Single-incision Laparoscopic Sleeve Gastrectomy Research Articles

Needlescopic Laparoscope Sleeve Gastrectomy (NLSG): a Potential Surgical Approach.

Laparoscopic sleeve gastrectomy has become the most popular weight loss surgery currently, but it inevitably leaves multiple small scars in the abdomen. Although the appearance of single-incision laparoscopic sleeve gastrectomy achieve better cosmetic results, it may lead to postoperative complications such as umbilical hernia and umbilical infection. The author has developed a new surgical approach that can compensate for these deficiencies, which we called needlescopic laparoscope sleeve gastrectomy (NLSG). Four consecutive patients underwent needlescopic laparoscope sleeve gastrectomy between July 2024 and August 2024. A 3-mm trocar located at the lower left abdomen is for the 2.7-mm needlescopic laparoscope to observe. Another 3-mm trocar located at the right upper abdomen is for the 2.7-mm needlescopic intestinal clamp to assist in surgery. The 12-mm trocar at the navel serves as the main operating hole, through which the ultrasonic knife and endoscopic linear cutter stapler enters. All 3-mm incisions are not sutured, and the 12-mm incision at the navel is sutured intradermally to achieve complete invisibility of the wound. All patients used the same surgical instruments, technique, and perioperative protocol. The procedure was successfully performed in all patients. The average surgical time is 57 ± 9.1min. There were no mortalities or postoperative complications noted during the 3-month follow-up period. Needlescopic laparoscope sleeve gastrectomy is safe, feasible, and great potential.

Trocar number and placement for laparoscopic sleeve gastrectomy and comparison of single-incision and conventional laparoscopic sleeve gastrectomy: a systematic review and meta-analysis.

Conventional laparoscopic sleeve gastrectomy (CLSG) has been conducted in multiple centers for treating morbid obesity, however, there are no standard criteria for (1) placing the trocar; and (2) how many trocars should be used. Single-incision laparoscopic sleeve gastrectomy (SLSG), a newly emerged technique in 2008, has been proposed as an alternative to CLSG in recent years, however, there is no definite evidence for this. A systematic literature search was performed using the PubMed, Embase, Web of Science, and Cochrane Library databases for laparoscopic sleeve gastrectomy cases from January 2006 to October 2022. We then summarized the trocar numbers and placement patterns among these studies. A meta-analysis was conducted to compare the difference between SLSG and CLSG in the perioperative and postoperative indices. A total of 61 studies involving 20180 patients who underwent laparoscopic sleeve gastrectomy for treating morbid obesity were included in the systematic review, including 11 on SLSG, 35 on CLSG, and 15 studies comparing SLSG and CLSG. A systematic review showed that the trocar number varied in different CLSG studies, mainly using four or five trocars. The trocars were mainly placed in position, presenting an inverted trapezoid pattern and a left-predominant pattern. Meta-analysis showed that the operative time in the SLSG was significantly higher than that in the CLSG, and the pain Visual Analog Scale rating on postoperative day 1 in the CLSG was significantly higher than in the SLSG. There were no statistical significances in the other complications or surgical efficiency. In the CLSG, the majority of the trocars were arranged in an inverted trapezoid pattern and were of the left-predominant type. Although SLSG is a feasible technique in selected patients, there is insufficient evidence to recommend its widespread use compared with CLSG. High-quality randomized controlled trials with large study populations and long follow-up periods will be required in the future.

Left Hypochondrium or Transumbilical Single-Incision Laparoscopic Sleeve Gastrectomy for the Treatment of Severe Obesity: Surgical Technique and Results of a Tertiary Referral Bariatric Center.

