Single-Port Laparoscopy Compared with Conventional Laparoscopic Surgery: A Systematic Review and Meta-Analysis

Area of Science:

• Minimally Invasive Surgery
• Surgical Techniques
• Comparative Effectiveness Research

Background:

• Single-port laparoscopy (SPL) is an advancement in minimally invasive surgery aiming to reduce trauma and improve cosmesis.
• Debate continues regarding the benefits and limitations of SPL versus conventional multi-port laparoscopy (MPL).

Purpose of the Study:

• To systematically review and analyze comparative outcomes between SPL and MPL.
• Evaluate operative, recovery, complication, and patient-reported outcomes.

Main Methods:

• Systematic search of electronic databases (Jan 2000-Oct 2023) adhering to PRISMA guidelines.
• Inclusion of randomized controlled trials comparing SPL and MPL.
• Analysis using random-effects models with heterogeneity explored via subgroup analyses.

Main Results:

• Analysis of 43 RCTs (5807 patients) revealed SPL had longer operative times (+10.5 min) but superior cosmetic satisfaction and reduced early postoperative pain.
• Overall complication rates were similar between groups (p=0.31).
• SPL was associated with a significantly increased risk of incisional hernia (OR: 2.26; p=0.009).

Conclusions:

• SPL provides enhanced cosmetic outcomes and early pain relief.
• These benefits are offset by increased operative time and a higher risk of incisional hernias.
• Heterogeneity highlights the critical role of surgeon experience, patient selection, and technique in optimizing SPL outcomes.