Single incision laparoscopic fundoplication: A systematic review of the literature

Table 1 Included studies

Included studies
ID	Ref.	Country	Type of study	Center	Year	Operation type	Surgeons	Experience	Sample	Gender (M/F)	Age	BMI	Follow up
27417943	Buckley et al[30]	United States	Retrospective	Single center	2016	Nissen	3	No	21	n/a	n/a	n/a	34 (8.3) mo
26350663	Sukharamwala et al[17]	United States	Prospective	Single center	2015	Nissen	n/a	n/a	190	67/123	55(14.7)	27(3.9)	n/a
24960483	Agaba et al[26]	United States	Retrospective	Single center	2014	Nissen	2	Yes	3	n/a	n/a	n/a	60 mo
24686364	Galvani et al[24]	United States	Retrospective	Single center	2014	Nissen	1	Yes	2	0/2	43.4 (4)	22(3)	n/a
24615563	Wu et al[25]	China	Retrospective	Single center	2014	Nissen	n/a	n/a	5	n/a	n/a	n/a	1 mo
23585169	Strzalka et al[31]	Poland	Retrospective	Single center	2013	Nissen	n/a	n/a	1	n/a	n/a	n/a	n/a
10.5336/medsci.2012-31954	Yilmaz et al[22]	Turkey	Retrospective	Single center	2013	Nissen	1	n/a	10	3/7	35(8.5)	24.6 (3)	n/a
22146016	Eyuboglu et al[20]	Turkey	Retrospective	Single center	2012	Nissen	n/a	n/a	22	5/17	28(5.75)	n/a	8 mo
20306152	Miyazaki et al[19]1	Japan	Retrospective	Single center	2012	Nissen	Surgical team	n/a	4	2/2	52.5 (11.7)	20.9 (1.1)	n/a
22278618	Mizuno et al [21]2	Japan	Retrospective	Single center	2012	Nissen	n/a	n/a	2	1/1	65.5 (13.4)	30.5 (0.7)	18 mo
21991503	Barbaros et al[18]	Turkey	Case report	Single center	2011	Nissen	n/a	n/a	1	1/0	29	n/a	n/a
21059609	Dapri et al[23]	Belgium	Case report	Single center	2011	Nissen	n/a	n/a	1	0/1	21	n/a	6 mo
21471786	Hawasli et al[12]	United States	Case report	Single center	2011	Nissen	n/a	n/a	1	0/1	36	29	1 wk
20306152	Hamzaoglu et al[11]	Turkey	Case series	Single center	2010	Nissen	n/a	n/a	3	1/2	40(17.5)	26.3 (4.93)	1 wk
Total									266	79/156	51.05	26.75	19.27
26315292	Fukuda et al[14]	Japan	Retrospective	Single center	2016	Heller and Dor	Surgical team	No	10	1/9	53.6 (18.3)	19.7 (2)	n/a
24615563	Wu et al[25]	China	Retrospective	Single center	2014	Heller and Dor	n/a	n/a	4	n/a	n/a	n/a	1 mo
23896255	Ross et al[32]	United States	Prospective	Single center	2013	Heller and Dor	Surgical team	No	120	56/64	53(17.4)	25(4.7)	33 (7.9) mo
23088902	Yamada et al[28]	Japan	Case report	Single center	2013	Heller and Dor	n/a	n/a	1	0/1	56	n/a	12 mo
22218875	Yano et al[29]	Japan	Case report	sIngle center	2012	Heller and Dor	n/a	n/a	1	1/0	31	n/a	n/a
21969159	Nakajima et al[27]	Japan	Case report	Single center	2011	Heller and Dor	1	yes	1	1/0	58	n/a	1 mo
Total									137	59/74	52.9	24.59	31.5
26350663	Sukharamwala et al[17]	United States	Prospective	Single center	2015	Toupet	n/a	n/a	110	28/82	66(13.2)	26(3.8)	n/a
Total									513	166/312	55.01	25.9	27.6

¹Only data for Nissen extracted- Heller and Dor data duplicate;

²In the study of Mizuno et al[21] only data from adult patients extracted. n/a: Not available.

