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

## TL;DR

Single-port laparoscopy improves cosmetic results and reduces early postoperative pain but takes longer and increases hernia risk compared to conventional laparoscopy.

## Contribution

A systematic review and meta-analysis comparing single-port and conventional laparoscopy outcomes, highlighting trade-offs in operative time, cosmetic satisfaction, and complication risks.

## Key findings

- Single-port laparoscopy increases operative time by about 10.5 minutes compared to conventional laparoscopy.
- Single-port laparoscopy improves cosmetic satisfaction and reduces postoperative pain within 24 hours.
- Single-port laparoscopy increases the risk of incisional hernias compared to conventional laparoscopy.

## Abstract

Background/Objectives: Single-port laparoscopy represents a significant advancement in minimally invasive surgical techniques and is designed to reduce surgical trauma and enhance cosmetic outcomes. However, ongoing debate surrounds its relative benefits and limitations as compared with conventional multi-port laparoscopy. This study systematically reviewed and analyzed comparative outcomes between these two approaches. Methods: We conducted a comprehensive systematic search of major electronic databases from January 2000 to October 2023, following PRISMA guidelines. Only randomized controlled trials comparing single-port laparoscopy with conventional laparoscopy were included. We analyzed operative outcomes, postoperative recovery parameters, complications, and patient-reported measures using random-effects models, with heterogeneity explored through subgroup analyses. Results: Forty-three randomized controlled trials involving 5807 patients were analyzed. Single-port laparoscopy demonstrated longer operative times (weighted mean difference: +10.5 min; 95% CI: 7.83–13.18; p < 0.001), superior cosmetic satisfaction (standardized mean difference: +0.61; 95% CI: 0.39–0.83; p < 0.001), and reduced postoperative pain within 24 h (standardized mean difference: −0.58; 95% CI: −0.95 to −0.21; p = 0.002). The overall complication rates showed no significant differences (risk ratio: 0.94; 95% CI: 0.78–1.14; p = 0.31), though incisional hernia risk increased with single-port laparoscopy (odds ratio: 2.26; 95% CI: 1.23–4.15; p = 0.009). Conclusions: Single-port laparoscopy offers meaningful improvements in cosmetic outcomes and early pain relief, balanced against longer operative times and increased hernia risk. The substantial heterogeneity observed underscores the importance of surgeon experience, appropriate patient selection, and optimal technique selection in determining outcomes.