Technical aspects of single-incision laparoscopic sleeve gastrectomy (SILSG) vary depending on surgeon's experience and availability of surgical equipment. We have performed more than 3000 SILSGs using standardized technique with left hypochondrium or transumbilical access. The aim of this study is to describe the SILSG technique in a stepwise manner providing technical tips and pitfalls for a left hypochondrium or transumbilical approach and report results of SILSG experience in a tertiary referral bariatric center. A detailed description of left hypochondrium and transumbilical SILSG is provided. Data from all consecutive patients who underwent SILSG between August 2010 and August 2017 were prospectively collected and retrospectively analyzed and reported. One thousand eight hundred patients underwent SILSG, from which 384 (21.3%) using a transumbilical approach. Mean age was 42.3 years, median BMI 45.3 kg/m2, and median operative time 88 min. An additional port was required in 89 patients (4.9%). Postoperative mortality and morbidity rates were 0.05% and 7.5%, respectively. Relaparoscopy and/or endoscopic treatment were required for intra-abdominal bleeding in 27 patients (1.5%) and staple-line leakage in 35 patients (1.9%). Mean excess weight losses were 71.1%, 73.7%, and 70.4% at 1, 2, and 4 years after SILSG, respectively. Two years after SILSG, sustained statistical significant remission of major obesity-related comorbidities was noted. Incisional hernia occurred in 39 patients (2.1%). The use of specific instruments allows standardization of left hypochondrium SILSG, which can be routinely performed for the treatment of severe obesity. Transumbilical approach for SILSG should be reserved for well-selected patients and experienced bariatric surgeons.

Comparison of Single-Incision and Conventional Laparoscopic Sleeve Gastrectomy for Morbid Obesity: a Meta-Analysis.

Single-incision laparoscopic sleeve gastrectomy (SILSG) has been proposed as an alternative to conventional laparoscopic sleeve gastrectomy (CLSG) in obese patients. This study aims to compare the surgical outcomes of these two techniques. A meta-analysis of existing literature obtained through a systematic literature search in the PubMed, EMBASE, and Cochrane Library CENTRAL databases from 2009 to 2019 was conducted. Eleven articles including 1168 patients were analyzed. Patients in the SILSG group reported greater satisfaction with cosmetic scar outcomes than those in the CLSG group (SMD = 2.47, 95% CI = 1.10 to 3.83, P = 0.00). There was no significant difference between the SILSG group and the CLSG group regarding operative time, intraoperative estimated blood loss, conversion rate, intraoperative complications, length of hospital stay, postoperative analgesia, postoperative complications, excess weight loss (EWL), and improvements in comorbidities (P > 0.05). Compared to CLSG, SILSG resulted in improved cosmetic satisfaction and showed no disadvantages in terms of surgical outcomes; thus, SILSG can serve as an alternative to CLSG for obese patients. Nonetheless, high-quality randomized controlled trials (RCTs) with large study populations and long follow-up periods are needed.

Three-Port Laparoscopic Sleeve Gastrectomy: Serial Cases Report

Background: Laparoscopic sleeve gastrectomy is the procedure of choice for bariatric surgery. It is a minimally invasive procedure that giving good outcome and less complication compared to other procedures. The multiport sleeve gastrectomy technique is usually described by using 4 to 6 ports and an additional port for a liver retractor. Single-incision laparoscopic sleeve gastrectomy was reported, but not widely adopted. Â Objective: To describe a convenient and applicable modified technique of three ports laparoscopy for sleeve gastrectomy that may give better outcome and cosmetic.Cases: Four patients were diagnosed with obese class II and III. Upper GI study was performed before surgery. We performed three ports laparoscopic sleeve gastrectomy. The 15 mm port was placed in the umbilical, for the camera. The second 12 mm port was placed in the right side of the umbilical for the stapler, and the third port, 5 mm was placed in the right hypochondrium midclavicular line. During the surgery, we used endoscope as guidance during gastric stapling and also for evaluation the stapler line and the size of the stomach. The postoperative condition was uneventful, the patients have less scar and less length of stay.Conclusion: Three ports laparoscopic sleeve gastrectomy is easy to perform, convenient and applicable, consume less time and also give excellent results for the patient's recovery.Â

Single Incision Versus Conventional Laparoscopic Sleeve Gastrectomy for Morbid Obesity: A Meta-Analysis.

The purpose of this study was to review the existing evidence on obese patients treated with single-incision laparoscopic sleeve gastrectomy (SILSG) or conventional laparoscopic sleeve gastrectomy (LSG), to compare the perioperative parameters and outcomes of the two bariatric procedures. A systematic literature search was performed in PubMed, Scopus, and Cochrane library, in accordance with the PRISMA guidelines. Seventeen articles met the inclusion criteria and incorporated 3843 patients. This study reveals comparable mean operative time, length of hospital stay, and complications between the two approaches. The SILSG approach was associated with enhanced cosmetic results, but increased incisional hernia rate. These outcomes should be treated with caution given the small number of included comparative studies. Well-designed, randomized controlled studies, comparing LSG to SILSG, are necessary to assess further their clinical outcomes.