Table 2 Patient characteristics

Patient characteristics
Ref.	Operation type	ASA I	ASA II	ASA III	ASA IV	Previous operation	Indication
Buckley et al[30]	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Sukharamwala et al[17]	Nissen	n/a	n/a	n/a	n/a	14	GERD
Agaba et al[26]	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Galvani et al[24]	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Wu et al[25]	Nissen	n/a	n/a	n/a	n/a	n/a	Hiatus Hernia
Strzalka et al[31]	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Yilmaz et al[22]	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Eyuboglu et al[20]	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Miyazaki et al[19] *	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Mizuno et al[21]**	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Barbaros et al[18]	Nissen	n/a	n/a	n/a	n/a	n/a	Hiatus Hernia
Dapri et al[23]	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Hawasli et al[12]	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Hamzaoglu et al[11]	Nissen	n/a	n/a	n/a	n/a	n/a	GERD
Fukuda et al[14]	Heller and Dor	n/a	n/a	n/a	n/a	n/a	Achalasia
Wu et al[25]	Heller and Dor	n/a	n/a	n/a	n/a	n/a	Achalasia
Ross et al[32]	Heller and Dor	n/a	n/a	n/a	n/a	5	Achalasia
Yamada et al[28]	Heller and Dor	n/a	n/a	n/a	n/a	n/a	Achalasia
Yano et al[29]	Heller and Dor	n/a	n/a	n/a	n/a	n/a	Achalasia
Nakajima et al[27]	Heller and Dor	n/a	n/a	n/a	n/a	n/a	Achalasia
Sukharamwala et al[17]	Toupet	n/a	n/a	n/a	n/a	14	GERD

n/a: Not available; ASA: American Society of Anesthesiologists; GERD: Gastroesophageal reflux disease.

Table 3 Technical characteristics

Technical characteristics
Ref.	Operation type	Single port device	Instruments	Liver retraction	Dissection device	Boogie	Suturing	Gas	Gas pressure
Buckley et al[30]	Nissen	SILS™	Conventional	n/a	n/a	n/a	n/a	n/a	n/a
Sukharamwala et al[17]	Nissen	SILS™	n/a	Pretzel Retractor	Monopolar or Ultrasonic dissectors	n/a	Endostich™ or V Lock™	n/a	n/a
Agaba et al[26]	Nissen	SILS™	n/a	n/a	n/a	n/a	n/a	n/a	15mmHg
Galvani et al[24]	Nissen	n/a	n/a	CINCH™ retractor	n/a	n/a	n/a	n/a	n/a
Wu et al[25]	Nissen	Conventional trocars in a single incision	Conventional	Cyanoacrylate glue	Harmonic™	n/a	Intracorporeal	n/a	n/a
Strzalka et al[31]	Nissen	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a
Yilmaz et al[22]	Nissen	SILS™	Conventional	Berk technique	Harmonic™	32Fr	Extracorporeal	CO2	13mmHg
Eyuboglu et al[20]	Nissen	Conventional trocars in a single incision or SILS™	n/a	Cerrahpasa retractor	Ligasure™ or Monopolar	n/a	Endostich™	n/a	n/a
Miyazaki et al[19] *	Nissen	Conventional trocars in a single incision or SILS™ or X-CONE™	n/a	Loop Retractor	n/a	n/a	n/a	n/a	n/a
Mizuno et al[21]**	Nissen	SILS™	ProSeed™ and Conventional	Loop Retractor	n/a	n/a	n/a	CO2	8mmHg
Barbaros et al[18]	Nissen	SILS™	Roticulating	Snowden Pencer™	Ligasure™	n/a	Endostich™	n/a	14mmHg
Dapri et al[23]	Nissen	Conventional trocars in a single incision	Dapri™ Karl Storz	Grasper	n/a	34Fr	Intracorporeal	n/a	n/a
Hawasli et al[12]	Nissen	Conventional trocars in a single incision	Roticulating	Veress	Sono-surg™	60FR	Endostich™	CO2	15mmHg
Hamzaoglu et al[11]	Nissen	SILS™	Roticulating	Instanbul Technique	Harmonic™	no	SILS™ STICH	n/a	n/a
Fukuda et al[14]	Heller and Dor	Conventional trocars in a single incision or SILS™ or EZ Access™	Conventional	Mini loop Retractor™ or Forceps	Harmonic™	n/a	n/a	CO2	n/a
Wu et al[25]	Heller and Dor	Conventional trocars in a single incision	Conventional	Cyanoacrylate glue	Harmonic™	n/a	Intracorporeal	n/a	n/a
Ross et al[32]	Heller and Dor	Conventional trocars in a single incision or SILS™ or Triport Plus™	Roticulating	Retractor	Bipolar or Ultrasonic dissectors	n/a	Intracorporeal or Endostich™	CO2	n/a
Yamada et al[28]	Heller and Dor	Wrapdisk™	Conventional	Silicon drain	Monopolar	n/a	n/a	CO2	8mmHg
Yano et al[29]	Heller and Dor	Conventional trocars in a single incision	n/a	Penrose drain	Monopolar	56Fr	Intracorporeal	CO2	12mmHg
Nakajima et al[27]	Heller and Dor	SILS™	Roticulating	Endo Close™	Monopolar or Enseal™	n/a	n/a	n/a	10mmHg
Sukharamwala et al[17]	Toupet	SILS™	n/a	Pretzel Retractor	Monopolar or Ultrasonic dissectors	n/a	Endostich™ or V Lock™	n/a	n/a

