Single-port Laparoscopic Surgery for the Treatment of Severe Obesity: Review and Perspectives
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REVIEW
Single-port Laparoscopic Surgery for the Treatment of Severe Obesity: Review and Perspectives Panagiotis Lainas 1,2 & Joseph Derienne 3 & Carmelisa Dammaro 1,2 & Naim Schoucair 1,2 & Niaz Devaquet 1,2 & Ibrahim Dagher 1,2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract This report aims to review current data on single-incision (single-port) laparoscopic surgery (SILS) for bariatric surgery. A comprehensive research of Pubmed database and Cochrane library on SILS bariatric surgery was conducted. Twenty-eight articles met inclusion criteria (3611 patients). Intraoperative and clinical outcomes for SILS sleeve gastrectomy (SG), Rouxen-Y gastric bypass (RYGB), and adjustable gastric banding (AGB) seem comparable to conventional laparoscopy. SILS for SG was safe and feasible with good outcomes. The same stands for RYGB but more studies are necessary for safe conclusions, while additional trocars are necessary to perform the procedure. AGB is feasible and safe by SILS but the declining number of annual procedures will probably limit the use of SILS. Major studies are unavailable for SILS and other bariatric procedures. Keywords Obesity . Bariatric surgery . Sleeve gastrectomy . Gastric bypass . SILS . Single-port
Introduction Single-incision, or single-port, laparoscopic surgery (SILS) is a rapidly developing laparoscopic approach that could represent the future for certain laparoscopic procedures. SILS was first applied in gynecology since 1967 [1]. Tubal ligation, referred to as surgical sterilization, was the first routinely performed procedure through a single incision at the umbilicus [2]. The first published report of the use of SILS in digestive surgery was for appendectomy in 1992, being named by the authors “single umbilical puncture” [3]. Several studies demonstrated that SILS is feasible for laparoscopic cholecystectomy; however, a long-lived debate exists on the feasibility, safety, and advantages of this approach when compared to conventional laparoscopy, with many authors refusing to recommend this approach for this indication [4–7]. In colorectal
surgery, SILS was first reported in 2008 when both Bucher et al. and Remzi et al. reported the use of SILS for right colectomy [8, 9]. Since then, numerous studies have proven SILS to be safe and feasible for the full array of benign and malignant colorectal indications in specialized centers, with a growing number of teams becoming partisans of this approach [10–15]. Finally, SILS has been used for other indications in abdominal surgery, such as small bowel, liver, pancreatic, splenic, adrenal, renal, and gastric cancer surgery [16–22]. The first reports of SILS in bariatric surgery can be found since 2008, mainly for laparoscopic sleeve gastrectomy (SG) and laparoscopic adjustable gastric banding (AGB) [23, 24]. Other bariatric procedures, such as Roux-en-Y gastric bypass (RYGB) or one-anastomosis gastric bypass (OAGB), have also been reported using SILS [25, 26]. The purpose of this work is to review and summarize curre
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