title: Single-port laparoscopic sleeve gastrectomy as a routine procedure in 1000 patients.
abstract: BACKGROUND
  Single-port laparoscopic sleeve gastrectomy (SPSG) is performed routinely in our department as an alternative to a conventional laparoscopic approach.
  
  
  OBJECTIVE
  The aim of this study was to report our surgical results and follow-up outcome after SPSG.
  
  
  METHODS
  Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Saclay University, France.
  
  
  METHODS
  Data from consecutive patients who underwent SPSG in our institution between August 2010 and July 2015 were prospectively collected and retrospectively analyzed. Patients with more than 1-year follow-up were included in our analysis for weight loss and co-morbidity.
  
  
  RESULTS
  A total of 1000 patients underwent SPSG during the study period. Median body mass index was 42.6 kg/m² (range: 33.8-84.6 kg/m²). Median operative time was 112 minutes (range: 50-360 min) and decreased over the years. Completion of the procedure required introduction of an extraport in 78 patients (7.8%). Postoperative mortality and morbidity rates were .1% and 8.1%, respectively. Relaparoscopy and/or endoscopic treatment were required to treat intra-abdominal bleeding in 24 patients (2.4%) and staple-line leakage in 28 patients (2.8%). Five hundred forty-six patients were considered for 1-year follow-up evaluation. Mean excess weight loss was 69% after 1 year and 62.2% after 2 years. Incisional hernia from the trocar site occurred in 20 (3.7%) patients.
  
  
  CONCLUSIONS
  Sleeve gastrectomy can be routinely performed using a single-incision laparoscopic technique with equivalent outcomes of surgical morbidity and weight loss compared with conventional laparoscopic surgery. Prospective comparative studies are necessary to assess the potential benefits of this minimally-invasive approach.
authors.affiliation: Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital, AP-HP, Clamart, France.
authors.forename: Martin
authors.initials: M
authors.lastname: Gaillard
authors.affiliation: Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital, AP-HP, Clamart, France.
authors.forename: Hadrien
authors.initials: H
authors.lastname: Tranchart
authors.affiliation: Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital, AP-HP, Clamart, France; Paris-Saclay University, Orsay, France.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Lainas
authors.affiliation: Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital, AP-HP, Clamart, France; Paris-Saclay University, Orsay, France.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ferretti
authors.affiliation: Department of Hepato-gastroenterology, Antoine Béclère Hospital, AP-HP, Clamart, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Perlemuter
authors.affiliation: Department of Digestive Minimally Invasive Surgery, Antoine Béclère Hospital, AP-HP, Clamart, France; Paris-Saclay University, Orsay, France. Electronic address: ibrahim.dagher@abc.aphp.fr.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Dagher
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000601:surgery; D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D019106:Postoperative Hemorrhage / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D012189:Retrospective Studies
keywords: Bariatric surgery; LESS; Obesity; SILS; Sleeve gastrectomy