Single Port Sleeve Gastrectomy as Safe Procedure in the Treatment of Morbidly Obese Patients

Background: Laparoscopic sleeve gastrectomy had gained popularity and acceptance among bariatric surgeons, mainly as a result of its low morbidity and mortality. Single-incision laparoscopic surgery (SILS), the most recent development in minimally invasive surgery, allows operations to be carried out through, only a single incision. The aim of our study was to evaluate the efficacy and safety of a laparoscopic single-incision sleeve gastrectomy for morbid obesity in comparison with multiport laparoscopic sleeve gastrectomy. Patients and methods: This is a prospective comparative study conducted between June 2012 to November 2015, which included 35 morbidly obese patients, divided into 2 groups. Group (A) included 18 patients who underwent multiport laparoscopic sleeve gastrectomy and group (B) included 17 patients who underwent single-incision laparoscopic sleeve gastrectomy. Conclusion: Laparoscopic single-incision sleeve gastrectomy seems to be safe and effective as same as conventional multiport sleeve gastrectomy. However, additional work must be carried out before these techniques achieve the level of standardization.

Single-Incision Laparoscopic Sleeve Gastrectomy: Review and a Critical Appraisal

Single-incision laparoscopic surgery has attracted a great deal of interest in the surgical community in recent years, including bariatric surgery. Single-incision laparoscopic sleeve gastrectomy (SILSG) has been proposed as an alternative to the multiport laparoscopic procedure; however, it has yet to meet wide acceptance and application. We aim to summarize existing data on SILSG and check the procedure's feasibility, technical details, safety, and, if possible, outcomes. We checked the most important databases for studies concerning SILSG and included all these that summarized the criteria placed and contained the data needed for this review. We excluded case reports. Nineteen studies complied with the criteria of our review, containing a total of 1679 patients. Their mean age has been 38.91 years and the mean preoperative body mass index has been 41.8 kg/m2. In majority of cases (60.5%), a left upper quadrant incision has been preferred and in 97.6%, a commercially available multiport system has been picked. A wide variety of instruments have been used and mean operating time has been 94.6 minutes. One conversion to open surgery has been reported and 7.4% required the placement of additional ports. There was a complication rate of 7.38% (most common being bleeding with a rate of 2.5%) and a reoperation rate of 2.8%. Mean excess weight loss for a follow-up of 1 year was achieved in 53.7% of patients and was 70.06%. A tendency for less analgesia and better wound satisfaction has been reported. SILSG is safe and feasible. However, there is insufficient evidence to recommend it as the new gold standard for sleeve gastrectomy in the place of conventional laparoscopic sleeve gastrectomy. Randomized controlled trials are needed to analyze the results and the possible benefits of this technique.

Single Incision Laparoscopic Bariatric Surgery: Challenging the Conventional

Sleeve gastrectomy has gained popularity over the years and is commonly performed laparoscopically through multiple small incisions. The arrival of single incision laparoscopic surgery has been a game changer, allowing for sleeve gastrectomy to be performed through a cosmetically more appeasing scar with improved patient satisfaction. In this article, we describe the history, technical challenges, proposed solutions to some of the hurdles faced during single-incision laparoscopic bariatric surgery and highlight our method of performing single incision laparoscopic sleeve gastrectomy purely through a single access device.

Transumbilical single incision laparoscopic sleeve gastrectomy (with video)

Transumbilical single incision laparoscopic sleeve gastrectomy (with video)

Single-port sleeve gastrectomy, a valuable procedure in the treatment of morbidly obese patients

