Single-incision laparoscopic bariatric surgery: a systematic review

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). Materials and Methods: We searched the most important databases. Randomized clinical trials and observational studies comparing SELBS 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 SlLBS 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 SlLBS group were more satisfied with the scar outcome. Conclusion: 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. (C) 2015 American Society for Metabolic and Bariatric Surgery. All rights reserved.