title: Single-incision laparoscopic bariatric surgery: a systematic review.
abstract: BACKGROUND
  Single-incision laparoscopic surgery has sparked a great deal of interest in the surgical community in recent years, including bariatric surgery. However, we still do not definitively know if this type of surgical approach provides benefits over conventional techniques without increasing morbidity and mortality.
  
  
  OBJECTIVE
  To evaluate the safety and efficacy of single-incision laparoscopic bariatric surgery (SILBS) compared with conventional laparoscopic bariatric surgery (CLBS).
  
  
  METHODS
  We searched the most important databases. Randomized clinical trials and observational studies comparing SILBS with CLBS were included. This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations.
  
  
  RESULTS
  Fourteen studies complied with the inclusion criteria for our analysis, which included 2357 patients (1179 SILBS group versus 1178 CLBS group). The duration of surgery was longer in the SILBS group and no major intraoperative complications were observed in these series. A small improvement in postoperative pain was indicated in the SILBS group. The overall morbidity rate was 5% in the SILBS group and 4.8% in the CLBS. There was 1 perioperative death in 1 study, which occurred in an adjustable gastric banding (AGB) group, at .1% of all cases of AGB and .005% of all SILBS cases. When cosmesis was evaluated, patients in the SILBS group were more satisfied with the scar outcome.
  
  
  CONCLUSIONS
  SILBS is a feasible technique to use in selected patients. However, there is insufficient evidence to recommend its widespread use compared with a conventional approach. More studies are needed to analyze the safety of this technique and its possible benefits.
authors.affiliation: Department of Surgery, La Mancha Centro General Hospital, San Juan, Spain. Electronic address: cmsurgery@hotmail.com.
authors.forename: Carlos
authors.initials: C
authors.lastname: Moreno-Sanz
authors.affiliation: Department of Surgery, La Mancha Centro General Hospital, San Juan, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Morandeira-Rivas
authors.affiliation: Department of Surgery, La Mancha Centro General Hospital, San Juan, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Sedano-Vizcaino
authors.affiliation: Research Support Unit, La Mancha Centro General Hospital, San Juan, Spain.
authors.forename: Jose María
authors.initials: JM
authors.lastname: Tenías-Burillo
authors.affiliation: Research Support Unit, La Mancha Centro General Hospital, San Juan, Spain.
authors.forename: Carmén
authors.initials: C
authors.lastname: Román-Ortíz
authors.affiliation: Department of Surgery, La Mancha Centro General Hospital, San Juan, Spain.
authors.forename: Juan Bautista Muñoz
authors.initials: JB
authors.lastname: de la Espada
mesh_terms: D050110:Bariatric Surgery / Q000379:methods*; D004954:Esthetics; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D061646:Operative Time; D010149:Postoperative Pain / Q000517:prevention & control
keywords: Roux-en-Y gastric bypass; Single-incision; Single-incision adjustable gastric banding; Single-incision bariatric surgery; Single-incision sleeve gastrectomy; Systematic; review