Background Laparoscopic sleeve gastrectomy has recently been proposed as a sole bariatric procedure because of the considerable weight loss that is achieved in morbidly obese patients. Single-incision laparoscopic sleeve gastrectomy has recently gained acceptance in bariatric surgery as the procedure has possible benefits. The aim of our study was to evaluate the feasibility and safety of a laparoscopic single-incision sleeve gastrectomy for morbid obesity. Patients and methods From January 2011 to March 2014, single-port laparoscopic sleeve gastrectomy through a special single-port silicon device that is flexible and reusable with a novel method for liver retraction was performed on 30 consecutive morbidly obese patients enrolled from Ain Shams University hospitals. The patients were 22 women (73.3%) and eight men (26.7%), mean age 31 years (range: 23-45) years. The patients recruited in this study had a mean BMI of 41.3 kg/m 2 (range: 35-45) kg/m 2 . The operative technique, operative time, postoperative hospital stay, and early and late postoperative complications were monitored, and the percentage of excess weight loss (%EWL), which was measured at 3, 6, and 12 months, respectively, was determined. Results A total of 30 single-incision laparoscopic sleeve gastrectomies were performed. The procedure was performed successfully in 27 patients (90%), with three conversions (10%) to traditional laparoscopic sleeve gastrectomy. The mean operative time was 92 min (range: 80-135) min, whereas the mean hospital stay was 2.4 days (range: 2-4) days. In terms of morbidities, there were six cases of vomiting (20%), one case of wound infection (3.3%), and two cases of incisional hernia (6.6%). The %EWL was 26, 38.3, and 61.43 at 3, 6, and 12 months, respectively. There were no mortalities in our study. Conclusion Laparoscopic single-incision sleeve gastrectomy seems to be safe, technically feasible, and reproducible. Our technique for liver retraction provides adequate exposure. However, additional work must be carried out before these techniques achieve the level of standardization. More flexible articulating instruments, high-illumination, high-magnification, flexible endoscopes, and free-standing insertable retractors need to be developed.

Transumbilical single-incision laparoscopic sleeve gastrectomy.

Sleeve gastrectomy has become an established primary bariatric surgical technique. Its relatively lower complexity has made it eligible to be performed by single-incision laparoscopy (single-incision laparoscopic sleeve gastrectomy, SILSG). The aim of this paper is to present our SILSG technique and surgical outcomes and demonstrate that SILSG is a safe and feasible procedure using conventional laparoscopic instruments. All patients who underwent SILSG since December 2012 in our institution were analyzed. The operative technique involved creation of a transumbilical incision and the introduction of a GelPoint device with four trocars. Rigid instruments were used in all patients. Gastric transection was performed 4 cm proximal to the pylorus and calibrated with a 36-Fr bougie. Hemostasis of the staple line was achieved with metallic clips. A total of 74 patients underwent SILSG. Their mean age and body mass index were 34.2 ± 9.2 years and 34.0 ± 3.2 kg/m(2) (range 30.0-42.7 kg/m(2)), respectively. The mean operative time was 48 ± 10 min. No reoperations or deaths occurred. One patient developed portal vein thrombosis. The mean length of hospital stay was 2.4 ± 2.0 days. The cosmetic result was satisfactory in all patients. SILSG is a safe and feasible procedure when performed with the technique described herein. This technique allows for the use of conventional laparoscopic instruments and reasonable operative times. The main benefit of the procedure is an excellent cosmetic result with virtually no visible scars.

Single-incision laparoscopic sleeve gastrectomy: initial experience in 20 patients and 2-year follow-up

SummaryBackgroundThe transumbilical route began being clinically feasible with or without unique access devices.SettingThe setting for this study was a private practice at Clínica Las Condes, Santiago, Chile.ObjectiveThe objective was to describe our experience performing a laparoscopic sleeve gastrectomy (LSG) via transumbilical route using a single-port access device in addition to standard laparoscopic instruments.MethodA prospective nonrandomized protocol was applied to patients fulfilling the following inclusion criteria: to have been medically indicated for an LSG, to have a body mass index (BMI) of less than or equal to 40 kg/m2, and the distance between the xiphoid appendix and umbilicus should be less than 22 cm. All patients were female with a median (p50) age of 34.5 (ranging from 21 to 57) years, a median weight of 92 (ranging from 82.5 to 113) kg, and a median BMI of 35.1 (ranging from 30.5 to 40) kg/m2. The device insertion technique, the gastrectomy, and postoperative management are described.ResultsLSG via transumbilical route was successfully carried out in 19 of the 20 patients in whom the procedure was performed; one patient had to be converted to a conventional laparoscopic procedure. Mean operating time was 127 (ranging from 90 to 170) min. On the second postoperative day, all patients were assessed through an upper gastrointestinal barium-contrasted radiological series. There was neither morbidity nor mortality in this group. Excess weight loss at 25 months after surgery was 114 %.ConclusionsSingle-port LSG can be successfully performed in selected obese patients with a BMI of less than 40 kg/m2 using traditional laparoscopic instruments. The technique allows performing a safe and effective vertical gastrectomy.