n/a: Not available.

Table 4 Perioperative outcomes

Perioperative outcomes
Ref.	Operation type	Open conversion	Multiport conversion	Operation duration	LOS	Blood loss	Complications	Recurrence	Mortality	Incisional hernia
Buckley et al[30]	Nissen	0	n/a	n/a	n/a	n/a	2	0	0	2
Sukharamwala et al[17]	Nissen	n/a	n/a	130 (42.7)	2 (1.1)	n/a	n/a	n/a	n/a	n/a
Agaba et al[26]	Nissen	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a	n/a
Galvani et al[24]	Nissen	0	1	164 (83)	n/a	23 (4)	n/a	n/a	n/a	n/a
Wu et al[25]	Nissen	0	0	146 (13)	n/a	n/a	0	0	0	0
Strzalka et al[31]	Nissen	0	0	100	1	n/a	0	n/a	0	0
Yilmaz et al[22]	Nissen	0	2	93 (14.1)	2.2(0.9)	n/a	0	0	0	0
Eyuboglu et al[20]	Nissen	0	0	n/a	1	n/a	0	0	0	0
Miyazaki et al[19] *	Nissen	0	2	202.7 (61.1)	15.5 (10.6)	25 (23)	0	0	0	0
Mizuno et al[21]**	Nissen	0	0	147.5 (45.9)	10 (2)	10 (7)	0	0	0	0
Barbaros et al[18]	Nissen	0	0	120	1	n/a	0	0	0	0
Dapri et al[23]	Nissen	n/a	n/a	122	2	0	0	0	0	0
Hawasli et al[12]	Nissen	0	0	52	1	n/a	0	0	0	0
Hamzaoglu et al[11]	Nissen	0	0	190 (17.3)	2	30 (17.3)	0	0	0	0
		0 (0%)	5 (9.8%)	130.71	2.2	21.3	2 (2.8%)	0 (0%)	0 (0%)	2 (2.8%)
Fukuda et al[14]	Heller and Dor	0	7	223.5 (46.3)	9.7(2.4)	16 (17.8)	0	0	0	0
Wu et al[25]	Heller and Dor	0	0	133 (20)	n/a	n/a	0	0	0	0
Ross et al[32]	Heller and Dor	0	12	129 (39.2)	2 (2.7)	n/a	9	n/a	0	0
Yamada et al[28]	Heller and Dor	n/a	n/a	248	2	0	0	0	0	0
Yano et al[29]	Heller and Dor	n/a	n/a	236	4	0	0	0	0	0
Nakajima et al[27]	Heller and Dor	0	0	220	4	10	0	0	0	0
		0 (0%)	19 (14%)	138.3	2.6	13.07	9 (6.5%)	0 (0%)	0 (0%)	0 (0%)
Sukharamwala et al[17]	Toupet	n/a	n/a	145 (58.4)	3 (5.2)	n/a	n/a	n/a	n/a	n/a
Total		0 (0%)	24 (12.9%)	136.3	2.49	17.04	11 (5.2%)	0 (0%)	0 (0%)	2 (0.9%)

n/a: Not available.