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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research results

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%.

Research conclusions

The results of this systematic review confirm the safety and efficacy of the single port laparoscopic fundoplication, although the technique is not yet standardized.

Research perspectives

Due to the lack of high-quality studies, further well designed studies are necessary to determine the role of SI fundoplication.