Single-Incision Laparoscopic Sleeve Gastrectomy Versus Multiport Laparoscopic Sleeve Gastrectomy: Analysis of 80 Cases in a Single Center

Through efficacy and improved safety, multiport laparoscopic sleeve gastrectomy (LAPS-G) has emerged as an important and broadly available treatment option for people with severe and complex obesity. Because a single-incision laparoscopic sleeve gastrectomy (SILS-G) would be less invasive, we applied this novel surgical technique for a selected number of patients enrolled into our minimally invasive bariatric program. A retrospective review of prospectively collected data from 80 morbidly obese patients who qualified for SILS-G or LAPS-G was performed from January 2011 to May 2012. SILS-G and LAPS-G were performed in 40 patients, respectively. All patients were female. Mean age was 41 (range, 19-73) years (SILS-G, 37 [19-62] years; LAPS-G, 43 [24-73] years; P=not significant). Preoperative body mass index was 40.8 (35.1-45.0) kg/m(2) in the SILS-G group and 43.8 (35.0-47.8) kg/m(2) in the LAPS-G group (P=not significant). Total operative time was significantly lower in the SILS-G group (85±21 minutes) compared with the LAPS-G group (97±26 minutes) (P<.05). Median percentage excess weight loss was comparable in both groups (SILS-G, 57.2%; LAPS-G, 53.7%) at 6.6 months after surgery. Mean hospital stay was 5 days (SILS-G, 5 [4-24] days; LAPS-G, 6 [4-14] days; P=not significant). Complication rates were low in both groups: leakage, 2.5% in SILS-G and 0% in LAPS-G; bleeding, 2.5% in SILS-G and 2.5% in LAPS-G; and trocar-site hernia, 0% in both groups. Patients operated on with single-incision laparoscopy had a significantly better cosmetic outcome as assessed by a scar satisfaction assessment questionnaire (P<.01). SILS-G is a feasible and safe operative procedure that leads to a significant reduction of total operative time compared with a multiport access procedure. Further potential benefits associated with single-incision laparoscopic surgery remain to be investigated objectively.

Single-Incision Sleeve Gastrectomy for Successful Treatment of a Gastrointestinal Stromal Tumor

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that are located specifically in the gastrointestinal tract, with up to 60% of occurrences in the stomach, 30% in the small intestine, and 10% in the esophagus, colon, and rectum. The annual incidence of GISTs is about 15 cases per million, which in the United States equals 5000 cases per year. In most cases, these tumors are asymptomatic and are found incidentally on computed tomography scan or by endoscopy. Preoperative evaluation is based on location, size, and anatomic features and helps to confirm the diagnosis of the GIST and assess outcomes. Surgical intervention is the gold standard for treatment of nonmetastatic GISTs. We report the case of an 80-year-old man with a gastric mass on the posterior surface of the greater curvature of the stomach at the junction of the gastric antrum and the pylorus, found incidentally on a computed tomography scan. The patient underwent a diagnostic laparoscopy and a single-incision laparoscopic sleeve gastrectomy. After histologic evaluation, the resected lesion was determined to be a gastrointestinal stromal tumor. A single-incision laparoscopic sleeve gastrectomy for the resection of GISTs is a feasible and appropriate method if the lesion is a safe distance from the pylorus and the gastroesophageal junction for gross negative margins to be obtained. Its advantages include decreased pain and a shorter hospital stay compared with other methods.

Single-Incision Sleeve Gastrectomy Versus Conventional Laparoscopic Sleeve Gastrectomy—a Randomised Pilot Study

This is a prospective pilot study done to evaluate the feasibility and to assess the outcomes and complication rates of the single-incision sleeve gastrectomy versus the conventional five-port laparoscopic sleeve gastrectomy. A prospective comparative analysis was done of 50 patients in each arm who underwent laparoscopic sleeve gastrectomy and single-incision sleeve gastrectomy from September 2009 until April 2010. Both groups were matched for age, gender and BMI and were then randomly assigned to either group. Postoperative pain scoring was done using the visual analogue scale. Postoperative outcomes in terms of pain scores, excess weight loss, resolution of comorbidities and complication rates were compared in both groups, at the end of 6months. Operating times in both groups were comparable with experience. Intraoperative blood loss was similar in both groups. VAS scoring revealed lesser postoperative pain after the first 8h in the single-incision group as compared to the laparoscopy group-P < 0.0001. At 6months, excess weight loss and resolution of comorbidities were comparable in both groups. There were no major complications or mortalities in either group. Single-incision laparoscopic sleeve gastrectomy is a feasible surgical procedure for morbid obesity in selected individuals. When compared to conventional laparoscopic sleeve gastrectomy, it has equally effective weight loss and resolution of comorbidities. It also has the added benefits of little or no visible scarring and reduced postoperative pain.

