Conventional laparoscopy vs. single port surgery from a patient's point of view: influence of demographics and body mass index

Single port surgery (SP) using a transumbilical approach is gaining more popularity, but who is the driving force behind this development: surgeons, industry, or patients? We evaluated patient's perception in conjunction with demographic data and body mass index (BMI) concerning conventional (multiport) and single port laparoscopy. Surgical patients were surveyed preoperatively and demographic data was recorded. Using the example of cholecystectomy, open surgery (OP), conventional laparoscopy (CL), and SP was explained. Participants were asked to rate importance of abstract items using a 5-point Likert scale (1: extremely important; 5: not important at all), decide between CL and SP and give reasons for their decision. One hundred and fifty (79 females, 52.7 %) patients were surveyed. One hundred and six (70.7 %) would prefer SP. Abstract items such as complications (1.29 +/- 0.835) and surgeon's experience (1.23 +/- 0.673) were rated higher than cosmesis (2.64 +/- 1.398), length of hospital stay (2.13 +/- 1.190), or cost of hospitalization (3.06 +/- 1.428). Educational status and experience with prior surgery had no influence on decision making but especially younger patients more often decide in favor of SP (p = 0.007). In addition, more females (p = 0.254) and obese (p = 0.214) patients would opt for SP without reaching statistical significance. Superior cosmesis and reduced postoperative pain were the main arguments. However, only 11.1 % of obese patients stated that cosmesis is a reasonable argument to favor SP whereas 56.4 % of patients with a normal weight did (p < 0.001). The majority of patients surveyed would prefer SP because of potential benefits such as superior cosmesis and reduced postoperative pain. Prior surgery and educational status had no influence on decision making whereas slightly more female and obese and especially younger patients are prone to SP.