Published online Mar 27, 2019. doi: 10.4240/wjgs.v11.i3.179
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
The implementation of the minimal invasive principles in fundoplication resulted in reduced length of hospital stay, overall morbidity, and earlier return to daily activities. In order to further enhance the advantages of minimally invasive operations, single incision (SI) laparoscopic fundoplication was introduced.
Several studies comparing SI laparoscopic fundoplications to the conventional multiport approaches reported an increased operation duration, and high rates of multiport conversion and incisional hernia.
This study was designed in order to provide a comprehensive appraisal of the intraoperative technical variations and the postoperative outcomes in patients submitted to SI fundoplication.
A systematic review of the literature available, in the electronic scholar databases (Medline, Scopus and Web of Science) was performed. All human trials that reported results on SI fundoplication, with an adult study population were considered eligible to be included in the study.
In total, 19 studies were included in this systematic review, comprising 266, 137 and 110 SI Nissen, Heller and Dor and Toupet fundoplications, respectively. Mean overall operation duration was 136.3 min. The total conversion rate to multiport laparoscopic fundoplication was 12.9%. Overall complication rate was 5.2%, while the rate of incisional hernia was 0.9%.
The results of this systematic review confirm the safety and efficacy of the single port laparoscopic fundoplication, although the technique is not yet standardized.
Due to the lack of high-quality studies, further well designed studies are necessary to determine the role of SI fundoplication.