Single incision laparoscopic surgeries have emerged as a new viable technique. To further improve cosmesis and perhaps reduce the morbidity associated with current laparoscopic operations single incision laparoscopic surgery has been advocated for multiple procedures. This video demonstrates the techniques of performing single incision laparoscopic sleeve gastrectomy. As with many minimally invasive procedures, patient selection is crucial for the success of the surgery. This patient was a 32 year old female undergoing laparoscopic sleeve gastrectomy for BMI 39. Due to her comorbidity of HIV, she was not an ideal patient for gastric banding or gastric bypass. She had no previous abdominal surgical scars with the exception of a C-section.

A 4 cm incision was made at the umbilicus and 4 ports were placed, 3-5 mm ports and one liver retractor. There were 2 working ports, including one Real Hand instrument and a flexible laparoscope. One of the 5mm ports was later exchanged to 15 mm to accommodate the stapler (endo GIA) and the removal of the specimen.

The total operative time was 168 minutes, and there were no intraoperative complications. The patient underwent upper GI series on post-operative day #1 and discharged on post-operative day #2.

Single incision laparoscopic sleeve gastrectomy is a safe and feasible procedure with excellent cosmetic result.