Single-incision laparoscopic sleeve gastrectomy for morbid obesity: video technique and review of first 10 patients

Single-incision laparoscopic sleeve gastrectomy for morbid obesity: video technique and review of first 10 patients

Single-incision laparoscopic sleeve gastrectomy versus conventional multiport laparoscopic sleeve gastrectomy: technical considerations and strategic modifications

Background Since its inception, minimal access surgery has been a dynamic field, experiencing successive leaps in technique and instrumental design. Each improvement in minimal access surgery must demonstrate that patients benefit from the change in approach, without compromising the outcome. The present study presents the technical considerations and strategic modifications for single-incision laparoscopic sleeve gastrectomy. We also compared the newly adopted single-incision laparoscopic approach with conventional multiport laparoscopic sleeve gastrectomy. Methods Of the 26 patients included in the present study, 14 underwent single-incision laparoscopic sleeve gastrectomy and 12 underwent conventional multiport sleeve gastrectomy. All procedures were performed by the same surgeon (A.A.S.) during a 12-month period from September 2008 to August 2009 at Michigan State University Kalamazoo Center for Medical Studies. Results The Mann-Whitney U tests showed with 95% confidence that the difference in pain scores and length of hospital stay in the single-incision laparoscopic sleeve gastrectomy group were statistically significant. A modest increase occurred in the operative time in the single-incision laparoscopic sleeve gastrectomy group. This difference was the least statistically significant of all variables ( P = .055). Conclusion Single-incision laparoscopic sleeve gastrectomy was associated with less postoperative pain, a lower need for analgesia, and a decreased length of hospital stay compared with conventional multiport laparoscopic sleeve gastrectomy. This was achieved without decreasing the quality of surgery or the outcomes offered by the conventional multiport counterpart.

Single-Incision Sleeve Gastrectomy Using a Novel Technique for Liver Retraction

Laparoscopic sleeve gastrectomy has rapidly gained popularity in the field of bariatric surgery, mainly due to its low morbidity and mortality. Traditionally, 4 to 6 trocars are used. Single-access surgery has emerged as an attempt to decrease incisional morbidity and enhance cosmetic benefits. We present our initial 7 patients undergoing single-incision laparoscopic sleeve gastrectomy using a novel technique for liver retraction. Patients who underwent single-incision laparoscopic sleeve gastrectomy between March 2009 and May 2009 were analyzed. A 4-cm left paramedian incision was used. Laparoscopic sleeve gastrectomy was performed in a standard fashion using a 40 French bougie. Seven patients underwent single-incision sleeve gastrectomy at the University of Illinois at Chicago. They were all female with a mean age of 34 years. Preoperative BMI was 49 kg/m² (range, 39 to 64). There were no intraoperative complications. Mean operative time was 103 minutes. Estimated blood loss was minimal. All 7 patients were discharged on postoperative day 2 and were doing well without any complications at 3.1 ± 0.7 months after surgery. Single-incision laparoscopic sleeve gastrectomy is safe and feasible and can be performed without changing the existing principles of the procedure. Our technique for internal liver retraction provides adequate exposure and is reproducible. Development of improved standard instrumentation is required for this technique to become popular.

Single-Incision Transumbilical Laparoscopic Sleeve Gastrectomy

Laparoscopic sleeve gastrectomy has been gaining popularity due to its simplicity and outstanding results. This procedure is no exception to attempts aimed at minimizing abdominal port access. In this article, the senior author (AAS) presents his technique for an entirely transumbilical single-incision approach where no extraumbilical incisions are necessary. Seven patients underwent laparoscopic sleeve gastrectomies using this single-incision, totally transumbilical technique. The same surgeon (AAS) performed all surgical interventions. The same perioperative protocol and operative techniques were implemented for all the patients. A total of 7 single-incision transumbilical laparoscopic sleeve gastrectomies were successfully performed using this technique. Two patients required lysis of adhesions, and 1 patient underwent an umbilical hernia repair during the procedure. Mean operating time was 143 minutes. One of the patients required the insertion of an additional trocar. There were no mortalities or postoperative complications noted during the mean follow-up period of 1.5 months. Single-incision laparoscopic sleeve gastrectomy performed entirely through the umbilicus is safe, technically feasible, and reproducible.