Single Port Laparoscopy: A Meta-Analysis of Benefits, Limitations, and Evolution

Background/Objectives: Single port laparoscopy (SPL) represents an evolution in mi-nimally invasive surgical techniques aimed at reducing access trauma and improving cosmetic outcomes. This meta-analysis examines the benefits, limitations, and evolutio-nary trajectory of SPL across surgical specialties to provide a comprehensive understan-ding of its clinical utility. Methods: A systematic search of electronic databases (PubMed/MEDLINE, Embase, Cochrane Library, Web of Science) was conducted for studies published between January 2000 and October 2023 comparing SPL with conventional laparoscopy. The PRISMA guidelines were followed for study selection and data extraction. Randomized controlled trials and prospective comparative studies were included. Outcomes of interest included operative metrics, postoperative recovery, complications, and patient-reported outcomes. Meta-analyses were performed using random-effects models with heterogeneity explored through subgroup analyses and meta-regression. Results: Analysis of 43 randomized controlled trials (5,807 patients) demonstrated that SPL was associated with longer operative times (WMD: +10.5 minutes; p< 0.001), superior cosmetic satisfaction (SMD: +0.61; p< 0.001), and reduced postoperative pain within 24 hours (SMD: -0.58; p=0.002). No significant differences were observed in overall com-plication rates (RR: 0.94; p=0.31), though heterogeneity was substantial across outcomes (I²: 29-83%). Subgroup analyses revealed surgeon experience, access device type, patient selection, and procedural complexity as significant moderators of between-study varia-tions. Conclusions: SPL can be performed safely across various surgical disciplines when conducted by appropriately trained surgeons, with its primary advantage being cosmetic outcomes. While significant technical challenges remain, including instrument crowding, compromised triangulation, and increased costs, ongoing technological innovations continue to address these limitations. The selective application of SPL to appropriate procedures and patient populations represents the most balanced approach to maximizing benefits while mitigating limitations.