Systematic Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Mar 27, 2019; 11(3): 179-190
Published online Mar 27, 2019. doi: 10.4240/wjgs.v11.i3.179
Single incision laparoscopic fundoplication: A systematic review of the literature
Konstantinos Perivoliotis, Chamaidi Sarakatsianou, Konstantinos Tepetes, Ioannis Baloyiannis
Konstantinos Perivoliotis, Konstantinos Tepetes, Ioannis Baloyiannis, Department of Surgery, University Hospital of Larissa, Larissa 41110, Greece
Chamaidi Sarakatsianou, Department of Anesthesiology, University Hospital of Larissa, Larissa 41110, Greece
Author contributions: Balolyiannis I contributed to study conception and design; Perivoliotis K and Sarakatsianou C contributed to acquisition of data, analysis and interpretation of data; Perivoliotis K contributed to drafting of manuscript; Tepetes K and Baloyiannis I contributed to critical revision.
Conflict-of-interest statement: The authors declare no potential conflicts of interest.
PRISMA 2009 Checklist statement: This Systematic Review was conducted according to PRISMA Guidelines.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ioannis Baloyiannis, MD, PhD, Assistant Professor, Department of Surgery, University Hospital of Larissa, Mezourlo, Larissa 41110, Greece. ibalogian@med.uth.gr
Telephone: +30-241-3502731
Received: February 10, 2019
Peer-review started: February 11, 2019
First decision: February 26, 2019
Revised: March 12, 2019
Accepted: March 16, 2019
Article in press: March 16, 2019
Published online: March 27, 2019
Processing time: 45 Days and 19.3 Hours
Abstract
BACKGROUND

Fundoplication, was first introduced as a surgical treatment method of gastroesophageal reflux disease. Consequently, several modifications of this method have been described, whereas laparoscopic fundoplication was recently introduced. Although single incision (SI) fundoplication was considered as an alternative to the conventional laparoscopic approach, several studies reported an increased operation duration, and high rates of multiport conversion and incisional hernia.

AIM

To provide a current overview of the technical variations and the postoperative outcomes of patients submitted to SI fundoplication.

METHODS

The present systematic review of the literature was designed and conducted on the basis of the PRISMA guidelines. A systematic screening of the electronic scholar databases (Medline, Scopus and Web of Science) was performed.

RESULTS

Literature search resulted in the identification of 19 studies. Overall, 266, 137 and 110 SI Nissen, Dor and Toupet fundoplications were reported, respectively. In the majority of the trials, standard laparoscopic instruments were used. The left liver lobe was displayed through the use of forceps, graspers, retractors, drains or even glue. Both intra-corporeal and extracorporeal suturing was described. Mean operative time was 136.3 min. Overall complication rate was 5.2% and the rate of incisional hernia was 0.9%. No mortality was reported.

CONCLUSION

Due to the methodological heterogeneity and the lack of high quality studies comparing multi to single access techniques and the several variations, we conclude that further well designed studies are necessary, in order to evaluate the role of SI fundoplication.

Keywords: Single incision; Single port; Fundoplication; Nissen; Dor; Toupet

Core tip: This systematic review summarizes all available data about the use of single incision laparoscopic fundoplication. Although the technique is not yet standardized, this study validates the safety and efficacy of the single port approach compared to conventional multiport approach.