Journal of Surgery Concepts & Practice >

2025 , Vol. 30 >Issue 03: 202 - 206

DOI: https://doi.org/10.16139/j.1007-9610.2025.03.04

Experts forum

Single-incision bariatric surgery: advantages and challenges

  • DONG Wenpei ,
  • YANG Jianjun ,
  • GU Yan
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  • Department of General Surgery, Huadong Hospital, Fudan University, Shanghai 200040, China

Received date: 2025-05-15

  Online published: 2025-09-01

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Abstract

Single-incision bariatric surgery, as a significant advancement in minimally invasive surgery, achieves weight loss goals through a single small incision, offering advantages such as minimal trauma, concealed scarring, and rapid postoperative recovery. The single-incision laparoscopic sleeve gastrectomy (SILSG) currently represents the most widely performed single-incision bariatric procedure globally, demonstrating weight loss efficacy and complication rates comparable to traditional multi-incision laparoscopy alongside significantly higher patient satisfaction. However, the clinical adoption of single-incision bariatric surgery still faces technical challenges with relative scarcity in robust clinical research evidence and underdeveloped standardized surgical protocols and training systems. To further establish a specialized training system and expert consensus for single-incision bariatric surgery that aligns with China's national conditions is of great significance for promoting the standardized implementation of SILSG-represented procedures.

Key words： Bariatric surgery; Single-incision surgery; Minimally invasive surgery; Laparoscopic sleeve gastrectomy(LSG)

Cite this article

DONG Wenpei , YANG Jianjun , GU Yan . Single-incision bariatric surgery: advantages and challenges[J]. Journal of Surgery Concepts & Practice, 2025 , 30(03) : 202 -206 . DOI: 10.16139/j.1007-9610.2025.03.04

