; 11:65–69.
27.
SaberAA, El-GhazalyTH, DewoolkarAV, et al.Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: Technical considerations and strategic modifications. Surg Obes Relat Dis, 2010; 6:658–664.
28.
SucherR, ReschT, MohrE, 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; 24:83–88.
29.
ZacharoulisD, SiokaE, PapamargaritisD, et al.Influence of the learning curve on safety and efficiency of laparoscopic sleeve gastrectomy. Obes Surg, 2012; 22:411–415.
30.
MagouliotisDE, TasiopoulouVS, SiokaEet al.Robotic versus Laparoscopic Sleeve Gastrectomy for Morbid Obesity: A Systematic Review and Meta-analysis. Obes Surg, 2017; 27:245.
31.
Moreno-SanzC, Morandeira-RivasA, Sedano-VizcainoC, et al.Single-incision laparoscopic bariatric surgery: A systematic review. Surg Obes Relat Dis, 2015; 11:248–258.
32.
MarksJM, PhillipsMS, TacchinoR, et al.Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy. J Am Coll Surg, 2013; 216:1037–1047.
33.
LaiEC, YangGP, TangCN, et al.Prospective randomized comparative study of single incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy. Am J Surg, 2011; 202:254–258.
34.
MagouliotisDE, TasiopoulouVS, SiokaE, et al.Impact of bariatric surgery on metabolic and gut microbiota profile: A systematic review and meta-analysis. Obes Surg, 2017; 27:1345–1357.
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