title: Single port sleeve gastrectomy: strategic use of technology to re-establish fundamental tenets of multiport laparoscopy.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy is commonly performed using multiple ports. The quest to minimize surgical trauma has led to the development of single port laparoscopy, which has been shown to be a safe, less-invasive method of performing a variety of abdominal surgeries. We describe the feasibility and safety of single port sleeve gastrectomy (SPSG) for morbid obesity at an academic affiliate of a university hospital.
  
  
  METHODS
  A total of 25 patients undergoing elective SPSG were compared with a demographically similar contemporaneous cohort of 9 patients who underwent standard multiple port laparoscopic sleeve gastrectomy. The data collected included the operative time, narcotic consumption, duration of patient controlled analgesia use, subjective pain scores, and length of stay.
  
  
  RESULTS
  The patients undergoing SPSG experienced significantly less pain at 1 hour postoperatively (P = .039). No statistically significant difference was found in pain between the 2 groups at 12 and 24 hours (P = .519 and P = .403, respectively). The quantity of narcotic use (P = .538), duration of patient controlled analgesia use (P = .820), and length of stay (P = .571) were not significantly different between the 2 groups. The operative time for SPSG was 118 minutes versus 101 minutes for multiple port surgery (P = .160).
  
  
  CONCLUSIONS
  SPSG is safe and feasible for selected patients. The patients undergoing SPSG reported significantly less pain at the first postoperative hour. No significant differences between the 2 groups were seen in any of the other postoperative parameters.
authors.affiliation: Department of Surgery, St. Luke's-Roosevelt Hospital Center, University Hospital of Columbia, University of Columbia College of Physicians and Surgeons, New York, New York 10019, USA. kopark@chpnet.org
authors.forename: Koji
authors.initials: K
authors.lastname: Park
authors.forename: John N
authors.initials: JN
authors.lastname: Afthinos
authors.forename: David
authors.initials: D
authors.lastname: Lee
authors.forename: Ninan
authors.initials: N
authors.lastname: Koshy
authors.forename: James J
authors.initials: JJ
authors.lastname: McGinty
authors.forename: Julio A
authors.initials: JA
authors.lastname: Teixeira
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000706:statistics & numerical data; D016022:Case-Control Studies; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D017792:Surgical Stapling; D015431:Weight Loss; D055815:Young Adult
chemical_list: D009294:Narcotics