title: Single-incision laparoscopic sleeve gastrectomy versus multiport laparoscopic sleeve gastrectomy: analysis of 80 cases in a single center.
abstract: BACKGROUND
  Through efficacy and improved safety, multiport laparoscopic sleeve gastrectomy (LAPS-G) has emerged as an important and broadly available treatment option for people with severe and complex obesity. Because a single-incision laparoscopic sleeve gastrectomy (SILS-G) would be less invasive, we applied this novel surgical technique for a selected number of patients enrolled into our minimally invasive bariatric program.
  
  
  METHODS
  A retrospective review of prospectively collected data from 80 morbidly obese patients who qualified for SILS-G or LAPS-G was performed from January 2011 to May 2012.
  
  
  RESULTS
  SILS-G and LAPS-G were performed in 40 patients, respectively. All patients were female. Mean age was 41 (range, 19-73) years (SILS-G, 37 [19-62] years; LAPS-G, 43 [24-73] years; P=not significant). Preoperative body mass index was 40.8 (35.1-45.0) kg/m(2) in the SILS-G group and 43.8 (35.0-47.8) kg/m(2) in the LAPS-G group (P=not significant). Total operative time was significantly lower in the SILS-G group (85±21 minutes) compared with the LAPS-G group (97±26 minutes) (P<.05). Median percentage excess weight loss was comparable in both groups (SILS-G, 57.2%; LAPS-G, 53.7%) at 6.6 months after surgery. Mean hospital stay was 5 days (SILS-G, 5 [4-24] days; LAPS-G, 6 [4-14] days; P=not significant). Complication rates were low in both groups: leakage, 2.5% in SILS-G and 0% in LAPS-G; bleeding, 2.5% in SILS-G and 2.5% in LAPS-G; and trocar-site hernia, 0% in both groups. Patients operated on with single-incision laparoscopy had a significantly better cosmetic outcome as assessed by a scar satisfaction assessment questionnaire (P<.01).
  
  
  CONCLUSIONS
  SILS-G is a feasible and safe operative procedure that leads to a significant reduction of total operative time compared with a multiport access procedure. Further potential benefits associated with single-incision laparoscopic surgery remain to be investigated objectively.
authors.affiliation: Department of Visceral, Transplant, and Thoracic Surgery, Innsbruck Medical University , Innsbruck, Austria .
authors.forename: Robert
authors.initials: R
authors.lastname: Sucher
authors.forename: Thomas
authors.initials: T
authors.lastname: Resch
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Mohr
authors.forename: Alexander
authors.initials: A
authors.lastname: Perathoner
authors.forename: Matthias
authors.initials: M
authors.lastname: Biebl
authors.forename: Johann
authors.initials: J
authors.lastname: Pratschke
authors.forename: Reinhard
authors.initials: R
authors.lastname: Mittermair
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015391:Gastroplasty / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult