Advances are being made on the technical front with regards to keyhole surgery. Single incision keyhole surgery started a few years ago and was based on the principle of using one large incision through the belly button to accommodate a three channelled port. The three channels are used to introduce a camera and two instruments to perform the operation. As a result of lack of triangulation, the technical aspect of the operation changes slightly which may prolong the procedure in comparison its equivalent standard keyhole operation. However, the functional recovery and cosmetic appearances of a single scar are such that the benefits of a single incision far outweigh the extra time needed to perform the procedure.
Single incision keyhole appendicectomy and cholecystomy are now quite common. Weight loss band surgery has recently been performed through single incision and this study indicates very good outcomes from single incision sleeve gastrectomy.