References

[1] NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults[J]. Lancet, 2024, 403(10431):1027-1050.
[2] EMMERICH S D, FRYAR C D, STIERMAN B, et al. Obesity and severe obesity prevalence in adults: United States, August 2021-August 2023[J]. NCHS Data Brief, 2024,(508):10.15620/cdc/159281.
[3] PAN X F, WANG L, PAN A. Epidemiology and determinants of obesity in China[J]. Lancet Diabetes Endocrinol, 2021, 9(6):373‐392.
[4] ENGLISH W J, WILLIAMS D B. Metabolic and bariatric surgery: an effective treatment option for obesity and cardiovascular disease[J]. Prog Cardiovasc Dis, 2018, 61(2):253-269.
[5] CLAPP B, PONCE J, CORBETT J, et al. American So-ciety for Metabolic and Bariatric Surgery 2022 estimate of metabolic and bariatric procedures performed in the United States[J]. Surg Obes Relat Dis, 2024, 20(5):425-431.
[6] 中国医师协会外科医师分会肥胖和代谢病外科专家工作组, 中国医师协会外科医师分会肥胖代谢外科综合管理专家工作组, 中国肥胖代谢外科研究协作组. 中国肥胖代谢外科数据库:2023年度报告[J]. 中华肥胖与代谢病电子杂志, 2024, 10(2):73-83.
  Chinese Society for Metabolic and Bariatric Surgery (CSMBS), Chinese Society for Integrated Health of Metabolic and Bariatric Surgery (CSMBS IH), Chinese Obesity and Metabolic Surgery Collaborative (COMES Collaborative). Chinese obesity and metabolic surgery database: annual report 2023[J]. Chin J Obes Metab Dis(electronic edition), 2024, 10(2):73-83.
[7] BROWN W A, LIEM R, AL-SABAH S, et al. Metabolic bariatric surgery across the IFSO chapters: key insights on the baseline patient demographics, procedure types, and mortality from the eighth IFSO global registry report[J]. Obes Surg, 2024, 34(5):1764-1777.
[8] SABER A A, ELGAMAL M H, ITAWI E A, et al. Single incision laparoscopic sleeve gastrectomy (SILS): a novel technique[J]. Obes Surg, 2008, 18(10):1338-1342.
[9] NGUYEN N T, HINOJOSA M W, SMITH B R, et al. Single laparoscopic incision transabdominal (SLIT) surgery-adjustable gastric banding: a novel minimally invasive surgical approach[J]. Obes Surg, 2008, 18(12):1628-1631.
[10] HUANG C K, HOUNG J Y, CHIANG C J, et al. Single incision transumbilical laparoscopic Roux-en-Y gastric bypass: a first case report[J]. Obes Surg, 2009, 19(12):1711-1715.
[11] TACCHINO R M, GRECO F, MATERA D, et al. Single-incision laparoscopic gastric bypass for morbid obesity[J]. Obes Surg, 2010, 20(8):1154-1160.
[12] TACCHINO R M, GRECO F, MATERA D. Single-incision laparoscopic biliopancreatic diversion[J]. Surg Obes Relat Dis, 2010, 6(4):444-445.
[13] WIDJAJA J, YANG J, DONG W, et al. Single-port one anastomosis sleeve gastrectomy with transit bipartition: initial experience and technique[J]. Obes Surg, 2024, 34(7):2739-2743.
[14] ENOCHS P E. Review of single-port laparoscopic sleeve gastrectomy as a routine procedure in 1000 patients[J]. Surg Obes Relat Dis, 2016, 12(7):1277.
[15] LAINAS P, DERIENNE J, ZERVAKI S, et al. Left hypochondrium or transumbilical single-incision laparoscopic sleeve gastrectomy for the treatment of severe obesity: surgical technique and results of a tertiary referral bariatric center[J]. Obes Surg, 2021, 31(11):5063-5070.
[16] MAURIELLO C, CHOUILLARD E, D'ALESSANDRO A, et al. Retrospective comparison of single-port sleeve gastrectomy versus three-port laparoscopic sleeve gastrectomy: a propensity score adjustment analysis[J]. Obes Surg, 2018, 28(7):2105-2112.
[17] TRANCHART H, REBIBO L, GAILLARD M, et al. Short-term outcomes of single-port versus conventional laparoscopic sleeve gastrectomy: a propensity score matched analysis[J]. Surg Endosc, 2020, 34(9):3978-3985.
[18] PORTA A, AIOLFI A, MUSOLINO C, et al. Prospective comparison and quality of life for single-incision and conventional laparoscopic sleeve gastrectomy in a series of morbidly obese patients[J]. Obes Surg, 2017, 27(3):681-687.
[19] STEFANOPOULOS A, ECONOMOPOULOS K P, KALLES V. Single incision laparoscopic sleeve gastrectomy: a review[J]. Obes Surg, 2015, 25(8):1502-1510.
[20] ATAYA K, BSAT A M, ALJAAFREH A, et al. Single incision versus conventional multiport laparoscopic sleeve gastrectomy: meta-analysis and systematic review[J]. Cureus, 2023, 15(10):e46956.
[21] SUN S D, WU P P, ZHOU J F, et al. Comparison of single-incision and conventional laparoscopic sleeve gastrectomy for morbid obesity: a meta-analysis[J]. Obes Surg, 2020, 30(6):2186-2198.
[22] YANG J, WIDJAJA J, WANG R, et al. Routine gastric suspension technique in single-port sleeve gastrectomy procedure[J]. Surg Endosc, 2023, 37(12):9651-9657.
[23] ZHENG X, GUO Y, ZHANG N, et al. How to suture the staple line more easily in single-port sleeve gastrectomy? Our unique method[J]. Obes Surg, 2021, 31(2):875-876.
[24] EDGERTON C, HESHMATI K, HERMAN A, et al. Fellowship training influences learning curves for laparoscopic sleeve gastrectomy[J]. Surg Endosc, 2022, 36(2):1601-1608.
[25] KHIDIR N, GAGNER M, EL MATBOULY M, et al. Single-port sleeve gastrectomy compared with conventional laparoscopic sleeve gastrectomy: 5-year follow-up of weight loss, comorbidity resolution, and cost[J]. Surg Innov, 2020, 27(3):265-271.
[26] LEE D Y, REHMANI S S, GUEND H, et al. The incidence of trocar-site hernia in minimally invasive bariatric surgery: a comparison of multi versus single-port laparoscopy[J]. Surg Endosc, 2013, 27(4):1287-1291.
[27] MAGOULIOTIS D E, TASIOPOULOU V S, SVOKOS A A, et al. Single incision versus conventional laparoscopic sleeve gastrectomy for morbid obesity: a meta-analysis[J]. J Laparoendosc Adv Surg Tech A, 2018, 28(6):690-699.
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